Cartilage Defect Treatment Using High-Density Autologous Chondrocyte Implantation

López‐Alcorocho, Juan Manuel; Aboli, L.; Guillén-Vicente, Isabel; Rodríguez‐Iñigo, Elena; Guillén-Vicente, Marta; Fernández-Jaén, Tomás; Arauz, Santiago; Abelow, Steve; Guillén-García, Pedro

doi:10.1177/1947603517693045

Cited by 28 publications

(36 citation statements)

References 34 publications

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“…To solve these abnormalities, surgery by means of autologous chondrocyte transplantation with the techniques of ICA or ICAM are currently available. Even though the newly generated extracellular matrix after autologous chondrocyte transplantation is not the same as the native tissue generated it is still better than that the reparation of tissue (3).…”

Section: Discussionmentioning

confidence: 97%

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Melatonin stimulates extracellular matrix formation in human articular cartilage chondrocytes

Pintor

2019

Melatonin Res.

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The articular cartilage present in joints is permanently subjected to physical stress, thus producing injuries and consequently pain. Chondrocytes are responsible for repairing this damage, but often the reparation tissue is inadequate. The application of melatonin to human articular chondrocytes may be a better solution, by generating a good extracellular matrix. Human chondrocytes were assayed in the presence of melatonin, demonstrating that these cells generate more extracellular matrix indicated by the increased Alcian blue staining. This effect of melatonin was concentration- dependent and presented a pD2 value of 6.8 ± 0.1 (n=5). Melatonin also significantly promotes the production of collagen II quantified by western-blot analysis. The effect of melatonin on the collagen II production is also concentration-dependence, with a pD2 value of 6.9 ± 0.2 (n=5). In contrast, melatonin had little effect on the collagen X. The antagonistic study by its non-selective membrane receptor blocker luzindole or its MT2 specific blocker DH-97 identified that these actions of melatonin are mediated by melatonin membrane receptors, mainly by MT2. In summary, melatonin stimulates the production of extracellular matrix and collagen II in chondrocytes and these actions may have significantly clinical implications since it may benefit the autologous chondrocyte transplantations, the only way to maintain and repair the damaged cartilage.

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Section: Discussionmentioning

confidence: 97%

“…The only way to restore the damaged cartilage is by surgery, which is often combined with autologous chondrocyte transplantation. Basically, a sample of healthy cartilage is taken and cells are multiplied, these cells are then implanted in the damaged cartilage after removing the injured area (3).…”

Section: Introductionmentioning

confidence: 99%

Melatonin stimulates extracellular matrix formation in human articular cartilage chondrocytes

Pintor

2019

Melatonin Res.

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“…Cartilaginous tissue has no blood vessels or nerves, and is composed of 5% chondrocytes and 95% mesochondrium; thus, it has a poor self-repairing and regenerative capacity (12). Regenerative medicine has become a focal point, allowing regenerating of defective cartilaginous tissues using autologous chondrocytes (13)(14)(15). However, the application of chondrocytes in repair strategies has a number of limitations, including the limited availability of adult chondrocytes.…”

Section: Discussionmentioning

confidence: 99%

Isolation and characterization of stem cells from differentially degenerated human lumbar zygapophyseal articular cartilage

Xiao

Wang

et al. 2018

Mol Med Report

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The present study aimed to verify the presence of stem cells with multilineage differentiation potential in human lumbar zygapophyseal articular cartilage (LZAC) and to compare the chondrogenic potential of cells obtained from differentially degenerated articular cartilage samples. Surgically obtained human lumbar zygapophyseal joint tissues were classified into the normal, mildly degenerated and severely degenerated groups, according to their pathological characteristics. Primary chondrocytes from these groups were cultured, and stem cells were selected using a monoclonal cell culture method. Differences in stem cell morphology between the three groups were observed using inverted microscopy and phalloidin staining. In addition, stem cell chondrogenic potential was determined through induced differentiation and cellular staining. Gene and protein expression levels of the chondrogenic-specific markers aggrecan, collagen type-II and SRY-related high-mobility-group box 9 were determined using reverse transcription-quantitative polymerase chain reaction and western blotting. The clonogenic ability of stem cells in the three groups was determined using a clonogenic assay. It was revealed that stem cells with multilineage differentiation potential were isolated from all three cartilage groups; however, the cells obtained from severely degenerated articular cartilage resulted in severe fibrosis, whilst those obtained from mildly degenerated articular cartilage possessed stronger chondrogenic and clonogenic abilities. Taken together, stem cells with multilineage differentiation potential and clonal properties were identified in human LZAC, and these characteristics were more prominent in mildly degenerated as compared with severely degenerated articular cartilage.

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“…[1][2][3][4] Several studies have shown success with a variety of surgical techniques in a variety of patient populations. [5][6][7][8][9][10][11] There are limited randomized trials, however, to allow for effective comparison of the techniques that are most effective in treating isolated cartilage defects of the knee, specifically in adults. 12 Furthermore, secondary to the limitations of available high-level studies, the incidence of procedures performed has not been well described, especially with regard to indications.…”

mentioning

confidence: 99%

“…Thus, there continues to be debate regarding best practices, and practice trends continue to change as surgeons seek to improve current treatments with advancing techniques and refined indications. 10,[16][17][18][19] Despite questions regarding best practices and indications, McCormick et al 20 noted a 5% annual increase in the number of cartilage surgical procedures between 2004 and 2011.…”

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confidence: 99%

Surgical Trends in Articular Cartilage Injuries of the Knee, Analysis of the Truven Health MarketScan Commercial Claims Database from 2005-2014

Bonazza

Smuin

Joshi

et al. 2019

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose: To evaluate trends in procedures for the treatment of chondral injuries of the knee using the MarketScan database in the hope that further work can be performed to refine the indications for chondral intervention Methods: The MarketScan Research Database was searched using Current Procedure Terminology, 4th edition, codes to identify patients who underwent chondral procedures of the knee from 2005-2014. Combined procedures, including meniscal transplant or osteotomy, were also identified. Patients were characterized by gender, age group and year of initial procedure. A c 2 test was used to evaluate differences in surgical trends between individual patient groups delineated by age and gender. The Cochran-Armitage trend test was used to identify significant differences in surgical trends yearly. Results: Of 148,373,254 unique patients, 520,934 patients underwent a total of 599,119 procedures. Arthroscopy with debridement/shaving of articular cartilage decreased in proportion from 75% of all procedures in 2005 to 51% of all procedures in 2014 (P < .0001). Open osteochondral allograft saw the greatest change during the study period; a higher number of females than males underwent condral procedures (P < .0001). Patients aged 45-54 underwent the most procedures (32.9% of all procedures). A total of 483 patients underwent chondral procedures in conjunction with meniscal transplant with variable incidence during the study period. A total of 1,418 patients underwent chondral procedures in conjunction with osteotomy; cumulative incidence decreased from 4.5 procedures per 1,000,000 patients/year in 2005 to 2.6 procedures per 1,000,000 patients/year in 2014 (P < .0001). Conclusions: Knee arthroscopy with debridement/shaving of articular cartilage remains the most common procedure performed. Although open allograft and autograft transplantation saw a sustained increase in incidence, the overall incidence of cartilage procedures, as well as those performed with osteotomies, declined. Level of Evidence: Level IV, cross-sectional study.

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Cartilage Defect Treatment Using High-Density Autologous Chondrocyte Implantation

Abstract: HD-ACI is a safe and effective technique for the treatment of cartilage defects, improving clinical and subjective perception of knee functionality. These preliminary results encourage future studies comparing this technique with traditional ACI.

Cited by 28 publications

References 34 publications

Melatonin stimulates extracellular matrix formation in human articular cartilage chondrocytes

Melatonin stimulates extracellular matrix formation in human articular cartilage chondrocytes

Isolation and characterization of stem cells from differentially degenerated human lumbar zygapophyseal articular cartilage

Surgical Trends in Articular Cartilage Injuries of the Knee, Analysis of the Truven Health MarketScan Commercial Claims Database from 2005-2014

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