Summary

The analysis of the adhesive and frictional properties of commercially available fibrin sealant adhesives used in cartilage repair.

Abstract

Fibrin sealant (glue) is a widely available product that uses fibrinogen and thrombin to create clots. Although it is frequently used for adjunct hemostasis, it is also commonly used as an adhesive for articular cartilage repair surgery, including for delaminated flaps, matrix autologous chondrocyte implantation (MACI), particulated articular cartilage techniques, and tissue engineered implants. However, the adhesive strength of commercially available fibrin sealants for cartilage repair surgery is unknown. The objective of this study was to measure the ex-vivo adhesive and frictional properties of Vistaseal (Ethicon) and Tisseel (Baxter) for articular cartilage repair.

Juvenile bovine stifle explants were used to test the adhesive and tribological properties of the fibrin sealants. For uniaxial tension and lap shear testing, 5 mm-diameter osteochondral composites were used. The cartilage portion of the explant was the most superficial 2mm of the removed cartilage. The subchondral bone portion of the explant was processed to match the size of the cartilage explant and to ensure the removal of the calcified cartilage zone. The cartilage and bone explants were glued together using 10 µL each of fibrin and thrombin (n=9/group). Cartilage annuli (4 mm-inner diameter) filled with either 60 mg minced cartilage and fibrin sealant (30 µL each of fibrin and thrombin), or fibrin sealant alone also underwent tribological testing.

No significant differences were seen between Vistaseal and Tisseel in tensile modulus, tensile strength, interfacial shear modulus, interfacial shear strength, or coefficient of friction.

While no differences in adhesive or tribological properties of Vistaseal and Tisseel were observed, the adhesive stiffness and strength of both sealants were 1,000x lower than the tensile properties of native bovine cartilage (Williamson, 2003). Additionally, the coefficient of friction for both minced cartilage plus fibrin and fibrin alone were 10x greater than intact native bovine cartilage (Link, 2020). The utility of fibrin sealants to effectively secure cartilage implants into the mechanically demanding joint environment should be further examined.