Early Efficacy of Type I Collagen-Based Matrix-Assisted Autologous Chondrocyte Transplantation for the Treatment of Articular Cartilage Lesions

Abstract

Background: Articular cartilage is a complex structure that allows for low frictional gliding and effective shock absorption. Various sports injuries and inflammatory conditions can lead to lesions in the articular cartilage, which has limited regenerative potential. Type I collagen combined with autologous chondrocytes in a three-dimensional culture were used to induce the regeneration of single-layer autologous expanded chondrocytes without chondrogenic differentiation.Purpose: To assess the clinical, radiological, and histological changes following collagen-based autologous chondrocyte transplantation (MACT) for chondral knee lesions.Methods: The study prospectively enrolled 20 patients with symptomatic knee chondral lesions (mean size lesion was 2.41 ± 0.43 cm2, range: 2.0–3.4 cm2) in the lateral femoral condyle and femoral groove who underwent type I collagen-based MACT between July 2017 and July 2019. knee injury and osteoarthritis outcome score (KOOS) was assessed before the procedure, and periodic clinical follow-up was conducted every 3 months for a maximum of 12 months following the procedure and at 1-year intervals thereafter. Magnetic resonance imaging (MRI) T2 mapping of repaired cartilage was also used for the quantitative analysis of regeneration. In one patient, second-look arthroscopy was performed to assess cartilage regeneration characteristics, and a portion of regenerated cartilage was harvested for histological evaluation 12 months after implantation.Results: At pre-operation and at three, six, 12, and 24 months after the operation, KOOS pain, symptoms, daily life activities, sports and recreation, as well as the quality of life were significantly improved between every two time points. Hematoxylin and eosin (HE) staining indicated that the newly formed cartilage was comprised of naive chondrocytes. Safranin O-fast (S-O) green staining of the regenerated tissue revealed fibroblast-like cells surrounded by glycosaminoglycans. Immunohistochemistry (IHC) analysis indicated that collagen type II was uniformly distributed at the deep zone of articular cartilage and type I collagen mainly depositing in the superficial cartilage layer. The T2 values for repaired tissue gradually decreased, eventually approaching near-average values.Conclusion: The present study demonstrated that type I collagen-based MACT is a clinically effective treatment for improving functionality and pain levels. Histological evidence confirmed hyaline cartilage induction and showed that repaired cartilage tended to emerge from the deep to the superficial layer. The quantitative MRI T2 mapping test indicated that there still was a difference between the transplanted cartilage and the surrounding hyaline cartilage. Taken together, the current method represents an efficient approach for the restoration of knee cartilage lesions.

Bioactive Phenylboronic Acid‐Functionalized Hyaluronic Acid Hydrogels Induce Chondro‐Aggregates and Promote Chondrocyte Phenotype

“…Thus, PBA moieties could enhance the formation of chondrocyte clusters by promoting the formation of cell filopodia, which promoted cell–cell contacts and favored cartilage differentiation. [ 36 ] Cells with filopodia had higher adhesion strength than those without filopodia. [ 37 ] Therefore, the chondrocytes on the AHAMA‐PBA hydrogel surfaces were able to bond tightly to the interface by forming multiple filopodia.…”

Magnetic resonance imaging and ultrasound elastography in the context of preclinical pharmacological research: significance for the 3R principles

“…In a phase I–II trial T 2 reductions upon intra-articular administration of ex vivo expanded autologous mesenchymal stromal cells indicated cartilage regeneration ( Soler et al, 2016 ). Three recent studies demonstrated T 2 reductions after implanting a biomaterial scaffold seeded with chondrocytes ( Li et al, 2021 ; Xu et al, 2021 ; Janacova et al, 2022 ). In two of the studies early efficacy suggesting cartilage repair translated into cartilage T 2 reductions within 3–6 months of implantation, accompanied by improvements in functionality and pain levels ( Li et al, 2021 ; Xu et al, 2021 ).…”

“…Three recent studies demonstrated T 2 reductions after implanting a biomaterial scaffold seeded with chondrocytes ( Li et al, 2021 ; Xu et al, 2021 ; Janacova et al, 2022 ). In two of the studies early efficacy suggesting cartilage repair translated into cartilage T 2 reductions within 3–6 months of implantation, accompanied by improvements in functionality and pain levels ( Li et al, 2021 ; Xu et al, 2021 ). Texture analysis of T 2 quantitative maps has also been introduced to study cartilage repair ( Janacova et al, 2022 ).…”

Modern methods of chondroplasty and possibilities of stimulation of regenerative processes of articular cartilage (Part 2)

“…В настоящее время часто используют мембраны на основе гиалуроновой, полигликолиевой кислот, агарозы и альгината, а также различных полимеров, которые могут быть представлены в виде волокон, сетки или гелей [5,6].…”

“…Так же как ACI, методика предполагает двухэтапное хирургическое вмешательство. Однако, в отличие от них, в MACI после культивирования АХ засевали на какой-либо скаффолд (трехмерную матрицу) и культивировали еще в течение 3 дней, а затем имплантировали в область дефекта [5,6]. Было показано, что трехмерная структура матриц способствует поддержанию дифференцированного фенотипа хондроцитов и правильному распределению их в дефекте [11,12].…”