The Osteochondral Autograft Transfer System in Hand Surgery: A Comprehensive Evidence-Based Guide for the Hand Surgeon.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Conflicts of interest and sources of funding: none declared. 2. Bioact Mater. 2025 Mar 1;49:23-38. doi: 10.1016/j.bioactmat.2025.02.035. eCollection 2025 Jul. Immune-modulated adhesive hydrogel for enhancing osteochondral graft adhesion and cartilage repair. Zhou J(1)(2), Ji X(1)(2), Xue Y(3), Yang W(1)(2), Zhong G(1)(2), Zhou Z(1)(2), Chen X(3), Lei Z(1)(2), Lu T(4), Zhang Y(1)(2), Liu J(3), Ma L(1)(2)(5). Author information: (1)Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, China. (2)Guang Dong Engineering Technology Research Center of Functional, Repair of Bone Defects and Biomaterials, Guangzhou, 510080, China. (3)Department of Mechanical and Energy Engineering, Southern University of Science and Technology, Shenzhen, 518055, China. (4)National Engineering Research Center for Healthcare Devices, Guangdong Key Lab of Medical Electronic Instruments and Polymer Material Products, Institute of Biological and Medical Engineering, Guangdong Academy of Sciences, Guangzhou, Guangdong, 510316, China. (5)Department of Orthopedics, Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, NO. 49, Dadong Road, Ganzhou, Jiangxi Province, 341000, China. Osteochondral autograft transfer system (OATS) can effectively improve cartilage injuries by obtaining bone-cartilage grafts from healthy sites and implanting them into the defective areas. However, in up to 40 % of patients, the lack of a stable adhesive interface between the osteochondral graft and the normal tissue surface reduces the repair efficiency. In this work, we report an injectable and biocompatible poly (N-hydroxyethyl acrylamide-N-hydroxy succinimide)/Gelatin (PHE-Gel) hydrogel, featuring the instant formation of a tough bio-interface, which allows for robust adhesion with osteochondral grafts. Through physicochemical characterization, we found that a system composed of 10%PHE-Gel possesses superior interfacial toughness and excellent biocompatibility. In vitro, mechanistic studies and RNA-seq analysis had shown that 10%PHE-Gel promotes the expression of cartilage anabolic metabolism genes by upregulating the hypoxia-inducible factor alpha (HIF-α) signaling pathway and downregulating the tumor necrosis factor (TNF) signaling pathway. Dimethyloxalylglycine (DMOG) loaded liposome (DMOG-Lip) promotes the transition of M1 macrophages to M2 macrophages, shifting the microenvironment towards a pro-repair direction. Studies on a rabbit OATS model indicated that DMOG-Lip loaded 10%PHE-Gel (10%PHE-Gel@DMOG-Lip) effectively modulated the immune microenvironment, facilitated the repair of the hyaline cartilage, and inhibited further degeneration of cartilage. This composite hydrogel offers a promising solution for enhancing OATS repair in tissue engineering and has the potential to improve outcomes in cartilage restoration procedures. © 2025 The Authors. DOI: 10.1016/j.bioactmat.2025.02.035 PMCID: PMC11919398