Matrix-Associated Autologous Chondrocyte Implantation

Gille, Justus; Behrens, P.; Schulz, Arndt P.; Oheim, Ralf; Kienast, B.

doi:10.1177/1947603516638901

Cited by 77 publications

(71 citation statements)

References 33 publications

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“…The study population 12 years after surgery involved a reduced follow-up rate due to limited patient participation and compliance as found to be associated with patient recruitment over long-term follow-up periods. 19,23,24 However, the extent of the current study population is equivalent to the previous studies of long-term matrixassisted ACI. 19,24 During the past years, different studies have been reporting successful long-term outcome of pACI as a cartilage repair procedure.…”

Section: Discussionmentioning

confidence: 99%

“…19,23,24 However, the extent of the current study population is equivalent to the previous studies of long-term matrixassisted ACI. 19,24 During the past years, different studies have been reporting successful long-term outcome of pACI as a cartilage repair procedure. Follow-up of minimum 10 years showed survivorship of the repair site in 71% of the treated patients together with improved function in 75% 37 and satisfactory survival rates corresponding to significant clinical improvements could be reported up to 20 years after surgery.…”

Section: Discussionmentioning

confidence: 99%

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Long-Term Clinical and MRI Results of Matrix-Assisted Autologous Chondrocyte Implantation for Articular Cartilage Defects of the Knee

et al. 2018

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Objective To evaluate the long-term clinical and radiological outcome of matrix-assisted autologous chondrocyte implantation (mACI) for articular cartilage defects in the knee joint. Design Clinical evaluation was assessed in 21 patients with full-thickness cartilage defects, International Cartilage Repair Society (ICRS) grade IV. Clinical scoring was performed preoperatively and 12 years after transplantation using the International Knee Documentation Committee (IKDC) score, the Lysholm score, the Knee injury and Osteoarthritis Outcome Score (KOOS), and the Noyes sports activity rating scale. Morphologic evaluation of the repair tissue was assessed by magnetic resonance imaging (MRI) in 14 patients using the Kreuz-Henderson score. Results Clinical evaluation revealed significant improvement in the IKDC, the Lysholm, the KOOS, and the Noyes score. Morphological evaluation by MRI showed moderate to complete defect filling in 10 of 14 patients, demonstrating normal to nearly normal values in mean 74.29% of all assessed parameters. Significant correlation of the parameter cartilage signal and clinical outcome was found with the IKDC, Lysholm, and KOOS subscales ADL (activities of daily living) and QoL (quality of life). Conclusions The clinical and radiological outcomes 12 years after transplantation suggest the confirmation of the promising results of the mid-term follow-up. This study therefore provides first indications that the implantation of mACI might be a suitable option for long-term cartilage repair. Future controlled studies need to address the exact parameters influencing the long-term outcome of mACI.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Long-Term Clinical and MRI Results of Matrix-Assisted Autologous Chondrocyte Implantation for Articular Cartilage Defects of the Knee

et al. 2018

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“…As a result of cartilage avascularity, low chondrocyte proliferative activity, and high extracellular matrix protein density, the intrinsic healing ability of the native cartilage tissue is limited and thus no tissue regeneration can be observed following cartilage injuries like chondral defects, microfractures, etc. Two common operative procedures (i.e., the autologous chondrocyte implantation, ACI, and the matrix-associated autologous chondrocyte implantation, MACI) used for cartilage repair exhibit limitations with regard to the cartilage defect size and geometry [ 1 , 3 , 4 , 5 , 6 , 7 ]. On the other hand, non-invasive topical administration via the injection of in situ forming cell-laden hydrogels could offer a promising alternative to the above operative procedures [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Biomimetic Cell-Laden MeHA Hydrogels for the Regeneration of Cartilage Tissue

et al. 2020

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Methacrylated hyaluronic acid (MeHA) and chondroitin sulfate (CS)-biofunctionalized MeHA (CS-MeHA), were crosslinked in the presence of a matrix metalloproteinase 7 (MMP7)-sensitive peptide. The synthesized hydrogels were embedded with either human mesenchymal stem cells (hMSCs) or chondrocytes, at low concentrations, and subsequently cultured in a stem cell medium (SCM) or chondrogenic induction medium (CiM). The pivotal role of the synthesized hydrogels in promoting the expression of cartilage-related genes and the formation of neocartilage tissue despite the low concentration of encapsulated cells was assessed. It was found that hMSC-laden MeHA hydrogels cultured in an expansion medium exhibited a significant increase in the expression of chondrogenic markers compared to hMSCs cultured on a tissue culture polystyrene plate (TCPS). This favorable outcome was further enhanced for hMSC-laden CS-MeHA hydrogels, indicating the positive effect of the glycosaminoglycan binding peptide on the differentiation of hMSCs towards a chondrogenic phenotype. However, it was shown that an induction medium is necessary to achieve full span chondrogenesis. Finally, the histological analysis of chondrocyte-laden MeHA hydrogels cultured on an ex vivo osteochondral platform revealed the deposition of glycosaminoglycans (GAGs) and the arrangement of chondrocyte clusters in isogenous groups, which is characteristic of hyaline cartilage morphology.

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“…While comprising the same scaffold associated potentials, the application of MACI also simplifies the surgery by omitting both the chondrocyte injection underneath a membrane and the watertight sealing to ensure chondrocyte containment within the lesion. While studies have demonstrated reduced rates of re-operation in membrane ACI compared with periosteal ACI, further comparative studies are needed to show superiority among these techniques [ 54 , 55 •, 56 ].…”

Section: Introductionmentioning

confidence: 99%

Patellofemoral Cartilage Repair

Mestriner

Ackermann

Gomoll

2018

Curr Rev Musculoskelet Med

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Purpose of ReviewThis review provides an overview of well-established and newly developed cartilage repair techniques for cartilage defects in the patellofemoral joint (PFJ). An algorithm will be presented for approaching cartilage defects considering the distinct anatomy of both the patellar and trochlear articular surfaces.Recent FindingsRecent studies on cartilage repair in the PFJ have demonstrated improved outcomes in an attempt to delay or obviate the need for arthroplasty, and improve symptoms in young patients. While autologous chondrocyte implantation shows good and excellent outcomes for chondral lesions, osteochondral defects are adequately addressed with osteochondral allograft transplantation. In case of patellar malalignment, concomitant tibial tubercle osteotomy can significantly improve outcomes. Particulated cartilage and bone marrow aspirate concentrate are potential new alternative treatments for cartilage repair, currently in early clinical studies.SummaryDue to the frequency of concomitant anatomic abnormalities in the PFJ, a thorough clinical examination combined with careful indication for each procedure in each individual patient combined with meticulous surgical technique is central to achieve satisfying outcomes. Additional comparative studies of cartilage repair procedures, as well as investigation of newer techniques, are needed.

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Matrix-Associated Autologous Chondrocyte Implantation

Abstract: The significantly improved results on 3 scores after 15 years suggest that MACI represents a suitable treatment of local cartilage defects in the knee.

Cited by 77 publications

References 33 publications

Long-Term Clinical and MRI Results of Matrix-Assisted Autologous Chondrocyte Implantation for Articular Cartilage Defects of the Knee

Long-Term Clinical and MRI Results of Matrix-Assisted Autologous Chondrocyte Implantation for Articular Cartilage Defects of the Knee

Biomimetic Cell-Laden MeHA Hydrogels for the Regeneration of Cartilage Tissue

Patellofemoral Cartilage Repair

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