Articular cartilage solutions for the knee: present challenges and future direction

Krych, Aaron J.; Gobbi, Alberto; Lattermann, Christian; Nakamura, Norimasa

doi:10.1136/jisakos-2015-000037

Cited by 14 publications

(19 citation statements)

References 96 publications

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“…During ACI, healthy chondrocytes are first harvested from a non-weight-bearing area of the joint and then transplanted back into cartilage lesions following in vitro isolation and culture expansion. 1 - 6 …”

Section: Introductionmentioning

confidence: 99%

“…Although the results of ACI treatment have been encouraging indicating the formation of hyaline like tissue, 1 , 5 , 6 obtaining chondrocytes in sufficiently high cell densities and maintenance of their differentiation state is technically difficult. 2 , 3 , 7 Hence, alternative cell sources are sought to replace chondrocytes.…”

Section: Introductionmentioning

confidence: 99%

“…They have also shown the ability to differentiate into various cell types, including chondrocytes, under laboratory conditions. 1 - 5 Studies concerning the application of MSCs in cartilage repair have mainly focused on the use of bone marrow derived MSCs (BM-MSCs) and it has been shown that chondrogenic differentiation of these cells is induced by growth factors, in particular the transforming growth factor β (TGF-β) family. 8 - 10 Wakitani et al 11 were the first to demonstrate the efficacy of BM-MSCs in cartilage repair.…”

Section: Introductionmentioning

confidence: 99%

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Canine articular cartilage regeneration using mesenchymal stem cells seeded on platelet rich fibrin

Kazemi

Asenjan

Dehdilani

et al. 2017

Bone & Joint Research

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ObjectivesMesenchymal stem cells have the ability to differentiate into various cell types, and thus have emerged as promising alternatives to chondrocytes in cell-based cartilage repair methods. The aim of this experimental study was to investigate the effect of bone marrow derived mesenchymal stem cells combined with platelet rich fibrin on osteochondral defect repair and articular cartilage regeneration in a canine model.MethodsOsteochondral defects were created on the medial femoral condyles of 12 adult male mixed breed dogs. They were either treated with stem cells seeded on platelet rich fibrin or left empty. Macroscopic and histological evaluation of the repair tissue was conducted after four, 16 and 24 weeks using the International Cartilage Repair Society macroscopic and the O’Driscoll histological grading systems. Results were reported as mean and standard deviation (sd) and compared at different time points between the two groups using the Mann-Whitney U test, with a value < 0.05 considered statistically significant.ResultsHigher cumulative macroscopic and histological scores were observed in stem cell treated defects throughout the study period with significant differences noted at four and 24 weeks (9.25, sd 0.5 vs 7.25, sd 0.95, and 10, sd 0.81 vs 7.5, sd 0.57; p < 0.05) and 16 weeks (16.5, sd 4.04 vs 11, sd 1.15; p < 0.05), respectively. Superior gross and histological characteristics were also observed in stem cell treated defects.ConclusionThe use of autologous culture expanded bone marrow derived mesenchymal stem cells on platelet rich fibrin is a novel method for articular cartilage regeneration. It is postulated that platelet rich fibrin creates a suitable environment for proliferation and differentiation of stem cells by releasing endogenous growth factors resulting in creation of a hyaline-like reparative tissue.Cite this article: D. Kazemi, K. Shams Asenjan, N. Dehdilani, H. Parsa. Canine articular cartilage regeneration using mesenchymal stem cells seeded on platelet rich fibrin: Macroscopic and histological assessments. Bone Joint Res 2017;6:98–107. DOI: 10.1302/2046-3758.62.BJR-2016-0188.R1.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Canine articular cartilage regeneration using mesenchymal stem cells seeded on platelet rich fibrin

Kazemi

Asenjan

Dehdilani

et al. 2017

Bone & Joint Research

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“…The osteochondral autograft transfer (OATS) is based on transfering autologous whole tissue (bone and cartilage), using a single or multiple osteochondral autografts, for delivering genuine hyaline articular cartilage to the defect, aiming the immediate restoration of the joint surface (Krych et al 2016). László Hangody (Hangody et al 1997; Hangody & Karpati 1993) in 1992, created the mosaicplasty resurfacing concept, involving the transfer of multiple small-sized, cylindrical osteochondral grafts.…”

Section: Introductionmentioning

confidence: 99%

Knee donor-site morbidity after mosaicplasty – a systematic review

et al. 2016

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BackgroundMosaicplasty has been associated with good short- to long-term results. Nevertheless, the osteochondral harvesting is restricted to the donor-site area available and it may lead to significant donor-site morbidity.PurposeProvide an overview of donor-site morbidity associated with harvesting of osteochondral plugs from the knee joint in mosaicplasty procedure.MethodsComprehensive search using Pubmed, Cochrane Library, SPORTDiscus and CINAHL databases was carried out through 10th October of 2016. As inclusion criteria, all English-language studies that assessed the knee donor-site morbidity after mosaicplasty were accepted. The outcomes were the description and rate of knee donor-site morbidity, sample’s and cartilage defect’s characterization and mosaicplasty-related features. Correlation between mosaicplasty features and rate of morbidity was performed. The methodological and reporting quality were assessed according to Coleman’s methodology score.ResultsTwenty-one studies were included, comprising a total of 1726 patients, with 1473 and 268 knee and ankle cartilage defects were included. The defect size ranged from 0.85 cm2 to 4.9 cm2 and most commonly 3 or less plugs (averaging 2.9 to 9.4 mm) were used. Donor-site for osteochondral harvesting included margins of the femoral trochlea (condyles), intercondylar notch, patellofemoral joint and upper tibio-fibular joint. Mean donor-site morbidity was 5.9 % and 19.6 % for knee and ankle mosaicplasty procedures, respectively. Concerning knee-to-knee mosaicplasty procedures, the most common donor-site morbidity complaints were patellofemoral disturbances (22 %) and crepitation (31 %), and in knee-to-ankle procedures there was a clear tendency for pain or instability during daily living or sports activities (44 %), followed by patellofemoral disturbances, knee stiffness and persistent pain (13 % each). There was no significant correlation between rate of donor-site morbidity and size of the defect, number and size of the plugs (p > 0.05).ConclusionsOsteochondral harvesting in mosaicplasty often results in considerable donor-site morbidity. The donor-site morbidity for knee-to-ankle (16.9 %) was greater than knee-to-knee (5.9 %) mosaicplasty procedures, without any significant correlation between rate of donor-site morbidity and size of the defect, number and size of the plugs. Lack or imcomplete of donor-site morbidity reporting within the mosaicplasty studies is a concern that should be addressed in future studies.Level of evidenceLevel IV, systematic review of Level I-IV studies.

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“…This has meant treatment strategies have remained challenging and now therapies have focused on tissue engineering for effective chondral injury treatment. Several biological strategies have been investigated and each are in different phases of development and vary in levels of evidence [10]. One accepted biological regenerative strategy is autologous chondrocyte implantation and this is associated with some amount of joint morbidity due to the requirement of cartilage biopsy from a normal region of the joint [14].…”

Section: Introductionmentioning

confidence: 99%

Enhancement of chondrogenic differentiation supplemented by a novel small compound for chondrocyte-based tissue engineering

et al. 2020

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Purpose: Chondrocyte-based tissue engineering has been a promising option for the treatment of cartilage lesions. In previous literature, TD198946 has been shown to promote chondrogenic differentiation which could prove useful in cartilage regeneration therapies. Our study aimed to investigate the effects of TD198946 in generating engineered cartilage using dedifferentiated chondrocyte-seeded collagen scaffolds treated with TD198946. Methods: Articular chondrocytes were isolated from mini pig knees and expanded in 2-dimensional cell culture and subsequently used in the experiments. 3-D pellets were then cultured for two weeks. Cells were also cultured in a type I collagen scaffolds for four weeks. Specimens were cultured with TD198946, BMP-2, or both in combination. Outcomes were determined by gene expression levels of RUNX1, SOX9, ACAN, COL1A1, COL2A1 and COL10A1, the glycosaminoglycan content, and characteristics of histology and immunohistochemistry. Furthermore, the maturity of the engineered cartilage cultured for two weeks was evaluated through subcutaneous implantation in nude mice for four weeks. Results: Addition of TD198946 demonstrated the upregulation of gene expression level except for ACAN, type II collagen and glycosaminoglycan synthesis in both pellet and 3D scaffold cultures. TD198946 and BMP-2 combination cultures showed higher chondrogenic differentiation than TD198946 or BMP-2 alone. The engineered cartilage maintained its extracellular matrices for four weeks post implantation. In contrast, engineered cartilage treated with either TD198946 or BMP-2 alone was mostly absorbed. Conclusions: Our results indicate that TD198946 could improve quality of engineered cartilage by redifferentiation of dedifferentiated chondrocytes pre-implantation and promoting collagen and glycosaminoglycan synthesis.

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Articular cartilage solutions for the knee: present challenges and future direction

Cited by 14 publications

References 96 publications

Canine articular cartilage regeneration using mesenchymal stem cells seeded on platelet rich fibrin

Canine articular cartilage regeneration using mesenchymal stem cells seeded on platelet rich fibrin

Knee donor-site morbidity after mosaicplasty – a systematic review

Enhancement of chondrogenic differentiation supplemented by a novel small compound for chondrocyte-based tissue engineering

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