Long-term results of rib perichondrial grafts for repair of cartilage defects in the human knee

Bouwmeester, S. J. M.; Beckers, Jmh; Kuijer, Roel; Linden, AJ van der; Bulstra, Sjoerd K.

doi:10.1007/s002640050175

Cited by 95 publications

(91 citation statements)

References 26 publications

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“…Results of Lysholm score were similar to those of Peterson et al [20] (92.4 points, mean follow-up 5.6 years). Patient selection was close to ours with respect to mean age, mean defect size and number of previous operations.…”

Section: Discussionsupporting

confidence: 86%

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Treatment of osteochondritis dissecans of the femoral condyle with autologous bone grafts and matrix-supported autologous chondrocytes

Steinhagen

Bruns

Deuretzbacher

et al. 2009

International Orthopaedics (SICOT)

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The objective of this study was to determine the clinical outcome of combined bone grafting and matrixsupported autologous chondrocyte transplantation in patients with osteochondritis dissecans of the knee. Between January 2003 and March 2005, 21 patients (mean age 29.33 years) with symptomatic osteochondritis dissecans (OCD) of the medial or lateral condyle (grade III or IV) of the knee underwent reconstruction of the joint surface by autologous bone grafts and matrix-supported autologous chondrocyte transplantation. Patients were followed up at three, six, 12 and 36 months to determine outcomes by clinical evaluation based on Lysholm score, IKDC and ICRS score. Clinical results showed a significant improvement of Lysholm-score and IKDC score. With respect to clinical assessment, 18 of 21 patients showed good or excellent results 36 months postoperatively. Our study suggests that treatment of OCD with autologous bone grafts and matrix-supported autologous chondrocytes is a possible alternative to osteochondral cylinder transfer or conventional ACT.

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Section: Discussionsupporting

confidence: 86%

“…These patients, as well as patients with persisting symptoms after refixation, require new options for surgical treatment. Recently, OCD treatment with autologous periosteum or perichondrium [20], osteochondral autograft transfer (OATS) and transplantation of autologous chondrocytes (ACT) have been reported [7][8][9].…”

Section: Discussionmentioning

confidence: 99%

Treatment of osteochondritis dissecans of the femoral condyle with autologous bone grafts and matrix-supported autologous chondrocytes

Steinhagen

Bruns

Deuretzbacher

et al. 2009

International Orthopaedics (SICOT)

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“…This technique has been reported to give an initial cartilage repair in the defect [33,34]. On the long term poor results related to overgrowth of the graft and ossification are reported by Bouwmeester et al [26]. This report of Bouwmeester was one of the first reports illustrating the need to prevent ossification of the repaired cartilage and the need to maintain cells in their chondrogenic phase.…”

Section: Periosteal and Perichondrium Arthroplastymentioning

confidence: 98%

“…When using progenitor cells for cartilage repair, ossification of the repaired tissue may impair clinical results. Examples hereof are ossification and formation of interlesional osteophytes when applying techniques such as microfracture and periosteum or perichondrium plasty [25,26]. These findings illustrate that maintaining differentiated progenitor cells in their chondrogenic state is a challenging task in cartilage repair.…”

Section: The Role Of Periosteum In Autologous Chondrocyte Transplantamentioning

confidence: 99%

“…Both biopsies and MRI's have shown that cartilage repair may be hampered by unwanted hypertrophy and ossification. Peterson was the fist to describe this unwanted hypertrophy during ACT, while interlesional osteophytes are reported after microfracture procedures, minced cartilage procedures, and perichondrium arthroplasty [25,26]. Interlesional osteophytes can seen as a consequence of ossification of the repaired cartilage.…”

Section: Hypertrophy and Ossification After Cartilage Repairmentioning

confidence: 99%

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Cartilage Tissue Engineering; Lessons Learned From Periosteum

Emans¹

2011

J Tissue Sci Eng

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Cartilage, due to its unique physiology (lack of vasculature), can be potentially repaired using tissue engineered in the laboratory, by combining cells and with a supporting scaffold. This requires a marriage between material science, cell biology, and translational medicine, a concept well established as Tissue Engineering.Over the years the in vivo and in vitro chondrogenic potential of periosteum has been recognised by many researchers and as such periosteum is explored both to repair cartilage defects directly by transplanting periosteum into the cartilage defect or by using periosteum as a cell source for cartilage engineering purposes. The initial example hereof is the first generation of Autologous Chondrocyte Transplantation. Graft hypertrophy and ossification remain the primary drawbacks of cartilage repair strategies using engineered cartilage. These drawbacks may (partially) be due to the endochondral ossification process that can take over when cartilage is repaired. In this process chondrogenesis of progenitor cells is followed by hypertrophy of these cells and subsequent ossification. Periosteal progenitor cells go through this process in order to heal bone fractures. This review provides an overview of the role of periosteum in cartilage repair and cartilage tissue engineering and illustrates how periosteum can be used as a model to study the endochondral process. Such studies may provide clues to further optimize cartilage tissue engineering by identifying important factors which are capable of maintaining cells in their chondrogenic phenotype. Finally, the use of periosteum to engineer cartilage in vivo at an extra-articular site is described.

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Effect of material geometry on cartilagenous tissue formationin vitro

Bhardwaj

Pilliar

Grynpas

et al. 2001

J. Biomed. Mater. Res.

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The effect of material geometry, as defined by average pore size, on chondrocyte phenotype and cartilagenous tissue formation in vitro was examined. Bovine articular chondrocytes were plated on porous titanium alloy (Ti6Al4V) discs of different average pore sizes (13, 43, and 68 microm) and grown in culture for 4 weeks. Chondrocyte phenotype was maintained as indicated by the synthesis of large proteoglycans (Kav +/- SD: 13 microm = 0.28 +/- 0.01; 43 microm = 0.29 +/- 0.01; 68 microm = 0.27 +/- 0.02) and type II collagen. Light microscopical examination of histological sections of the composites showed that cartilagenous tissue had formed on all discs. The cartilagenous tissue on the discs of the smallest average pore size (13 microm) was significantly thicker than the tissue on the discs of larger average pore sizes and also had greater amounts of proteoglycan [mean glycosaminoglycan content +/- SD microg/disc): 13 microm = 246.9 +/- 7.8; 43 microm = 190.4 +/- 10.2; 68 microm = 156.6 +/- 25.8, p = 0.002] and DNA [mean DNA content +/- SD microg/disc): 13 microm = 12.5 +/- 0.6; 43 microm = 8.3 +/- 0.2; 68 microm = 9.3 +/- 0.9, p = 0.0008]. However, the amount of proteoglycan accumulated per cell was similar in the tissues generated on the discs of different average pore sizes. In contrast, the amount of collagen in the cartilagenous tissues showed no significant differences between the different pore sizes, but the amount of collagen accumulated per cell was less in the tissue formed on the smallest pore size disc (13 microm) as compared with the tissue formed on the discs of the larger pore sizes [mean hydroxyproline content/DNA (microg/microg) +/- SD: 13 microm = 1.56 +/- 0.2; 43 microm = 2.19 +/- 0.2; 68 microm = 2.3 +/- 0.3]. These results suggest that material geometry, as defined by pore size, can affect the amount and composition of the cartilagenous tissue that forms.

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Long-term results of rib perichondrial grafts for repair of cartilage defects in the human knee

Cited by 95 publications

References 26 publications

Treatment of osteochondritis dissecans of the femoral condyle with autologous bone grafts and matrix-supported autologous chondrocytes

Treatment of osteochondritis dissecans of the femoral condyle with autologous bone grafts and matrix-supported autologous chondrocytes

Cartilage Tissue Engineering; Lessons Learned From Periosteum

Effect of material geometry on cartilagenous tissue formationin vitro

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