Matrix assisted autologous chondrocyte transplantation for cartilage treatment

Abstract

ObjectivesMatrix-assisted autologous chondrocyte transplantation (MACT) has been developed and applied in the clinical practice in the last decade to overcome most of the disadvantages of the first generation procedures. The purpose of this systematic review is to document and analyse the available literature on the results of MACT in the treatment of chondral and osteochondral lesions of the knee.MethodsAll studies published in English addressing MACT procedures were identified, including those that fulfilled the following criteria: 1) level I-IV evidence, 2) measures of functional or clinical outcome, 3) outcome related to cartilage lesions of the knee cartilage.ResultsThe literature analysis showed a progressively increasing number of articles per year. A total of 51 articles were selected: three randomised studies, ten comparative studies, 33 case series and five case reports. Several scaffolds have been developed and studied, with good results reported at short to medium follow-up.ConclusionsMACT procedures are a therapeutic option for the treatment of chondral lesions that can offer a positive outcome over time for specific patient categories, but high-level studies are lacking. Systematic long-term evaluation of these techniques and randomised controlled trials are necessary to confirm the potential of this treatment approach, especially when comparing against less ambitious traditional treatments.

Characterization of Chondrogenic Gene Expression and Cartilage Phenotype Differentiation in Human Breast Adipose-Derived Stem Cells Promoted by Ginsenoside Rg1 In Vitro

“…The alizarin Red staining procedure for calcium precipitation (mineralization) was as follows (1). Fix cells in 2.5% glutaraldehyde (freshly prepared in 1× PBS buffer) for 10-15 minutes at room temperature (2). Remove the fixation solution, and wash cells with 1× PBS (pH adjusted to 4.2) 1-2 times (3).…”

“…This technique consists of three main steps, including the isolation of chondrocytes from healthy cartilage tissue, chondrocyte cultivation or expansion in vitro over 2-3 weeks, and re-injection of chondrocytes into the injured cartilage, covered with a periosteal flap [1]. This method gained international acceptance within the orthopedic surgery field [2,3] and was further refined by adding biomaterials such as coated scaffolds, membranes, and different matrices [4,5]. Despite this wide acceptance, several studies have revealed certain problems and limitations of ACT, including cell leakage, the requirement for high cell concentrations, and apoptosis of the re-injected chondrocytes.…”

What Is the Effect of Matrices on Cartilage Repair? A Systematic Review

“…In the setting of microfracture, this is referred to as autologous matrix-(or collagen-)induced chondrogenesis [11,37] and, in the setting of chondrocyte implantation, is known as matrix-assisted chondrocyte transplantation or second-/third-generation autologous chondrocyte transplantation, which is not currently available in the United States [20]. These biologic matrices are composed of cartilage extracellular matrix molecules or biopolymers that function as a scaffold for marrow components or transplanted chondrocytes to form more hyaline-like repair tissue in articular cartilage defects [35].…”

Positive impact of IGF-1-coupled nanoparticles on the differentiation potential of human chondrocytes cultured on collagen scaffolds

“…[15][16][17][18] Superficial cartilage defects have mainly been treated with hyaluronic acid (HA), while chondral and osteochondral lesions have been medicated by means of HA and autologous cartilage transplantation (ACT) since 1994. [19][20][21][22][23] In the latter case, the use of matrixassisted autologous chondrocyte transplantation has become increasingly attractive since 1998, because articular cartilage defects of varying degrees can be replenished more easily and in a more targeted manner. 22,24 So far, a variety of different synthetic and natural materials have been investigated with respect to cartilage repair.…”

“…[19][20][21][22][23] In the latter case, the use of matrixassisted autologous chondrocyte transplantation has become increasingly attractive since 1998, because articular cartilage defects of varying degrees can be replenished more easily and in a more targeted manner. 22,24 So far, a variety of different synthetic and natural materials have been investigated with respect to cartilage repair. 3,25 The main focus lies on restoring the complex structure and properties of hyaline cartilage to achieve long-term improvements in cartilage engineering.…”