Results of Chondrocyte Implantation with a Fibrin-Hyaluronan Matrix: A Preliminary Study

Abstract

Fibrin, a homologous polymer, is the natural scaffold of wound healing and therefore a candidate as a carrier for cell transplantation. We explored a novel matrix-based implant cartilage repair composed of both fibrin and hyaluronan in a defined ratio that takes advantage of the biological and mechanical properties of these two elements. The matrix was seeded with autologous chondrocytes expanded in the presence of a proprietary growth factor variant designed to preserve their chondrogenic potential. We prospectively followed eight patients with symptomatic-chronic cartilage defects treated with this carrier. Patients had arthroscopy to harvest autologous chondrocytes then grown in autologous serum. Chondrocytes were cultured in the presence of the FGF variant and then seeded on the fibrin-hyaluronan matrix. About 4 weeks following biopsy, the patients underwent implantation of the constructs by miniarthrotomy. Three of the eight patients had transient effusion. Clinical performance was measured by Lysholm and IKDC scores, MRI, and the need for secondary surgery. The clinical outcome of a 1-year followup demonstrated increase of clinical scores.

Cell-based tissue engineering strategies used in the clinical repair of articular cartilage

“…The product is a fibrinogen/hyaluronic acid scaffold seeded with expanded autologous chondrocytes. Cells were expanded in the presence of autologous serum and 10 ng/mL fibroblast growth factor 2 variant (FGF2v) (26). FGF2v has been shown to increase cell proliferation rates and maintain the chondrocytic phenotype during expansion (27).…”

“…FGF2v has been shown to increase cell proliferation rates and maintain the chondrocytic phenotype during expansion (27). The scaffold was described to be composed of homologous human fibrinogen (Omrix Biopharamceuticals, New York, NY) copolymerized with recombinant hyaluronan (Ferring Pharmaceuticals, Switzerland) with the use of thrombin and freeze-dried to yield a sponge-like, 3D structure (26). A company patent indicated that hyaluronic acid not only provides bioactivity to the matrix but also imparts viscoelastic properties to the scaffold (28).…”

“…A company patent indicated that hyaluronic acid not only provides bioactivity to the matrix but also imparts viscoelastic properties to the scaffold (28). Cells were injected into the scaffold with a syringe at 500,000 cells/cm 2 (26). The construct was cultured for 3-4 days prior to the implantation date.…”

“…The construct was cultured for 3-4 days prior to the implantation date. BioCart ™ II was ready for implantation 3 to 4 weeks after the first surgery (26). …”

Chondrogenesis of Human Mesenchymal Stem Cells by Local Transforming Growth Factor-Beta Delivery in a Biphasic Resorbable Carrier

“…12,18 They have also been used as gel carriers themselves for the transplantation of expanded autologous chondrocytes. 19,20 Autologous fibrin glue (FG) as well as partial autologous fibrin glue (PAF) were regarded as promising alternatives to commercial FG because they seemed favorable with respect to invasion by cells 21 and to morphology and viability of chondrocytes. 22 However, lower fibrin concentrations, poor fibrin crosslinking, and rapid liquefaction due to reduced resistance to fibrinolysis may represent drawbacks of their use.…”