Treatment Outcomes of Autologous Chondrocyte Implantation for Full-Thickness Articular Cartilage Defects of the Trochlea

Mandelbaum, Bert R.; Browne, Jon E.; Fu, Freddie H.; Micheli, Lyle J.; Moseley, J. Bruce; Erggelet, Christoph; Anderson, Allen F.

doi:10.1177/0363546507299528

Cited by 139 publications

(117 citation statements)

References 27 publications

Supporting

Mentioning

111

Contrasting

Order By: Relevance

“…Previous studies have investigated tissue engineering and cellular therapies for treating early stage OA, and autologous chondrocyte implantation has demonstrated positive clinical outcomes (9,10). Nevertheless, due to the poor self-renewal and regeneration potential of chondrocytes, it is a slow process that may lead to fibrocartilage rather than hyaline cartilage (11,12). Furthermore, this two-stage surgical procedure and is predominantly used to treat cartilage defects caused by injury rather than OA.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of mesenchymal stem cells in treating patients with osteoarthritis of the knee: A meta-analysis

Cui

Wang

et al. 2016

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

Abstract. To assess the clinical efficacy and safety of mesenchymal stem cell (MSC) treatment for osteoarthritis of the knee (KOA), a systematic electronic literature search was performed on PubMed, EMBASE and Web of Science. Studies published in English from the earliest record to December 2014 were searched using the following keywords: Cartilage defect, cartilage repair, osteoarthritis, KOA, stem cells, MSCs, bone marrow concentrate (BMC), adipose-derived mesenchymal stem cells, synovial-derived mesenchymal stem cells and peripheral blood-derived mesenchymal stem cells. The effect sizes of selected studies were determined by extracting pain scores from the visual analog scale and functional changes from International Knee Documentation Committee and Lysholm and Western Ontario and McMaster Universities Osteoarthritis Index before and after MSCs or reference treatments at 3, 6, 12, and 24 months. The factors were analyzed and the outcomes were modified after comparing the MSC group pooled values with the pretreatment baseline or between different treatment arms. A systematic search identified 18 clinical trials on this topic, including 10 single-arm prospective studies, four quasi-experimental studies and four randomized controlled trials that used BMCs to treat 565 patients with KOA in total. MSC treatment in patients with KOA showed continual efficacy for 24 months compared with their pretreatment condition. Effectiveness of MSCs was improved at 12 and 24 months post-treatment, compared with at 3 and 6 months. No dose-responsive association in the MSCs numbers was demonstrated. However, patients with arthroscopic debridement, activation agent or lower degrees of Kellgren-Lawrence grade achieved improved outcomes. MSC application ameliorated the overall outcomes of patients with KOA, including pain relief and functional improvement from basal evaluations, particularly at 12 and 24 months after follow-up.

show abstract

Section: Introductionmentioning

confidence: 99%

Efficacy of mesenchymal stem cells in treating patients with osteoarthritis of the knee: A meta-analysis

Cui

Wang

et al. 2016

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

show abstract

“…With chondrocytes contributing to less than 5% of the total tissue volume, and the limited biopsy size that can be collected from a minor weight-bearing area, only a small number of cells can be retrieved from the patient. Thus, to obtain the required cell number necessary for re-implantation, human articular chondrocytes (HAC) need to be expanded in vitro, a process during which the cells de-differentiate and lose their chondrogenic capacities to re-build stable hyalinelike tissue upon re-implantation (Mandelbaum et al, 2007). Chondrocyte de-differentiation has been characterized by changes in cell morphology, gene expression, extracellular matrix synthesis, surface marker expression patterns (Von der Mark et al, 1977;Schnabel et al, 2002;Marlovits et al, 2004;Diaz-Romero et al, 2005), as well as a progressive loss of intrinsic potential to form stable cartilage-like tissue in vitro (Giovannini et al, 2010), and after intramuscular injection in nude mice (Dell'Accio et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

Micromass co-culture of human articular chondrocytes and human bone marrow mesenchymal stem cells to investigate stable neocartilage tissue formation in vitro

Giovannini

Diaz-Romero²,

Aigner³

et al. 2010

eCM

142

107

View full text Add to dashboard Cite

Cell therapies for articular cartilage defects rely on expanded chondrocytes. Mesenchymal stem cells (MSC) represent an alternative cell source should their hypertrophic differentiation pathway be prevented. Possible cellular instruction between human articular chondrocytes (HAC) and human bone marrow MSC was investigated in micromass pellets. HAC and MSC were mixed in different percentages or incubated individually in pellets for 3 or 6 weeks with and without TGF-β1 and dexamethasone (±T±D) as chondrogenic factors. Collagen II, collagen X and S100 protein expression were assessed using immunohistochemistry. Proteoglycan synthesis was evaluated applying the Bern score and quantified using dimethylmethylene blue dye binding assay. Alkaline phosphatase activity (ALP) was detected on cryosections and soluble ALP measured in pellet supernatants. HAC alone generated hyaline-like discs, while MSC formed spheroid pellets in ±T±D. Co-cultured pellets changed from disc to spheroid shape with decreasing number of HAC, and displayed random cell distribution. In -T-D, HAC expressed S100, produced GAG and collagen II, and formed lacunae, while MSC did not produce any cartilagespecific proteins. Based on GAG, collagen type II and S100 expression chondrogenic differentiation occurred in -T-D MSC co-cultures. However, quantitative experimental GAG and DNA values did not differ from predicted values, suggesting only HAC contribution to GAG production. MSC produced cartilage-specific matrix only in +T+D but underwent hypertrophy in all pellet cultures. In summary, influence of HAC on MSC was restricted to early signs of neochondrogenesis. However, MSC did not contribute to the proteoglycan deposition, and HAC could not prevent hypertrophy of MSC induced by chondrogenic stimuli.

show abstract

“…Autologous chondrocyte implantation (ACI) has emerged as a successful viable alternative treatment in orthopaedics for arthroscopic intervention or joint replacement surgery (Brittberg et al, 1994;Mandelbaum et al, 2007;Peterson et al, 2003). Recently, further development of original ACI has led to the invention of in vitro three-dimensional (3D) cartilage implants that enabled easier surgical handling and facilitated cartilaginous tissue formation (Munirah et al, 2005;Munirah et al, 2007;Willers et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

The use of fibrin and poly(lactic-co-glycolic acid) hybrid scaffold for articular cartilage tissue engineering: an in vivo analysis

Munirah¹,

Sh²,

Ruszymah³

et al. 2008

eCM

View full text Add to dashboard Cite

Our preliminary results indicated that fibrin and poly(lacticco-glycolic acid) (PLGA) hybrid scaffold promoted early chondrogenesis of articular cartilage constructs in vitro. The aim of this study was to evaluate in vivo cartilaginous tissue formation by chondrocyte-seeded fibrin/PLGA hybrid scaffolds. PLGA scaffolds were soaked carefully, in chondrocyte-fibrin suspension, and polymerized by dropping thrombin-calcium chloride (CaCl 2 ) solution. PLGA-seeded chondrocytes were used as a control. Resulting constructs were implanted subcutaneously, at the dorsum of nude mice, for 4 weeks. Macroscopic observation, histological evaluation, gene expression and sulphated-glycosaminoglycan (sGAG) analyses were performed at each time point of 1, 2 and 4 weeks postimplantation. Cartilaginous tissue formation in fibrin/PLGA hybrid construct was confirmed by the presence of lacunae and cartilage-isolated cells embedded within basophilic ground substance. Presence of proteoglycan and glycosaminoglycan (GAG) in fibrin/PLGA hybrid constructs was confirmed by positive Safranin O and Alcian Blue staining. Collagen type II exhibited intense immunopositivity at the pericellular matrices. Chondrogenic properties were further demonstrated by the expression of gene encoded cartilage-specific markers, collagen type II and aggrecan core protein. The sGAG production in fibrin/PLGA hybrid constructs was higher than in the PLGA group. In conclusion, fibrin/PLGA hybrid scaffold promotes cartilaginous tissue formation in vivo and may serve as a potential cell delivery vehicle and a structural basis for articular cartilage tissue-engineering.

show abstract

Treatment Outcomes of Autologous Chondrocyte Implantation for Full-Thickness Articular Cartilage Defects of the Trochlea

Abstract: Autologous chondrocyte implantation appears to improve function and reduce symptoms in young to middle-aged patients with symptomatic, full-thickness articular cartilage lesions of the trochlea.

Cited by 139 publications

References 27 publications

Efficacy of mesenchymal stem cells in treating patients with osteoarthritis of the knee: A meta-analysis

Efficacy of mesenchymal stem cells in treating patients with osteoarthritis of the knee: A meta-analysis

Micromass co-culture of human articular chondrocytes and human bone marrow mesenchymal stem cells to investigate stable neocartilage tissue formation in vitro

The use of fibrin and poly(lactic-co-glycolic acid) hybrid scaffold for articular cartilage tissue engineering: an in vivo analysis

Contact Info

Product

Resources

About