Title: Scaffold Design and Optimization for Integrative Cartilage Repair
Description: Osteoarthritis, a degenerative joint disease that affects nearly 30 million Americans, is characterized by lesions of articular cartilage that often lead to severe pain and loss of joint function. The current economic burden of osteoarthritis is estimated to be approximately $190 billion, and with the prevalence of arthritis expected to rise due to the aging population, the associated costs are forecasted to increase. Debilitating osteoarthritis is managed clinically by the surgical implantation of a cartilage graft or cartilage cells to replace the damaged tissue; however, current repair methods often result in poor long-term outcomes due to inadequate integration of the graft with host cartilage and bone. Thus, there is a significant clinical need for approaches that enable functional connection of grafting devices to the host tissue. To address this challenge, the strategy described in this thesis is a versatile, cup-shaped fibrous scaffold system designed to promote the simultaneous integration of the cartilage graft with both the host cartilage and subchondral bone.

This thesis is guided by the hypotheses that 1) graft integration with native cartilage can be strengthened by inducing chondrocyte migration to the graft-cartilage junction through chemotactic factor release from the walls of the cup, and 2) graft integration with host bone and the formation of calcified cartilage can be facilitated by pre-incorporation of calcium phosphate nanoparticles in the base of the cup. To test these hypotheses, a microfiber-based integration cup was designed with degradable, polymer-based walls that release insulin-like growth factor-1, which is well-established for inducing chondrocyte migration, and a base consisting of polymer with calcium deficient apatite nanoparticles. In the first aim of this thesis, the dose of insulin-like growth factor-1 in the cup walls was optimized to enhance the migration of cells from surrounding cartilage into the scaffold, and this design was tested in vitro to ensure that the scaffold supports chondrocyte viability, growth, and biosynthesis of a cartilage-like matrix.

In the second aim of this thesis, the composition and dose of calcium phosphate in the base of the cup was optimized to support chondrocyte growth and the production of calcified cartilage-like tissue. Subsequently, in the third aim, the independently developed walls and base were joined into a scaffold that was tested in vitro and in vivo, using a simulated full thickness defect model, to examine its potential for clinical translation. Results from these studies demonstrate that the cup system can be implemented with autologous tissue and cell-based grafting strategies as well as with tissue engineered hydrogel grafts to promote integration with host tissue. Moreover, these investigations have yielded new insights into both chemical and structural parameters that direct chondrocyte migration and calcified cartilage formation. In summary, this thesis describes the design and optimization of a novel, multi-functional device for improving integration of cartilage grafts with host tissues.

The impact of the studies in this thesis extends beyond cartilage integration, as the interface scaffold design criteria elucidated here are readily applicable to the formation of interfaces between other grafts and host tissues.