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Peláez-Gorrea P, Damiá-Giménez E, Rubio-Zaragoza M, Cuervo-Serrato B, Hernández-Guerra ÁM, Miguel-Pastor L, Del Romero-Martínez A, Sopena-Juncosa J, Torres-Torrillas M, Santana A, Cugat-Bertomeu R, Vilar-Guereño JM, Carrillo-Poveda JM. The autologous chondral platelet-rich plasma matrix implantation. A new therapy in cartilage repair and regeneration: macroscopic and biomechanical study in an experimental sheep model. Front Vet Sci 2023; 10:1223825. [PMID: 38146499 PMCID: PMC10749322 DOI: 10.3389/fvets.2023.1223825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 11/17/2023] [Indexed: 12/27/2023] Open
Abstract
Introduction Articular cartilage injuries are a severe problem, and the treatments for these injuries are complex. The present study investigates a treatment for full-thickness cartilage defects called Autologous Chondral Platelet Rich Plasma Matrix Implantation (PACI) in a sheep model. Methods Chondral defects 8 mm in diameter were surgically induced in the medial femoral condyles of both stifles in eight healthy sheep. Right stifles were treated with PACI and an intraarticular injection with a plasma rich in growth factors (PRGF) solution [treatment group (TRT)], while an intraarticular injection of Ringer's lactate solution was administered in left stifles [Control group (CT)]. The limbs' function was objectively assessed with a force platform to obtain the symmetry index, comparing both groups. After 9 and 18 months, the lesions were macroscopically evaluated using the International Cartilage Repair Society and Goebel scales. Results Regarding the symmetry index, the TRT group obtained results similar to those of healthy limbs at 9 and 18 months after treatment. Regarding the macroscopic assessment, the values obtained by the TRT group were very close to those of normal cartilage and superior to those obtained by the CT group at 9 months. Conclusion This new bioregenerative treatment modality can regenerate hyaline articular cartilage. High functional outcomes have been reported, together with a good quality repair tissue in sheep. Therefore, PACI treatment might be a good therapeutic option for full-thickness chondral lesions.
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Affiliation(s)
- Pau Peláez-Gorrea
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
| | - Elena Damiá-Giménez
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
| | - Mónica Rubio-Zaragoza
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
| | - Belén Cuervo-Serrato
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
| | - Ángel María Hernández-Guerra
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
| | - Laura Miguel-Pastor
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
| | - Ayla Del Romero-Martínez
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
| | - Joaquín Sopena-Juncosa
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
| | - Marta Torres-Torrillas
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
| | - Angelo Santana
- Departament of Mathematics, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Ramón Cugat-Bertomeu
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
| | - José Manuel Vilar-Guereño
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
- Department of Animal Pathology, Instituto Universitario de Investigaciones Biomédicas y Sanitarias, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Jose Maria Carrillo-Poveda
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, CEU-Cardenal Herrera University, CEU Universities, Valencia, Spain
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Alcaide-Ruggiero L, Molina-Hernández V, Morgaz J, Fernández-Sarmiento JA, Granados MM, Navarrete-Calvo R, Pérez J, Quirós-Carmona S, Carrillo JM, Cugat R, Domínguez JM. Immunohistochemical Analysis of Knee Chondral Defect Repair after Autologous Particulated Cartilage and Platelet-Rich Plasma Treatment in Sheep. Int J Mol Sci 2023; 24:15157. [PMID: 37894837 PMCID: PMC10606679 DOI: 10.3390/ijms242015157] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/06/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
This study performs an analysis that will enable the evaluation of the quality, durability, and structure of repaired cartilaginous extracellular matrix tissue using an autologous-based particulated autograft cartilage and platelet-rich plasma treatment (PACI + PRP). A single-blind controlled experiment was conducted on 28 sheep to evaluate the efficacy of the PACI + PRP treatment for cartilage defects. Full-thickness 8 mm diameter defects were created in the weight-bearing area of both knees. The right knees received PACI + PRP. The left knees were treated with Ringer's lactate solution (RLS) or hyaluronic acid (HA) injections. Sheep were euthanized at 9- or 18-months post-surgery. An extensive immunohistochemical analysis was performed to assess collagen types (I, II, III, V, VI, IX, X, XI) and aggrecan positivity. A semiquantitative scoring system provided a detailed evaluation of immunostaining. Collagens and aggrecan scores in the PACI + PRP groups were similar to healthy cartilage. Significant differences were found in collagens associated with matrix maturity (II and V), degradation (IX), structure and mechanics (VI), and hypertrophy (X) between healthy cartilage and RLS- or HA-repaired cartilage. The PACI + PRP treatment advanced the repair cartilage process in chondral defects with mature hyaline cartilage and enhanced the structural and mechanical qualities with better consistent cartilage, less susceptible to degradation and without hypertrophic formation over time.
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Affiliation(s)
- Lourdes Alcaide-Ruggiero
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad de Córdoba, Hospital Clínico Veterinario, Campus de Rabanales, Ctra. Madrid-Cádiz Km 396, 14014 Córdoba, Spain; (J.M.); (J.A.F.-S.); (M.M.G.); (R.N.-C.); (S.Q.-C.); (J.M.D.)
- Fundación García Cugat para Investigación Biomédica, Plaza Alfonso Comín 5-7, 08023 Barcelona, Spain; (J.M.C.); (R.C.)
| | - Verónica Molina-Hernández
- Departamento de Anatomía y Anatomía Patológica Comparadas y Toxicología, UIC Zoonosis y Enfermedades Emergentes ENZOEM, Facultad de Veterinaria, Universidad de Córdoba, Edificio de Sanidad Animal, Campus de Rabanales, Ctra. Madrid-Cádiz Km 396, 14014 Córdoba, Spain;
| | - Juan Morgaz
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad de Córdoba, Hospital Clínico Veterinario, Campus de Rabanales, Ctra. Madrid-Cádiz Km 396, 14014 Córdoba, Spain; (J.M.); (J.A.F.-S.); (M.M.G.); (R.N.-C.); (S.Q.-C.); (J.M.D.)
| | - J. Andrés Fernández-Sarmiento
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad de Córdoba, Hospital Clínico Veterinario, Campus de Rabanales, Ctra. Madrid-Cádiz Km 396, 14014 Córdoba, Spain; (J.M.); (J.A.F.-S.); (M.M.G.); (R.N.-C.); (S.Q.-C.); (J.M.D.)
| | - María M. Granados
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad de Córdoba, Hospital Clínico Veterinario, Campus de Rabanales, Ctra. Madrid-Cádiz Km 396, 14014 Córdoba, Spain; (J.M.); (J.A.F.-S.); (M.M.G.); (R.N.-C.); (S.Q.-C.); (J.M.D.)
| | - Rocío Navarrete-Calvo
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad de Córdoba, Hospital Clínico Veterinario, Campus de Rabanales, Ctra. Madrid-Cádiz Km 396, 14014 Córdoba, Spain; (J.M.); (J.A.F.-S.); (M.M.G.); (R.N.-C.); (S.Q.-C.); (J.M.D.)
| | - José Pérez
- Departamento de Anatomía y Anatomía Patológica Comparadas y Toxicología, UIC Zoonosis y Enfermedades Emergentes ENZOEM, Facultad de Veterinaria, Universidad de Córdoba, Edificio de Sanidad Animal, Campus de Rabanales, Ctra. Madrid-Cádiz Km 396, 14014 Córdoba, Spain;
| | - Setefilla Quirós-Carmona
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad de Córdoba, Hospital Clínico Veterinario, Campus de Rabanales, Ctra. Madrid-Cádiz Km 396, 14014 Córdoba, Spain; (J.M.); (J.A.F.-S.); (M.M.G.); (R.N.-C.); (S.Q.-C.); (J.M.D.)
| | - José M. Carrillo
- Fundación García Cugat para Investigación Biomédica, Plaza Alfonso Comín 5-7, 08023 Barcelona, Spain; (J.M.C.); (R.C.)
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad CEU Cardenal Herrera, Hospital Clínico Veterinario, Calle Santiago Ramón y Cajal s/n, 46115 Valencia, Spain
| | - Ramón Cugat
- Fundación García Cugat para Investigación Biomédica, Plaza Alfonso Comín 5-7, 08023 Barcelona, Spain; (J.M.C.); (R.C.)
- Instituto Cugat y Mutualidad de Futbolistas Españoles, Delegación Catalana, 08023 Barcelona, Spain
| | - Juan M. Domínguez
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad de Córdoba, Hospital Clínico Veterinario, Campus de Rabanales, Ctra. Madrid-Cádiz Km 396, 14014 Córdoba, Spain; (J.M.); (J.A.F.-S.); (M.M.G.); (R.N.-C.); (S.Q.-C.); (J.M.D.)
- Fundación García Cugat para Investigación Biomédica, Plaza Alfonso Comín 5-7, 08023 Barcelona, Spain; (J.M.C.); (R.C.)
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Anitua E, Prado R, Guadilla J, Alkhraisat MH, Laiz P, Padilla S, García-Balletbó M, Cugat R. The Dual-Responsive Interaction of Particulated Hyaline Cartilage and Plasma Rich in Growth Factors (PRGF) in the Repair of Cartilage Defects: An In Vitro Study. Int J Mol Sci 2023; 24:11581. [PMID: 37511339 PMCID: PMC10380225 DOI: 10.3390/ijms241411581] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/10/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023] Open
Abstract
The treatment of chondral and osteochondral defects is challenging. These types of lesions are painful and progress to osteoarthritis over time. Tissue engineering offers tools to address this unmet medical need. The use of an autologous cartilage construct consisting of hyaline cartilage chips embedded in plasma rich in growth factors (PRGF) has been proposed as a therapeutic alternative. The purpose of this study was to dig into the potential mechanisms behind the in vitro remodelling process that might explain the clinical success of this technique and facilitate its optimisation. Chondrocyte viability and cellular behaviour over eight weeks of in vitro culture, type II collagen synthesis, the dual delivery of growth factors by hyaline cartilage and PRGF matrix, and the ultrastructure of the construct and its remodelling were characterised. The main finding of this research is that the cartilage fragments embedded in the three-dimensional PRGF scaffold contain viable chondrocytes that are able to migrate into the fibrin network, proliferate and synthesise extracellular matrix after the second week of in vitro culture. The characterization of this three-dimensional matrix is key to unravelling the molecular kinetics responsible for its efficacy.
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Affiliation(s)
- Eduardo Anitua
- Eduardo Anitua Foundation for Biomedical Research, 01007 Vitoria, Spain
- Regenerative Medicine Laboratory, BTI-Biotechnology Institute IMASD, 01007 Vitoria, Spain
- University Institute for Regenerative Medicine & Oral Implantology-UIRMI (UPV/EHU-Fundación Eduardo Anitua), 01007 Vitoria, Spain
| | - Roberto Prado
- Eduardo Anitua Foundation for Biomedical Research, 01007 Vitoria, Spain
- Regenerative Medicine Laboratory, BTI-Biotechnology Institute IMASD, 01007 Vitoria, Spain
- University Institute for Regenerative Medicine & Oral Implantology-UIRMI (UPV/EHU-Fundación Eduardo Anitua), 01007 Vitoria, Spain
| | - Jorge Guadilla
- Osakidetza Basque Health Service, Araba University Hospital, 01009 Vitoria, Spain
- Arthroscopic Surgery Unit, Hospital Vithas Vitoria, 01008 Vitoria, Spain
- Department of Surgery and Radiology and Physical Medicine, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 01006 Vitoria, Spain
| | - Mohammad H Alkhraisat
- Eduardo Anitua Foundation for Biomedical Research, 01007 Vitoria, Spain
- Regenerative Medicine Laboratory, BTI-Biotechnology Institute IMASD, 01007 Vitoria, Spain
- University Institute for Regenerative Medicine & Oral Implantology-UIRMI (UPV/EHU-Fundación Eduardo Anitua), 01007 Vitoria, Spain
| | - Patricia Laiz
- Fundación García Cugat para Investigación Biomédica, 08023 Barcelona, Spain
- Instituto Cugat, Hospital Quirónsalud, 08023 Barcelona, Spain
| | - Sabino Padilla
- Eduardo Anitua Foundation for Biomedical Research, 01007 Vitoria, Spain
- Regenerative Medicine Laboratory, BTI-Biotechnology Institute IMASD, 01007 Vitoria, Spain
- University Institute for Regenerative Medicine & Oral Implantology-UIRMI (UPV/EHU-Fundación Eduardo Anitua), 01007 Vitoria, Spain
| | - Montserrat García-Balletbó
- Fundación García Cugat para Investigación Biomédica, 08023 Barcelona, Spain
- Instituto Cugat, Hospital Quirónsalud, 08023 Barcelona, Spain
| | - Ramón Cugat
- Fundación García Cugat para Investigación Biomédica, 08023 Barcelona, Spain
- Instituto Cugat, Hospital Quirónsalud, 08023 Barcelona, Spain
- Mutualidad de Futbolistas Españoles, Delegación Catalana, 08010 Barcelona, Spain
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Alcaide-Ruggiero L, Molina-Hernández V, Morgaz J, Fernández-Sarmiento JA, Granados MM, Navarrete-Calvo R, Pérez J, Quirós-Carmona S, Carrillo JM, Cugat R, Domínguez JM. Particulate cartilage and platelet-rich plasma treatment for knee chondral defects in sheep. Knee Surg Sports Traumatol Arthrosc 2023:10.1007/s00167-022-07295-7. [PMID: 36598512 DOI: 10.1007/s00167-022-07295-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/12/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE Articular cartilage is vulnerable to multiple types of damage and it has limited reparative and regenerative capacities due to its absence of vascularity. Although a large number of therapeutic strategies exist to treat chondral defects, they have some limitations, such as fibrocartilage formation. Therefore, the goal of the present study was to evaluate the chondrogenic regenerative properties of an autologous-made matrix of particulated cartilage and platelet-rich plasma (PACI + PRP) implantation for the treatment of full-thickness chondral defects in sheep. METHODS A full-thickness 8 mm diameter cartilage defect was created in the weight-bearing area of the medial femoral condyle in both knees of 16 sheep. The right knees of all animals were treated with particulated autograft cartilage implantation and platelet-rich plasma, while the left knees were injected with Ringer's lactate solution or hyaluronic acid. The sheep were killed 9 or 18 months after surgery. Macroscopic evaluations were performed using three different scoring systems, and histopathological evaluations were performed using a modified scoring system based on different scoring systems. RESULTS The PACI + PRP groups showed statistically significant differences in the percentage of defect repair and chondrocytes in the newly formed cartilage tissue at 18 months compared to 9 months. CONCLUSIONS The results suggest that macroscopic appearance, histological structure and chondrocyte repair were improved when using PACI + PRP treatment for chondral defects, producing an outcome similar to the surrounding healthy cartilage. PACI + PRP is a totally autologous, easy, and unexpensive treatment that can be performed in one-step procedure and is useful as a therapeutic option for knee chondral defects.
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Affiliation(s)
- Lourdes Alcaide-Ruggiero
- Departamento de Medicina y Cirugía Animal. Facultad de Veterinaria, Universidad de Córdoba, Córdoba, Spain.,Fundación García Cugat para Investigación Biomédica, Barcelona, Spain
| | - Verónica Molina-Hernández
- Departamento de Anatomía y Anatomía Patológica Comparadas y Toxicología. UIC Zoonosis y Enfermedades Emergentes ENZOEM, Universidad de Córdoba, Córdoba, Spain.
| | - Juan Morgaz
- Departamento de Medicina y Cirugía Animal. Facultad de Veterinaria, Universidad de Córdoba, Córdoba, Spain
| | | | - María M Granados
- Departamento de Medicina y Cirugía Animal. Facultad de Veterinaria, Universidad de Córdoba, Córdoba, Spain
| | - Rocío Navarrete-Calvo
- Departamento de Medicina y Cirugía Animal. Facultad de Veterinaria, Universidad de Córdoba, Córdoba, Spain
| | - José Pérez
- Departamento de Anatomía y Anatomía Patológica Comparadas y Toxicología. UIC Zoonosis y Enfermedades Emergentes ENZOEM, Universidad de Córdoba, Córdoba, Spain
| | - Setefilla Quirós-Carmona
- Departamento de Medicina y Cirugía Animal. Facultad de Veterinaria, Universidad de Córdoba, Córdoba, Spain
| | - José M Carrillo
- Fundación García Cugat para Investigación Biomédica, Barcelona, Spain.,Departamento de Medicina y Cirugía Animal, Universidad CEU Cardenal Herrera, Valencia, Spain
| | - Ramón Cugat
- Fundación García Cugat para Investigación Biomédica, Barcelona, Spain.,Instituto Cugat y Mutualidad de Futbolistas Españoles, Delegación Catalana, Barcelona, Spain
| | - Juan M Domínguez
- Departamento de Medicina y Cirugía Animal. Facultad de Veterinaria, Universidad de Córdoba, Córdoba, Spain.,Fundación García Cugat para Investigación Biomédica, Barcelona, Spain
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Biologic principles of minced cartilage implantation: a narrative review. Arch Orthop Trauma Surg 2022; 143:3259-3269. [PMID: 36385655 DOI: 10.1007/s00402-022-04692-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 11/01/2022] [Indexed: 11/18/2022]
Abstract
Cartilage tissue has a very limited ability to regenerate. Symptomatic cartilage lesions are currently treated by various cartilage repair techniques. Multiple treatment techniques have been proposed in the last 30 years. Nevertheless, no single technique is accepted as a gold standard. Minced cartilage implantation is a newer technique that has garnered increasing attention. This procedure is attractive because it is autologous, can be performed in a single surgery, and is therefore given it is cost-effective. This narrative review provides an overview of the biological potential of current cartilage regenerative repair techniques with a focus on the translational evidence of minced cartilage implantation.
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Single Stage Minced Cartilage Repair. OPER TECHN SPORT MED 2022. [DOI: 10.1016/j.otsm.2022.150961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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REPARATIVE CHONDROGENESIS AT RATS SHINBONE PROXIMAL EPIPHYPHIS TRAUMATIC INJURY WITH THE USE OF WARTON DRUGS STAR CELLS MEZENCHENICHEMIS IN THE EXPERIMENT. WORLD OF MEDICINE AND BIOLOGY 2021. [DOI: 10.26724/2079-8334-2021-3-77-249-254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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