Arthroscopic second generation autologous chondrocytes implantation associated with bone grafting for the treatment of knee osteochondritis dissecans: Results at 6years

Filardo, Giuseppe; Kon, Elizaveta; Berruto, Massimo; Martino, Alessandro Di; Patella, Silvio; Muccioli, Giulio Maria Marcheggiani; Zaffagnini, Stefano; Marcacci, Maurilio

doi:10.1016/j.knee.2011.08.007

Cited by 72 publications

(53 citation statements)

References 37 publications

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“…Therefore, different scaffolds with different collagen, polyglycolic/polylactic acid, hyaluronic acid, and fibrin gel compositions have been engineered to achieve a more uniform and reproducible repair of the lesion. [87][88][89][90][91] Follow-up of these patient cohorts has shown successful regeneration and integration of the graft and healthy cartilage appearance. [92][93][94][95][96] Although the general outcome of the repair was positive, the newly formed cartilage did not entirely resemble the native articular cartilage.…”

Section: Why Animal Models Are Useful To Understand Oamentioning

confidence: 99%

“…Some issues presented themselves with this technique: of particular importance were the problems of dedifferentiation of chondrocytes into fibroblast‐like cells after monolayer culture and difficulties in the positioning of the grafted cells. Therefore, different scaffolds with different collagen, polyglycolic/polylactic acid, hyaluronic acid, and fibrin gel compositions have been engineered to achieve a more uniform and reproducible repair of the lesion . Follow‐up of these patient cohorts has shown successful regeneration and integration of the graft and healthy cartilage appearance .…”

Section: Regeneration After Insult: Injection Of Scs In the Articularmentioning

confidence: 99%

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Small animal models to understand pathogenesis of osteoarthritis and use of stem cell in cartilage regeneration

Piombo

2017

Cell Biochemistry & Function

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Osteoarthritis (OA) is one of the most common diseases, which affect the correct functionality of synovial joints and is characterized by articular cartilage degradation. Limitation in the treatment of OA is mostly due to the very limited regenerative characteristic of articular cartilage once is damaged. Small animal models are of particular importance for mechanistic analysis to understand the processes that affect cartilage degradation. Combination of joint injury techniques with the use of stem cells has been shown to be an important tool for understanding the processes of cartilage degradation and regeneration. Implementation of stem cells and small animal models are important tools to help researchers to find a solution that could ameliorate and prevent the symptoms of OA.

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Section: Why Animal Models Are Useful To Understand Oamentioning

confidence: 99%

Section: Regeneration After Insult: Injection Of Scs In the Articularmentioning

confidence: 99%

Small animal models to understand pathogenesis of osteoarthritis and use of stem cell in cartilage regeneration

Piombo

2017

Cell Biochemistry & Function

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“…More recently, stable results were reported up to 7 years of follow-up 39 and a good outcome was documented, using a modified technique with an associated bone grafting, also for the treatment of OCD at 6 years of follow-up. 40 Many other scaffolds have been recently proposed in preclinical studies; only a few have been introduced in the clinical practice, though, presenting promising results at shorter follow-up. 41,42…”

Section: Macimentioning

confidence: 99%

ACI and MACI

et al. 2012

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The ultrastructure of articular cartilage is unique: chondrocytes are sparsely distributed within the surrounding matrix, maintaining minimal cell to cell contact. The interaction between cells, collagen framework, aggrecan, and fluid constitutes the complex ultrastructure of hyaline cartilage making its replacement or reproduction difficult. 1 New, ambitious regenerative procedures are emerging as potential therapeutic options for the treatment of chondral lesions, aiming to recreate a hyaline-like tissue thus restoring a biologically and biomechanically valid articular surface with durable clinical results.Autologous chondrocyte implantation (ACI) has been introduced in 1987 in Sweden, and in 1994 Brittberg et al 2 published the first clinical report showing satisfactory results for isolated femoral condyle lesions. Since then, several studies followed documenting both the production of a hyaline-like articular surface and good results in the majority of the patients at medium-long follow-up. Treatment indications have been broadened 3-5 and this cell-based technique has gained increasing interest worldwide. 6-10 The development of bioengineering technology further improved this regenerative treatment approach: essentially, transplanting biodegradable molecules that are used as temporary scaffolds for the growth of living cells. 11 Matrix-assisted ACI (MACI) techniques have been introduced in the clinical practice one decade ago, showing good clinical results while at the same time overcoming most of the concerns related to the firstgeneration ACI. 12 The use of cell-loaded scaffolds to regenerate a cartilage-like tissue presents advantages from both the biological and surgical point of view, thus aiming to further optimize this regenerative surgical procedure. Surgical TechniqueThe surgical technique of both ACI and MACI consists of two steps. The first one is an arthroscopic procedure where a Abstract Regenerative procedures aim to recreate a hyaline-like tissue, thus restoring a biologically and biomechanically valid articular surface with durable clinical results. Autologous chondrocyte implantation (ACI) has been developed two decades ago, and both the production of a hyaline-like articular surface and a satisfactory clinical outcome have been documented at medium-long follow-up. Bioengineering technology further improved this regenerative treatment approach to include matrix-assisted ACI (MACI) techniques. These procedures have been introduced in the clinical practice one decade ago, showing similar results while at the same time overcoming most of the concerns related to the first-generation ACI. The use of scaffolds to create a cartilage-like tissue in a three-dimensional culture system allows for the optimization of the procedure from both the biological and surgical point of view. However, despite thousands of treated patients and many published studies suggesting good clinical results and durability of these procedures, the properties of healthy, normal articular cartilage are still unmatched by an...

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“…Cell‐based treatments using primary human chondrocytes and adult stem cells have delivered some success, but without evidence that they can provide a permanent or large‐scale solution. Although autologous chondrocyte implantation has been applied to treat focal cartilage defects [1, 2] the invasive procedure and dedifferentiation of cultured chondrocytes during monolayer expansion hinders its wider application [3]. Furthermore, complications such as hypertrophy, resulting in vascular invasion and calcification, have impeded progress [4, 5].…”

Section: Introductionmentioning

confidence: 99%

Cartilage Repair Using Human Embryonic Stem Cell-Derived Chondroprogenitors

Cheng

Kapacee

Jiang

et al. 2014

Stem Cells Translational Medicine

106

101

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In initial work, we developed a 14-day culture protocol under potential GMP, chemically defined conditions to generate chondroprogenitors from human embryonic stem cells (hESCs). The present study was undertaken to investigate the cartilage repair capacity of these cells. The chondrogenic protocol was optimized and validated with gene expression profiling. The protocol was also applied successfully to two lines of induced pluripotent stem cells (iPSCs). Chondrogenic cells derived from hESCs were encapsulated in fibrin gel and implanted in osteochondral defects in the patella groove of nude rats, and cartilage repair was evaluated by histomorphology and immunocytochemistry. Genes associated with chondrogenesis were upregulated during the protocol, and pluripotency-related genes were downregulated. Aggregation of chondrogenic cells was accompanied by high expression of SOX9 and strong staining with Safranin O. Culture with PluriSln1 was lethal for hESCs but was tolerated by hESC chondrogenic cells, and no OCT4-positive cells were detected in hESC chondrogenic cells. iPSCs were also shown to generate chondroprogenitors in this protocol. Repaired tissue in the defect area implanted with hESC-derived chondrogenic cells was stained for collagen II with little collagen I, but negligible collagen II was observed in the fibrin-only controls. Viable human cells were detected in the repair tissue at 12 weeks. The results show that chondrogenic cells derived from hESCs, using a chemically defined culture system, when implanted in focal defects were able to promote cartilage repair. This is a first step in evaluating these cells for clinical application for the treatment of cartilage lesions. STEM CELLS

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Arthroscopic second generation autologous chondrocytes implantation associated with bone grafting for the treatment of knee osteochondritis dissecans: Results at 6years

Cited by 72 publications

References 37 publications

Small animal models to understand pathogenesis of osteoarthritis and use of stem cell in cartilage regeneration

Small animal models to understand pathogenesis of osteoarthritis and use of stem cell in cartilage regeneration

ACI and MACI

Cartilage Repair Using Human Embryonic Stem Cell-Derived Chondroprogenitors

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