One-Step Repair for Cartilage Defects in a Rabbit Model

Dai, Linghui; He, Zhenming; Zhang, Xin; Hu, Xiaoqing; Yuan, Lan; Mei, Qiang; Zhu, Jingxian; Shao, Zhenxing; Zhou, Chunyan; Ao, Yingfang

doi:10.1177/0363546513518415

Cited by 46 publications

(18 citation statements)

References 37 publications

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“…A trapezoidal load function was applied to each indent site with loading (10 s), holding (2 s), and unloading (10 s). The microscopic geomorphology of the indentation zones was captured using a micro-scanning apparatus39. The mechanical properties of the chondrocytes were measured using a Bioscope Resolve AFM (Bruker AXS Corporation, Santa Barbara, CA), following previously established techniques40.…”

Section: Methodsmentioning

confidence: 99%

Effects of mechanical stress on chondrocyte phenotype and chondrocyte extracellular matrix expression

Liu

Zhang

et al. 2016

Sci Rep

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Mechanical factors play a key role in regulating the development of cartilage degradation in osteoarthritis. This study aimed to identify the influence of mechanical stress in cartilage and chondrocytes. To explore the effects of mechanical stress on cartilage morphology, we observed cartilages in different regions by histological and microscopic examination. Nanoindentation was performed to assess cartilage biomechanics. To investigate the effects of mechanical stress on chondrocytes, cyclic tensile strain (CTS, 0.5 Hz, 10%) was applied to monolayer cultures of human articular chondrocytes by using Flexcell-5000. We quantified the mechanical properties of chondrocytes by atomic force microscopy. Chondrocytes were stained with Toluidine blue and Alcian blue after exposure to CTS. The expression of extracellular matrix (ECM) molecules was detected by qPCR and immunofluorescence analyses in chondrocytes after CTS. Our results demonstrated distinct morphologies and mechanical properties in different cartilage regions. In conclusion, mechanical stress can affect the chondrocyte phenotype, thereby altering the expression of chondrocyte ECM.

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Section: Methodsmentioning

confidence: 99%

Effects of mechanical stress on chondrocyte phenotype and chondrocyte extracellular matrix expression

Liu

Zhang

et al. 2016

Sci Rep

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“…However, five years after surgery higher incidences of clinical failures are observed ( Hoemann et al, 2010 ; Van der Linden et al, 2013 ). The newly formed tissue generally consists of fibrocartilage repair tissue rather than hyaline cartilage, has limited filling of the defect, integrates poorly with the surrounding tissue and has inferior mechanical properties compared to hyaline cartilage ( Dai et al, 2014 ). Therefore, the need for regeneration of more durable cartilage tissue persists.…”

Section: Introductionmentioning

confidence: 99%

Improved cartilage regeneration by implantation of acellular biomaterials after bone marrow stimulation: a systematic review and meta-analysis of animal studies

Pot

Gonzales

Buma

et al. 2016

PeerJ

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Microfracture surgery may be applied to treat cartilage defects. During the procedure the subchondral bone is penetrated, allowing bone marrow-derived mesenchymal stem cells to migrate towards the defect site and form new cartilage tissue. Microfracture surgery generally results in the formation of mechanically inferior fibrocartilage. As a result, this technique offers only temporary clinical improvement. Tissue engineering and regenerative medicine may improve the outcome of microfracture surgery. Filling the subchondral defect with a biomaterial may provide a template for the formation of new hyaline cartilage tissue. In this study, a systematic review and meta-analysis were performed to assess the current evidence for the efficacy of cartilage regeneration in preclinical models using acellular biomaterials implanted after marrow stimulating techniques (microfracturing and subchondral drilling) compared to the natural healing response of defects. The review aims to provide new insights into the most effective biomaterials, to provide an overview of currently existing knowledge, and to identify potential lacunae in current studies to direct future research. A comprehensive search was systematically performed in PubMed and EMBASE (via OvidSP) using search terms related to tissue engineering, cartilage and animals. Primary studies in which acellular biomaterials were implanted in osteochondral defects in the knee or ankle joint in healthy animals were included and study characteristics tabulated (283 studies out of 6,688 studies found). For studies comparing non-treated empty defects to defects containing implanted biomaterials and using semi-quantitative histology as outcome measure, the risk of bias (135 studies) was assessed and outcome data were collected for meta-analysis (151 studies). Random-effects meta-analyses were performed, using cartilage regeneration as outcome measure on an absolute 0–100% scale. Implantation of acellular biomaterials significantly improved cartilage regeneration by 15.6% compared to non-treated empty defect controls. The addition of biologics to biomaterials significantly improved cartilage regeneration by 7.6% compared to control biomaterials. No significant differences were found between biomaterials from natural or synthetic origin or between scaffolds, hydrogels and blends. No noticeable differences were found in outcome between animal models. The risk of bias assessment indicated poor reporting for the majority of studies, impeding an assessment of the actual risk of bias. In conclusion, implantation of biomaterials in osteochondral defects improves cartilage regeneration compared to natural healing, which is further improved by the incorporation of biologics.

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“…Known as DeNovo ET, the technology would be available as an off-the-shelf option that uses minced allograft donor cartilage to fill chondral defects and has been demonstrated to generate cartilage similar to physiologic hyaline baseline. 40 , 61 Other novel techniques are attempting to evolve a single-step cartilage repair procedure, 6 , 7 , 18 one such example being the Cartilage Autograft Implantation System (CAIS). In a preclinical animal study, Frisbie et al 33 demonstrated CAIS and ACI as superior to an empty defect (negative control) in equine articular defects, with CAIS being superior to ACI.…”

Section: Clinical Application Of In Vitro–engineered Implantsmentioning

confidence: 99%

“… 14 In recent advances, multiple studies have documented several different techniques, some combining microfracture with biocompatible matrices and others using novel cell mixtures alone, both of which have shown the ability to proliferate a hyaline-like repair in isolated defects. 6 , 18 Certain techniques look to use stem cells to augment the existing ACI protocol, achieving proliferation and development in a single-step procedure. 7 These types of innovation are significant, as a single-step repair procedure would serve as a point-of-care surgical procedure for the primary treatment of isolated, full-thickness chondral lesions in the knee and decrease return trips to the operating room.…”

Section: Clinical Application Of In Vitro–engineered Implantsmentioning

confidence: 99%

Biologic Treatments for Sports Injuries II Think Tank—Current Concepts, Future Research, and Barriers to Advancement, Part 3

Zlotnicki

Geeslin

Murray

et al. 2016

Orthopaedic Journal of Sports Medicine

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Focal chondral defects of the articular surface are a common occurrence in the field of orthopaedics. These isolated cartilage injuries, if not repaired surgically with restoration of articular congruency, may have a high rate of progression to posttraumatic osteoarthritis, resulting in significant morbidity and loss of function in the young, active patient. Both isolated and global joint disease are a difficult entity to treat in the clinical setting given the high amount of stress on weightbearing joints and the limited healing potential of native articular cartilage. Recently, clinical interest has focused on the use of biologically active compounds and surgical techniques to regenerate native cartilage to the articular surface, with the goal of restoring normal joint health and overall function. This article presents a review of the current biologic therapies, as discussed at the 2015 American Orthopaedic Society for Sports Medicine (AOSSM) Biologics Think Tank, that are used in the treatment of focal cartilage deficiencies. For each of these emerging therapies, the theories for application, the present clinical evidence, and specific areas for future research are explored, with focus on the barriers currently faced by clinicians in advancing the success of these therapies in the clinical setting.

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One-Step Repair for Cartilage Defects in a Rabbit Model

Abstract: Microfracture combined with a DCCBM scaffold is a promising method that can be performed and adopted into clinical treatment for articular cartilage injuries.

Cited by 46 publications

References 37 publications

Effects of mechanical stress on chondrocyte phenotype and chondrocyte extracellular matrix expression

Effects of mechanical stress on chondrocyte phenotype and chondrocyte extracellular matrix expression

Improved cartilage regeneration by implantation of acellular biomaterials after bone marrow stimulation: a systematic review and meta-analysis of animal studies

Biologic Treatments for Sports Injuries II Think Tank—Current Concepts, Future Research, and Barriers to Advancement, Part 3

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