Treatment of Full-Thickness Chondral Defects With Hyalograft C in the Knee

Brix, M.; Stelzeneder, David; Chiari, Catharina; Koller, Ulrich; Nehrer, Stefan; Dorotka, Ronald; Windhager, Reinhard; Domayer, Stephan

doi:10.1177/0363546514526695

Cited by 65 publications

(60 citation statements)

References 39 publications

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“…The constructs are press fit into the defect without additional fixation. Rehabilitation involved immobilization for 24 h and CPM from 0-30° until full range after 4 weeks (62). Crutch-assisted, non weight-bearing ambulation was ordered for 6 weeks; touch-down weight-bearing to full weight-bearing was prescribed from weeks 7 to 12.…”

Section: Tissue Engineered Articular Cartilage Productsmentioning

confidence: 99%

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

2016

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One of the most important issues facing cartilage tissue engineering is the inability to move technologies into the clinic. Despite the multitude of review articles on the paradigm of biomaterials, signals, and cells, it is reported that 90% of new drugs that advance past animal studies fail clinical trials (1). The intent of this review is to provide readers with an understanding of the scientific details of tissue engineered cartilage products that have demonstrated a certain level of efficacy in humans, so that newer technologies may be developed upon this foundation. Compared to existing treatments, such as microfracture or autologous chondrocyte implantation, a tissue engineered product can potentially provide more consistent clinical results in forming hyaline repair tissue and in filling the entirety of the defect. The various tissue engineering strategies (e.g., cell expansion, scaffold material, media formulations, biomimetic stimuli, etc.) used in forming these products, as collected from published literature, company websites, and relevant patents, are critically discussed. The authors note that many details about these products remain proprietary, not all information is made public, and that advancements to the products are continuously made. Nevertheless, by fully understanding the design and production processes of these emerging technologies, one can gain tremendous insight into how to best use them and also how to design the next generation of tissue engineered cartilage products.

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Section: Tissue Engineered Articular Cartilage Productsmentioning

confidence: 99%

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

2016

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“…The HA-based scaffold, Hyalograft C, demonstrated promising results for the treatment of articular cartilage lesions, and like collagen, has also been used in MACI procedures [376,377]. However, results appeared less convincing for chronic lesions [378], and the product was recently discontinued failing EMA approval. More promisingly, a chitosan-based product, BST-CarGel, has been shown to result in better organised tissue repair compared to microfracture treatment alone [379], and further clinical evaluation will indeed be interesting to follow.…”

Section: Biomaterialsmentioning

confidence: 99%

The Good the Bad and the Ugly of Glycosaminoglycans in Tissue Engineering Applications

2017

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High sulfation, low cost, and the status of heparin as an already FDA- and EMA- approved product, mean that its inclusion in tissue engineering (TE) strategies is becoming increasingly popular. However, the use of heparin may represent a naïve approach. This is because tissue formation is a highly orchestrated process, involving the temporal expression of numerous growth factors and complex signaling networks. While heparin may enhance the retention and activity of certain growth factors under particular conditions, its binding ‘promiscuity’ means that it may also inhibit other factors that, for example, play an important role in tissue maintenance and repair. Within this review we focus on articular cartilage, highlighting the complexities and highly regulated processes that are involved in its formation, and the challenges that exist in trying to effectively engineer this tissue. Here we discuss the opportunities that glycosaminoglycans (GAGs) may provide in advancing this important area of regenerative medicine, placing emphasis on the need to move away from the common use of heparin, and instead focus research towards the utility of specific GAG preparations that are able to modulate the activity of growth factors in a more controlled and defined manner, with less off-target effects.

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“…To address some of the potential problems and limitations with the original ACI method, several alternatives have been developed over the past few years, many of which comprise of naturally derived materials . This includes the second‐generation ACI technique, Matrix‐induced ACI (MACI), which involves the use of a bilayer membrane constituted of porcine‐derived collagens I and III as a carrier matrix.…”

Section: Introductionmentioning

confidence: 99%

Synthetic Poly(Vinylalcohol)‐Based Membranes for Cartilage Surgery and Repair

Tai

Gao

et al. 2017

Biotechnology Journal

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Cell-based therapies for cartilage repair are continually being developed to treat osteoarthritis. The cells are either introduced directly by intra-articular injection or via a cell-seeded matrix scaffold. Here, poly(vinylalcohol)-based membranes are developed to be used for mesenchymal stem cell implantation in cartilage repair procedures, having controllable physicochemical properties such as porosity, mechanical strength, and permeability, and a unique self-sealing property. The membranes possess a bilayer structure with a less porous layer providing mechanical strength and selective permeability, exhibit an elastic modulus of between 0.3 and 0.9 MPa, and are permeable to molecules <40 kDa, which is in the range of cartilage permeability. Three different peptide ligands with the sequences Ac-GCGYGRGDSPG, Ac-GCG(OPG)4REGOFG(OPG)4, and Ac-GCG(OPG)7, respectively, are conjugated to the membranes and subject to in vitro cell adhesion and differentiation assays. Col I/Col II gene expression ratios indicated that the collagen-mimetic peptide, Ac-GCG(OPG)7, best supported mesenchymal stem cell differentiation into the chondrogenic lineage. Although low retention of the membrane is observed in vivo in a rabbit knee model, results suggest that the membrane was able to facilitate mesenchymal stem cell implantation and differentiation to chondrocytes. These PVA-based membranes provide a feasible, synthetic, off-the-shelf material for the delivery of stem cells, and can be modified for other surgical applications.

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Treatment of Full-Thickness Chondral Defects With Hyalograft C in the Knee

Abstract: MACT is an excellent surgical therapy for full-thickness cartilage defects of the knee, with good long-term results for simple defects. However, it should not be used in salvage cases.

Cited by 65 publications

References 39 publications

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

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

The Good the Bad and the Ugly of Glycosaminoglycans in Tissue Engineering Applications

Synthetic Poly(Vinylalcohol)‐Based Membranes for Cartilage Surgery and Repair

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