Influences of mechanical load in minimally invasive cartilage repair

Damaged articular cartilage exhibits a poor healing response and may predispose the injured joint to degenerative joint disease, which is a leading cause of pain and disability in the adult population of developed countries. Current treatment options for degenerative joint disease are limited. Total joint arthroplasty, which involves surgical implantation of synthetic bearing materials, can often relieve pain and improve basic mobility and is the standard treatment for late stage disease. Limitations to total joint arthroplasty include limited lifespan due to wear and/or implant loosening and a lower rate of success for revision surgeries. Ongoing improvements in material science and implant design contribute to improving success rates and implant survivability; however, alternate treatment strategies that aim to prevent or prolong degenerative changes are needed for younger and more active patients.;Improvements to the surgical procedure of mosaic arthroplasty were suggested based on the establishment of a relationship between impact load characteristics and cartilage cell viability. In place of using autograft tissue, the promise of creating functional 'tissue engineered' cartilage in vitro requires a fundamental understanding of cartilage mechanobiology. Evaluation of cartilage cell gene expression patterns in response to specific modes of mechanical loading revealed predominant inter-individual variability. Examination of the interaction between inter-individual chondrogenic capacity and dynamic hydrostatic pressure application suggests that these inherent inter-individual differences may dictate the efficacy of such mechanical preconditioning regimes. When joint degeneration is relatively advanced in younger individuals, an interim implant intended to augment the damaged tissue may be indicated. Development of custom cytotoxicity and frictional loading prescreening tests allowed comparison of candidate materials for potential new implant designs intended to articulate with the articular surface.;Of the current treatment strategies available, no single method of treatment is proven to exhibit consistent long-term success; rather, each approach has strengths and liabilities that should be considered in the selection of an appropriate treatment strategy. The goal of this thesis was to examine the influence of mechanical load in a select group of minimally invasive cartilage repair strategies in hopes of making a contribution toward improved patient outcomes and the further development of promising new treatment options.