Repair of a chondral defect using a cell free scaffold in a young patient - a case report of successful scaffold transformation and colonisation

Abstract

BackgroundChondral defects of the articular surface are a common condition that can lead to osteoarthritis if not treated. Therapy of this condition is a topic of constant debate and a variety of chondral repair strategies are currently used. One strategy involves implantation of a cell-free matrix of type I collagen (COL1), to provide a scaffold for chondrocyte migration and proliferation and extracellular matrix production. Although several studies have suggested that chondrocytes can move, to the best of our knowledge there is still no proof of chondrocyte occurrence in a former cell-free scaffold for articular cartilage repair in humans.Case presentationAn 18-year-old male patient underwent arthroscopic surgery of the knee for patellar instability and a chondral defect of the femoral condyle. Clinical outcome scores were recorded pre-operatively, after 6 weeks and after 6, 12, 24 and 36 months. MRI was recorded after 6 weeks and after 6, 12, 24 and 36 months postoperatively. At 42 months after implantation of a cell-free type I collagen matrix and reconstruction of the medial patellofemoral ligament, the patient was again treated arthroscopically for a tear of the medial meniscus of the same knee. A biopsy of the previous chondral defect was taken during arthroscopy for histological examination.ConclusionIn addition to good clinical and radiological results reported for cell-free scaffolds for cartilage repair in several other studies, transformation of the scaffold could be observed during re-arthroscopy for the meniscal tear. Histological examination of the specimen revealed articular cartilage with vital chondrocytes and a strong staining reaction for type II collagen (COL II), but no reaction for type I collagen staining. This might indicate a complete transformation of the scaffold and supports the theory that cell free scaffolds could support cell migration. Although the cell source remains unclear, migrating chondrocytes from the periphery remain a possibility.

Listening to Schneiderian Voices: A Novel Phenomenological Analysis

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Cell‐free scaffolds with different stiffness but same microstructure promote bone regeneration in rabbit large bone defect model

“…Therefore, modifying cell‐free biomaterial with suitable physical feature incorporation of endogenous stem/progenitor cells will be a very promising way in regeneration medicine and tissue engineering. One‐step surgical procedure and avoidance of defects from cell harvesting are important advantages of the cell‐free scaffolds . However, the classical two‐dimensional (2D) flat culture is not able to mimic the real environment that cells reside in vivo .…”

“…One-step surgical procedure and avoidance of defects from cell harvesting are important advantages of the cell-free scaffolds. 14 However, the classical two-dimensional (2D) flat culture is not able to mimic the real environment that cells reside in vivo. In contrast, cells attach to each other, form natural cell-to-cell attachments in three-dimensional (3D) and sense the mechanical properties of the matrix.…”

Effect of Laminin‐A4 inhibition on cluster formation of human osteoarthritic chondrocytes

“…Motility of chondrocytes is essential during growth, development, wound healing, and in the manufacturing of scaffolded cartilage implants …”

“…Motility of chondrocytes is essential during growth, development, wound healing, and in the manufacturing of scaffolded cartilage implants. 1,2 It was hypothesized that in osteoarthritis (OA) movement of chondrocytes within the cartilage matrix occurs during the formation of chondrocyte clusters. 3,4 These clusters are a typical histological feature in OA.…”