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Technical Brief

Structural and Chemical Modification to Improve Adhesive and Material Properties of Fibrin-Genipin for Repair of Annulus Fibrosus Defects in Intervertebral Discs

[+] Author and Article Information
Michelle A Cruz

Leni & Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY United States
michelle.astridcruz@gmail.com

Steven McAnany

Leni & Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY United States
mcanans@gmail.com

Nikita Gupta

Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY United States
gupta.niki@gmail.com

Rose Long

Leni & Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY United States
Rose.long@icahn.mssm.edu

Phillip R Nasser

Leni & Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY United States
philip.nasser@mssm.edu

David Eglin

Biomaterials and Tissue Engineering, AO Research Institute Davos, CH-7270 Davos, Switzerland
david.eglin@aofoundation.org

Andrew Hecht

Leni & Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY United States
andrew.hecht@mountsinai.org

Svenja Illien-junger

Leni & Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY United States
svenja.illien-junger@mssm.edu

James C Iatridis

Leni & Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY United States
james.iatridis@mssm.edu

1Corresponding author.

ASME doi:10.1115/1.4036623 History: Received June 08, 2016; Revised March 09, 2017

Abstract

Annulus fibrosus (AF) defects from intervertebral disc herniation and degeneration are highly correlated with back pain. Genipin crosslinked fibrin hydrogel (FibGen) is an injectable, space-filling AF sealant that was optimized to match AF shear properties and partially restored disc biomechanics. This study enhanced mechanical behaviors of FibGen to more closely match AF compressive, tensile and shear properties by adjusting genipin crosslink density and by creating a composite formulation by adding Poly(D,L-lactide-co-glycolide) (PDLGA). This study also evaluated effects of thrombin concentration and injection technique on gelation kinetics and adhesive strength. Increasing FibGen genipin concentration from 1 to 36mg/mL significantly increased adhesive strength (~5-35kPa), shear moduli (~10-110kPa) and compressive moduli (~25-150kPa) with concentration-dependent effects, and spanning native AF properties. Adding PDLGA to FibGen altered the material microstructure on electron microscopy and nearly tripled adhesive strength, but did not increase tensile moduli which remained nearly 5x below native AF, and had a small increase in shear moduli and significantly decreased compressive moduli. Increased thrombin concentration decreased gelation rate to <5 minutes and injection methods providing a structural FibGen cap increased pushout strength by ~40%. We conclude that FibGen is highly modifiable with tunable mechanical properties that can be formulated to be compatible with human AF compressive and shear properties and gelation kinetics and injection techniques compatible with clinical discectomy procedures. However, further innovations, perhaps with more efficient fiber reinforcement will be required to enable FibGen to match AF tensile properties.

Copyright (c) 2017 by ASME
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