Combined autologous chondrocyte implantation and meniscus reconstruction for large chondral defect in the lateral compartment due to discoid lateral meniscus tear: A case report

Kato, Yuki; Yamada, Shin; Hattori, Satoshi; Takazawa, Shuzo; Ohuchi, Hiroshi

doi:10.1016/j.reth.2018.11.002

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…This method, while effective in ensuring the membrane's press fixation to the bone and cartilage, presented challenges. Its complexity and difficulty, especially in certain lesion locations, led to the exploration of simpler techniques, such as the use of JuggerKnot Ⓡ soft anchors (Zimmer Biomet, Warsaw, Indiana, United States), which reported positive outcomes [ 5 ]. Our transition to JuggerKnot Ⓡ for periosteal fixation, followed by a shift to a collagen membrane, was motivated by the need for a more consistent approach and less hypertrophic response in transplanted cartilage [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Since February 2019, the introduction of collagen membranes in Japan has been reported to yield good results, including reduced hypertrophy of the transplanted cartilage [ 4 ]. The original method for suturing the JACC® involved a pull-out technique, which, due to its complexity, led to reports of suturing using soft anchors [ 5 ]. We report a case where we aimed for further simplification and improved fixation in the treatment of traumatic knee cartilage defects using JACC®, employing the knotless suture bridge method for fixing the collagen membrane, and achieved favorable short-term outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Autologous Chondrocyte Implantation With Collagen Membrane Using a Knotless Suture Bridge Technique

Seki,

Imagama

et al. 2024

Cureus

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Autologous chondrocyte implantation (ACI) has been covered by insurance in Japan since April 2013, expanding the range of treatments for extensive knee cartilage damage. Initially, the periosteum was used for the fixation of cultured cartilage, but since February 2019, the introduction of collagen membranes has shortened surgery time and simplified the procedure. We report a case where we used the knotless suture bridge technique for a more straightforward and secure fixation with a collagen membrane. The patient was a 61-year-old male who experienced right knee pain a year earlier when stepping downstairs. Conservative treatment at a local hospital was ineffective, and he was referred to our department. At the initial examination, the right knee had an extension of -5° and a flexion of 130°. A simple X-ray of the right knee showed osteosclerosis with a translucent bone image at the medial femoral condyle. Weight-bearing full-length X-ray of the lower limb showed a femorotibial angle (FTA) of 186°, a hip-knee-ankle (HKA) angle of 12.5° varus, a percentage of mechanical axis (%MA) of 15%, and a medial proximal tibial angle (MPTA) of 78°, indicating a significant varus deformity. CT and MRI revealed a cartilage defect of 36 mm in length and 16 mm in width and a bone defect with a maximum depth of 15 mm at the medial femoral condyle. The patient underwent surgery for a traumatic cartilage defect of the medial femoral condyle. For the bone defect, autologous bone grafting was performed, and for the cartilage defect, ACI was done. The ACI involved fixation with a collagen membrane using 1.3 mm suture tape and BC PushLock anchor (Arthrex, Naples, Florida, United States) in a knotless suture bridge technique. Additionally, hybrid closed-wedge high tibial osteotomy (HCWHTO) was performed for alignment correction. At eight months post surgery, MRI proton density sagittal images confirmed the joint surface by the cartilage layer, and the Modified Outerbridge Cartilage Repair Assessment (MOCART) score was 80. At 12 months post surgery, the Japanese version of the Knee Injury and Osteoarthritis Outcome Score (J-KOOS) improved from 46.43 to 82.14 for symptoms, 58.33 to 83.33 for pain, 95.59 to 100 for activities of daily living (ADL), 45 to 75 for sports, and 68.75 to 87.50 for quality of life (QOL). X-rays showed an FTA of 173°, an HKA of 0°, and a %MA of 58%, indicating a favorable course. The knotless suture bridge technique for collagen membrane fixation during ACI is considered a convenient and time-saving method.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Autologous Chondrocyte Implantation With Collagen Membrane Using a Knotless Suture Bridge Technique

Seki,

Imagama

et al. 2024

Cureus

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“…Excellent clinical results of ACI using JACC for large chondral defects have been reported. 21 , 22 Several investigators have verified the effect of PRP on osteochondral lesions using animal models, 3 , 6 , 14 , 26 , 27 but only a few have investigated the effects of PRP on ACI. 4 While several clinical studies have investigated the effects of PRP on osteochondral lesions, PRP was administered after microfracture in most of those studies, 11 , 37 and in only 1 study, PRP was administered after ACI.…”

Section: Discussionmentioning

confidence: 99%

Effect of Platelet-Rich Plasma on Autologous Chondrocyte Implantation for Chondral Defects: Results Using an In Vivo Rabbit Model

Kato

Yanada²,

Morikawa³

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Articular cartilage repair remains challenging despite the availability of techniques, including autologous chondrocyte implantation (ACI) for repairing large cartilage defects. Platelet-rich plasma (PRP) therapy, a novel therapy focused on chondrocyte regeneration, needs to be investigated regarding its potential to improve the outcomes of ACI. Purpose: To examine the effect of PRP therapy on the outcomes of cartilage repair using the ACI procedure in a rabbit model of knee joint cartilage damage. Study Design: Controlled laboratory study. Methods: A total of 30 knees in 15 Japanese White rabbits (joint cartilage damage model) were divided into nontreatment (n = 7), PRP (n = 8), ACI (n = 7), and combined ACI and PRP (n = 8) groups. At 4 weeks and 12 weeks postoperatively, histological and visual examination of the surgical site was performed, and the regenerated cartilage and calcified bone areas were measured by imaging the specimens. Results: Pretransplantation evaluation in the cultured cartilage showed the histological properties of hyaline cartilage. At 4 weeks postoperatively, the regenerated cartilage area at the surgical site showed a larger safranin O–positive area in the ACI group (2.73 ± 4.46 mm2) than in the combined ACI and PRP group (1.71 ± 2.04 mm2). Calcified bone formation in the ACI group was relatively lower than that in the other groups. Cartilage repair failure occurred in all groups at 12 weeks postoperatively. Conclusion: The authors found no positive effects of PRP on the outcomes of ACI in a rabbit model. There was a smaller safranin O–positive region with the addition of PRP to ACI compared with ACI alone. In the subchondral bone, bone formation might have been promoted by PRP. Clinical Relevance: Administering PRP at the time of ACI may not have a positive effect and may have deleterious effects on cartilage engraftment and regeneration.

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In vitro and in vivo efficacy of naturally derived scaffolds for cartilage repair and regeneration

Thomas,

Mercuri

2023

Acta Biomaterialia

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Combined autologous chondrocyte implantation and meniscus reconstruction for large chondral defect in the lateral compartment due to discoid lateral meniscus tear: A case report

Cited by 5 publications

References 22 publications

Autologous Chondrocyte Implantation With Collagen Membrane Using a Knotless Suture Bridge Technique

Autologous Chondrocyte Implantation With Collagen Membrane Using a Knotless Suture Bridge Technique

Effect of Platelet-Rich Plasma on Autologous Chondrocyte Implantation for Chondral Defects: Results Using an In Vivo Rabbit Model

In vitro and in vivo efficacy of naturally derived scaffolds for cartilage repair and regeneration

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