Second-generation arthroscopic autologous chondrocyte implantation for the treatment of degenerative cartilage lesions

Filardo, Giuseppe; Kon, Elizaveta; Martino, Alessandro Di; Patella, Silvio; Altadonna, Giulio; Balboni, Federica; Bragonzoni, Laura; Visani, Andrea; Marcacci, Maurilio

doi:10.1007/s00167-011-1732-5

Cited by 78 publications

(55 citation statements)

References 51 publications

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“…Multiple studies have shown a positive effect, with increased function and pain reduction. 7,8,13,16,19,23 In clinical practice, subchondral BME is a frequent radiological observation in the postoperative course after ACI. In the present study we observed a high overall incidence of BME (78%) during the postoperative course of 3 years after third-generation ACI.…”

Section: Discussionmentioning

confidence: 99%

Bone Marrow Edema in the Knee and Its Influence on Clinical Outcome After Matrix-Based Autologous Chondrocyte Implantation

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Bone Marrow Edema in the Knee and Its Influence on Clinical Outcome After Matrix-Based Autologous Chondrocyte Implantation

et al. 2015

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“…2012). These scores were lower, however, and failures were observed more frequently than what had been reported previously in non-arthritic populations (Kon et al.…”

Section: Methodsmentioning

confidence: 99%

Cartilage repair in the degenerative ageing knee

et al. 2016

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Background and purposeCartilage damage can develop due to trauma, resulting in focal chondral or osteochondral defects, or as more diffuse loss of cartilage in a generalized organ disease such as osteoarthritis. A loss of cartilage function and quality is also seen with increasing age. There is a spectrum of diseases ranging from focal cartilage defects with healthy surrounding cartilage to focal lesions in degenerative cartilage, to multiple and diffuse lesions in osteoarthritic cartilage. At the recent Aarhus Regenerative Orthopaedics Symposium (AROS) 2015, regenerative challenges in an ageing population were discussed by clinicians and basic scientists. A group of clinicians was given the task of discussing the role of tissue engineering in the treatment of degenerative cartilage lesions in ageing patients. We present the outcomes of our discussions on current treatment options for such lesions, with particular emphasis on different biological repair techniques and their supporting level of evidence.Results and interpretationBased on the studies on treatment of degenerative lesions and early OA, there is low-level evidence to suggest that cartilage repair is a possible treatment for such lesions, but there are conflicting results regarding the effect of advanced age on the outcome. We concluded that further improvements are needed for direct repair of focal, purely traumatic defects before we can routinely use such repair techniques for the more challenging degenerative lesions. Furthermore, we need to identify trigger mechanisms that start generalized loss of cartilage matrix, and induce subchondral bone changes and concomitant synovial pathology, to maximize our treatment methods for biological repair in degenerative ageing joints.

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“…As a result, subsequent studies developed different scaffolds composed of animal types I and III collagen, polyglycolic/polylactic acid, hyaluronic acid, fibrin gel and alginate to secure the cells within the lesion (i.e., matrix-assisted ACI, MACI; matrix-associated chondrocyte transplantation, MACT; and matrix-based ACI), as well as construction of engineered cartilage to achieve a more uniform repair of the lesion (Behrens et al, 2006;Beris et al, 2012;Filardo et al, 2012b;Pelissier et al, 2013;Rogers et al, 2010). The parameters and outcomes of mid-and long-term studies of patients treated with ACI, ACI seeded in scaff olds and other tissue-engineered cartilage techniques are listed in Table 1.…”

Section: Autologous Chondrocyte Transplantationmentioning

confidence: 99%

Clinical and experimental approaches to knee cartilage lesion repair and mesenchymal stem cell chondrocyte differentiation

Montoya¹,

Martínez²,

García-Robles³

et al. 2013

Biol. Res.

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Cartilage has poor regeneration capacity due to the scarcity of endogenous stem cells, its low metabolic activity and the avascular environment. Repair strategies vary widely, including microfracture, autologous or allogenic tissue implantation, and in vitro engineered tissues of autologous origin. However, unlike the advances that have been made over more than two decades with more complex organs, including vascular, cardiac or bone tissues, similar advances in tissue engineering for cartilage repair are lacking. Although the inherent characteristics of cartilage tissue, such as the lack of vascularity and low cellular diversity, suggest that it would be one of the more simple tissues to be engineered, its functional weight-bearing role and implant viability and adaptation make this type of repair more complex. Over the last decade several therapeutic approaches and innovative techniques show promise for lasting and functional regeneration of hyaline cartilage. Here we will analyze the main strategies for cartilage regeneration and discuss our experience.

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Second-generation arthroscopic autologous chondrocyte implantation for the treatment of degenerative cartilage lesions

Abstract: Case series, Level IV.

Cited by 78 publications

References 51 publications

Bone Marrow Edema in the Knee and Its Influence on Clinical Outcome After Matrix-Based Autologous Chondrocyte Implantation

Bone Marrow Edema in the Knee and Its Influence on Clinical Outcome After Matrix-Based Autologous Chondrocyte Implantation

Cartilage repair in the degenerative ageing knee

Clinical and experimental approaches to knee cartilage lesion repair and mesenchymal stem cell chondrocyte differentiation

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