Three-year clinical outcome after chondrocyte transplantation using a hyaluronan matrix for cartilage repair

Nehrer, Stefan; Domayer, Stephan; Dorotka, Ronald; Schatz, Klaus; Bindreiter, U.; Kotz, R.

doi:10.1016/j.ejrad.2005.08.005

Cited by 187 publications

(140 citation statements)

References 19 publications

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“…Moreover, the presence of HyA within scaffolds has been shown to create a chondroinductive environment in vitro and in vivo promoting synthesis of cartilage tissue (Wu et al, 2010, Correia et al, 2011, Nehrer et al, 2006, Welsch et al, 2010.…”

Section: Introductionmentioning

confidence: 99%

Addition of hyaluronic acid improves cellular infiltration and promotes early-stage chondrogenesis in a collagen-based scaffold for cartilage tissue engineering

Matsiko

Levingstone

O’Brien

et al. 2012

Journal of the Mechanical Behavior of Biomedical Materials

142

102

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Section: Introductionmentioning

confidence: 99%

Addition of hyaluronic acid improves cellular infiltration and promotes early-stage chondrogenesis in a collagen-based scaffold for cartilage tissue engineering

Matsiko

Levingstone

O’Brien

et al. 2012

Journal of the Mechanical Behavior of Biomedical Materials

142

102

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“…Successful applications of biodegradable matrices for chondrocyte transplantation utilizing a nonwoven mesh of hyaluronan has proven that hyaluronan can serve as a scaffold for cultured chondrocytes and allows implantation by gluing the cell-seeded constructs with fibrin. Clinical studies with midterm results confirm improvement of the clinical performance comparable with ACT, but with less surgical trauma with respect to the incision and time of surgery by avoiding suturing of the implant [9,20,21,27]. Additionally, the fibrin-hyaluronan matrix with its unique structure presents an important advantage with a high seeding efficacy and maintenance of the chondrocytic phenotype.…”

Section: Discussionmentioning

confidence: 64%

“…Initially, these matrices were used as a patch [34] but recently have been used as a cellsupport device. Basically, chondrocytes are precultured on the matrix and are implanted as a cell-seeded construct [2,27]. This approach allows a more predictable transport of the cells into the defect without the need for suturing.…”

Section: Introductionmentioning

confidence: 99%

“…This approach allows a more predictable transport of the cells into the defect without the need for suturing. Most of the biomaterials used in these techniques are natural biopolymers such as collagen [7,8,24] or hyaluronan [10,21,27] derived from animals or synthetic materials like polylactides [6].…”

Section: Introductionmentioning

confidence: 99%

“…This biocompatible, 3-D scaffold has been tested preclinically in conjunction with autologous cells with high chondrogenic potential obtained with the use of a proprietary FGF variant but this is the first report of the use in a clinical setting. Other studies on matrix assisted chondrocyte transplantation suggest an improvement of function and pain [21,27,28]. Apart from biopsies, high-resolution MRI and well-defined MRI variables are a reliable, reproducible and accurate tool for assessing cartilage repair tissue [22].…”

Section: Introductionmentioning

confidence: 99%

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

Nehrer

Chiari

Domayer

et al. 2008

Clin Orthop Relat Res

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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.

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Bio‐Inspired 3D Environments for Cartilage Engineering

Ribelles

2012

Biomimetic Approaches for Biomaterials Development

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José Luis Gómez Ribelles to Concha Articular Cartilage HistologyHyaline cartilage is a very specialized tissue in which a small number of cells, chondrocytes, are distributed in a quite particular organization. The extracellular matrix (ECM) is composed mainly of collagen type II fibers and proteoglycan aggregates, which are mainly formed by the association of aggrecan with a large number of glycosaminoglycan chains. The combination of the collagen fiber stiffness and the high water sorption capacity of glycosaminoglycans (GAGs) produces a hard tissue that is able to sustain the high compression loading to which articular cartilage is subjected [1-3] and is very permeable to water-soluble substances allowing the diffusion of nutrients and waste products of cell metabolism, which is crucial in the avascular tissue. Healthy articular cartilage contains between 70% and 75% of water, the GAGs content can be up to 20% depending on the joints and cartilage sites [4,5], and collagen type II can represent between 11% and 20% of the wet weight [6].Furthermore, ECM composition, and consequently its mechanical properties, cell shape, and cell distribution are not homogeneous. Different tissue layers, going from articular surface to subchondral bone, with quite different characteristics can be distinguished [7][8][9][10][11]. The articular surface layer contains flat chondrocytes dispersed in a network of collagen type II fibers preferentially aligned parallel to the surface, which gives the tissue a special ability to sustain the shear stress to which the articular surface is subjected. The transition zone contains dispersed rounded chondrocytes in a disordered network of collagen fibers. The deep zone contains large rounded chondrocytes ordered in columns perpendicular to articular surface and collagen fibers aligned in the same direction. Finally, the calcified cartilage is the interface with subchondral bone. It is characterized by hypertrophic chondrocytes, a high content of collagen type X in the ECM and by tissue mineralization. The level of GAGs is lower in the surface layer, increases in the transition zone, and is the highest in the deep zone. The elastic modulus of hyaline cartilage continuously increases with depth from the articular surface. Schinagl et al. [10] measured values Biomimetic Approaches for Biomaterials Development, First Edition. Edited by João F. Mano.

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Three-year clinical outcome after chondrocyte transplantation using a hyaluronan matrix for cartilage repair

Cited by 187 publications

References 19 publications

Addition of hyaluronic acid improves cellular infiltration and promotes early-stage chondrogenesis in a collagen-based scaffold for cartilage tissue engineering

Addition of hyaluronic acid improves cellular infiltration and promotes early-stage chondrogenesis in a collagen-based scaffold for cartilage tissue engineering

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

Bio‐Inspired 3D Environments for Cartilage Engineering

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