Biologic Joint Repair Strategies: The Mizzou BioJoint Story

Kuroki, Keiichi; Stoker, Aaron M.; Stannard, James P.; Bozynski, Chantelle C.; Cook, James L.; Pfeiffer, Ferris M.

doi:10.1177/0192623317735786

Cited by 13 publications

(19 citation statements)

References 59 publications

(95 reference statements)

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“…OCA transplantation is a cartilage restoration technique that overcomes the limitations of OAT but has been impeded by acceptable donor tissue availability, inconsistent allograft bone incorporation for larger grafts, and unreliable outcomes after multisurface or bipolar OCA transplantation in the knee. 3,[115][116][117][118] Key factors that influence these impediments include OCA chondrocyte viability at time of transplantation, surgical im-plantation techniques, patient immune responses, and patient compliance with prescribed postoperative rehabilitation protocols. 3,[116][117][118][119][120][121][122][123][124][125][126][127] Donor chondrocyte viability is critical to OCA transplantation success and has recently been addressed with a novel tissue preservation system.…”

Section: Osteochondral Autograft Transfermentioning

confidence: 99%

“…3,[115][116][117][118] Key factors that influence these impediments include OCA chondrocyte viability at time of transplantation, surgical im-plantation techniques, patient immune responses, and patient compliance with prescribed postoperative rehabilitation protocols. 3,[116][117][118][119][120][121][122][123][124][125][126][127] Donor chondrocyte viability is critical to OCA transplantation success and has recently been addressed with a novel tissue preservation system. 3,[116][117][118][119]123,128 OCA bone integration rates have been improved by preimplantation graft preparation techniques, use of autogenous bone marrow aspirate concentrate, improved implantation and fixation methods, and in-depth patient education and monitoring for postoperative rehabilitation protocols.…”

Section: Osteochondral Autograft Transfermentioning

confidence: 99%

“…3,[116][117][118][119][120][121][122][123][124][125][126][127] Donor chondrocyte viability is critical to OCA transplantation success and has recently been addressed with a novel tissue preservation system. 3,[116][117][118][119]123,128 OCA bone integration rates have been improved by preimplantation graft preparation techniques, use of autogenous bone marrow aspirate concentrate, improved implantation and fixation methods, and in-depth patient education and monitoring for postoperative rehabilitation protocols. 117,118,[129][130][131][132][133] While OCAs are not associated with immunorejection, subrejection immune responses likely influence cellular repopulation and revascularization of OCA bone, degradation of donor cartilage and bone, and whole-joint inflammatory and fibrosis responses that influence treatment success.…”

Section: Osteochondral Autograft Transfermentioning

confidence: 99%

“…As such, treatment strategies need to use a holistic approach to optimize efficacy. 3 The objective of this review article is to discuss the basic science rationale and principles that influence pathology, symptoms, treatment algorithms, and outcomes associated with articular cartilage defects in the knee.…”

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confidence: 99%

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Clinical Application of the Basic Science of Articular Cartilage Pathology and Treatment

et al. 2020

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The joint is an organ with each tissue playing critical roles in health and disease. Intact articular cartilage is an exquisite tissue that withstands incredible biologic and biomechanical demands in allowing movement and function, which is why hyaline cartilage must be maintained within a very narrow range of biochemical composition and morphologic architecture to meet demands while maintaining health and integrity. Unfortunately, insult, injury, and/or aging can initiate a cascade of events that result in erosion, degradation, and loss of articular cartilage such that joint pain and dysfunction ensue. Importantly, articular cartilage pathology affects the health of the entire joint and therefore should not be considered or addressed in isolation. Treating articular cartilage lesions is challenging because left alone, the tissue is incapable of regeneration or highly functional and durable repair. Nonoperative treatments can alleviate symptoms associated with cartilage pathology but are not curative or lasting. Current surgical treatments range from stimulation of intrinsic repair to whole-surface and whole-joint restoration. Unfortunately, there is a relative paucity of prospective, randomized controlled, or well-designed cohort-based clinical trials with respect to cartilage repair and restoration surgeries, such that there is a gap in knowledge that must be addressed to determine optimal treatment strategies for this ubiquitous problem in orthopedic health care. This review article discusses the basic science rationale and principles that influence pathology, symptoms, treatment algorithms, and outcomes associated with articular cartilage defects in the knee.

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Section: Osteochondral Autograft Transfermentioning

confidence: 99%

Section: Osteochondral Autograft Transfermentioning

confidence: 99%

Section: Osteochondral Autograft Transfermentioning

confidence: 99%

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confidence: 99%

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Clinical Application of the Basic Science of Articular Cartilage Pathology and Treatment

et al. 2020

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“…1 Cartilage has limited potential for intrinsic repair, 2,3 and most symptomatic cartilage injuries will eventually result in end-stage osteoarthritis. 4 As such, surgical intervention to address these lesions often offers the greatest potential for therapeutic benefit, reduction of pain, and return to sport. One treatment method that has demonstrated safety and efficacy for surgical treatment of large symptomatic chondral and osteochondral defects in the knee, hip, ankle, and shoulder is osteochondral allograft (OCA) transplantation.…”

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confidence: 99%

Comparison of Techniques for Preimplantation Treatment of Osteochondral Allograft Bone

Baumann

Bozynski

et al. 2018

J Knee Surg

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Articular defects are a major problem with few effective treatment options. Osteochondral allograft (OCA) transplantation can be an effective treatment; however, lack of OCA bone integration can cause failure. This controlled laboratory study was designed to compare clinically applicable methods for marrow element removal and enhanced delivery of bone marrow aspirate concentrate (BMC) to OCA bone. We hypothesized that compressed carbon dioxide (CO) treatment of OCA bone would result in significantly better marrow element removal, significantly more retention and distribution of viable osteoprogenitor cells, and significantly higher osteoinductive protein elution from OCAs compared with other preimplantation treatments. Fresh humeral heads ( = 24) were harvested and stored for 14 days, then randomly assigned to treatment based on marrow element removal and bone treatment: (standard of care [SOC]) ( = 4) - SOC high-pulse saline lavage, no BMC; (BMC) ( = 5) - saline lavage then canine BMC; (Drill + BMC) ( = 5) - 1.1 mm drill-hole immediately subchondral then saline lavage then BMC injection through drill hole; (Carb + BMC) ( = 5) - saline lavage then CO then BMC; or (Saline-Carb + BMC) ( = 5) - saline lavage and CO together then BMC. Treated OCAs were cultured for 14 days. On day 3, media were collected, centrifuged to isolate cells, and replaced. Cells were cultured for 11 days for colony forming unit (CFU) determination. OCA media were collected on days 7 and 14 of culture for analysis. On day 14, each graft was assessed for viable cell retention and distribution, and bone marrow element removal. BMC had significantly higher ( = 0.001) viable cell distribution compared with the SOC, Drill + BMC, Carb + BMC, and Saline-Carb + BMC groups. BMC and Drill + BMC had significantly higher ( < 0.05) CFUs than SOC, Carb + BMC, and Saline-Carb + BMC. Drill + BMC and Carb + BMC had the highest media concentrations of the osteoinductive biomarkers. The Carb + BMC and Saline-Carb + BMC groups were associated with significantly superior marrow element removal ( < 0.02) compared with the SOC, Drill + BMC, and BMC groups. Saline irrigation plus saturation with autogenous BMC appears to be the most advantageous preimplantation treatment for OCA transplantation.

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Comparison of meniscal allograft transplantation techniques using a preclinical canine model

Schreiner

Stannard

Bozynski

et al. 2020

Journal Orthopaedic Research

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Meniscal allograft transplantation (MAT) can be a safe, effective treatment for meniscal deficiency resulting in knee dysfunction, leading to osteoarthritis (OA) without proper treatment with 5-year functional success rates (75%-90%). While different grafts and techniques have generally proven safe and effective, complications include shrinkage, extrusion, progression of joint pathology, and failure. The objective of this study was to assess the functional outcomes after MAT using three different clinically-relevant methods in a preclinical canine model. The study was designed to test the hypothesis that fresh meniscal-osteochondral allograft transplantation would be associated with significantly better function and joint health compared with fresh-viable or fresh-frozen meniscus-only allograft transplantations. Three months after meniscal release to induce meniscus-deficient medial compartment disease, research hounds (n = 12) underwent MAT using meniscus allografts harvested from matched dogs. Three MAT conditions (n = 4 each) were compared: frozen meniscus-fresh-frozen meniscal allograft with meniscocapsular suture repair; fresh meniscus-fresh viable meniscal allograft (Missouri Osteochondral Preservation System (MOPS)-preservation for 30 days) with menisco-tibial ligament repair; fresh menisco-tibial-fresh, viable meniscal-tibialosteochondral allografts (MOPS-preservation for 30 days) with menisco-tibial ligament preservation and autogenous bone marrow aspirate concentrate on OCA bone. Assessment was performed up to 6 months after MAT. Pain, comfortable range of motion, imaging, and arthroscopic scores as well histological and cell viability findings were superior (P < .05) for the fresh menisco-tibial group compared with the two other groups. Novel meniscal preservation and implantation techniques with fresh, MOPS-preserved, viable meniscal-osteochondral allografts with meniscotibial ligament preservation appears to be safe and effective for restoring knee function and joint health in this preclinical model. This has the potential to significantly improve outcomes after MAT.

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Biologic Joint Repair Strategies: The Mizzou BioJoint Story

Cited by 13 publications

References 59 publications

Clinical Application of the Basic Science of Articular Cartilage Pathology and Treatment

Clinical Application of the Basic Science of Articular Cartilage Pathology and Treatment

Comparison of Techniques for Preimplantation Treatment of Osteochondral Allograft Bone

Comparison of meniscal allograft transplantation techniques using a preclinical canine model

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