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Human Chondrocytes from Human Adipose Tissue-Derived Mesenchymal Stem Cells Seeded on a Dermal-Derived Collagen Matrix Sheet: Our Preliminary Results for a Ready to Go Biotechnological Cartilage Graft in Clinical Practice. Stem Cells Int 2021; 2021:6664697. [PMID: 33679990 PMCID: PMC7929680 DOI: 10.1155/2021/6664697] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/16/2020] [Accepted: 02/06/2021] [Indexed: 12/15/2022] Open
Abstract
Background The articular cartilage is unique in that it contains only a single type of cell and shows poor ability for spontaneous healing. Cartilage tissue engineering which uses mesenchymal stem cells (MSCs) and adipose tissue-derived mesenchymal stem cells (AT-MSCs) is considered an attractive treatment for cartilage lesions and osteoarthritis. The establishment of cartilage regenerative medicine is an important clinical issue, but the search for cell sources able to restore cartilage integrity proves to be challenging. The aim of this study was to create cartilage grafts from the combination of AT-MSCs and collagen substrates. Methods Mesenchymal stem cells were obtained from human donors' adipose tissue, and collagen scaffold, obtained from human skin and cleaned from blood vessels, adipose tissues, and debris, which only preserve dermis and epidermis, were seeded and cultured on collagen substrates and differentiated to chondrocytes. The obtained chondrocyte extracellular matrix of cartilage was then evaluated for the expression of chondrocyte-/cartilage-specific markers, the Cartilage Oligomeric Matrix Protein (COMP), collagen X, alpha-1 polypeptide (COL10A1), and the Collagen II, Human Tagged ORF Clone (COL2A1) by using the reverse transcription polymerase chain reaction (RT-PCR). Results Our findings have shown that the dermal collagen may exert important effects on the quality of in vitro expanded chondrocytes, leading in this way that the influence of collagen skin matrix helps to produce highly active and functional chondrocytes for long-term cartilage tissue regeneration. Conclusion This research opens up the possibility of generating cartilage grafts with the precise purpose of improving the existing limitation in current clinical procedures.
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Tseng TH, Jiang CC, Lan HHC, Chen CN, Chiang H. The five year outcome of a clinical feasibility study using a biphasic construct with minced autologous cartilage to repair osteochondral defects in the knee. INTERNATIONAL ORTHOPAEDICS 2020; 44:1745-1754. [PMID: 32367232 DOI: 10.1007/s00264-020-04569-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/06/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Autologous minced cartilage has been used to repair cartilage defects. We have developed a biphasic cylindrical osteochondral construct for such use in human knees, and report the five year post-operative outcomes. METHODS Ten patients with symptomatic osteochondral lesion at femoral condyles were treated by replacing pathological tissue with the osteochondral composites, each consisted a DL-poly-lactide-co-glycolide chondral phase and a DL-poly-lactide-co-glycolide/β-tricalcium phosphate osseous phase. A flat chamber between the two phases served as a reservoir to house double-minced (mechanical pulverization and enzymatical dissociation) autologous cartilage graft. The osteochondral lesion was drill-fashioned a pit of identical dimensions as the construct. Graft-laden construct was press fit to the pit. Post-operative outcome was evaluated using Knee Injury and Osteoarthritis Outcome Score (KOOS) up to five years. Regenerated tissue was sampled with arthroscopic needle biopsy for histology at one year, and imaged with magnetic resonance at one, three, and five years to evaluate the neocartilage with MOCART chart. Subchondral bone integration was evaluated with computed tomography at three and five years. RESULTS Nine patients completed the five-year follow-up. Post-operative mean KOOS, except that of the "symptom" subscale, had been significantly higher than pre-operation from one year and maintained to five years. The change of MOCRAT scores of the regenerated cartilage paralleled the change of KOOS. The osseous phase remained mineralized during the five-year period, yet did not fully integrate with the host bone. CONCLUSIONS This novel construct for chondrocyte implantation yielded promising mid-term outcome. It repaired the osteochondral lesion with hyaline-like cartilage durable for at least five years.
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Affiliation(s)
- Tzu-Hao Tseng
- Department of Orthopaedic Surgery, National Taiwan University Hospital, 7 Chungsan South Road, Taipei, 10002, Taiwan
| | - Ching-Chuan Jiang
- Department of Orthopaedic Surgery, National Taiwan University Hospital, 7 Chungsan South Road, Taipei, 10002, Taiwan
| | - Howard Haw-Chang Lan
- Department of Medical Imaging and Radiological Sciences, College of Health Sciences, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | | | - Hongsen Chiang
- Department of Orthopaedic Surgery, National Taiwan University Hospital, 7 Chungsan South Road, Taipei, 10002, Taiwan.
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Niemeyer P, Laute V, John T, Becher C, Diehl P, Kolombe T, Fay J, Siebold R, Niks M, Fickert S, Zinser W. The Effect of Cell Dose on the Early Magnetic Resonance Morphological Outcomes of Autologous Cell Implantation for Articular Cartilage Defects in the Knee: A Randomized Clinical Trial. Am J Sports Med 2016; 44:2005-14. [PMID: 27206690 DOI: 10.1177/0363546516646092] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Although autologous chondrocyte implantation (ACI) has been established as a standard treatment for large full-thickness cartilage defects, the effect of different doses of autologous chondrocyte products on structural outcomes has never been examined. HYPOTHESIS In ACI, the dose level may have an influence on medium-term magnetic resonance morphological findings after treatment. STUDY DESIGN Randomized controlled trial; Level of evidence, 1. METHODS A total of 75 patients who underwent ACI using a pure, autologous, third-generation matrix-associated ACI product were divided into 3 groups representing different doses: 3 to 7 spheroids/cm(2), 10 to 30 spheroids/cm(2), and 40 to 70 spheroids/cm(2). Magnetic resonance imaging was performed at 1.5, 3, 6, and 12 months after ACI and was evaluated by the magnetic resonance observation of cartilage repair tissue (MOCART) score and the Knee injury and Osteoarthritis Outcome Score (KOOS). RESULTS MOCART scores showed improvements after 3 months, with slight dose dependence, and further improvement after 12 months, although without significant dose dependence. The mean MOCART scores after 3 months (0 = worst, 100 = best) were 59.8, 64.5, and 64.7 for the low-, medium-, and high-dose groups, respectively, and 62.9 for all patients; at 12 months, these were 74.1, 74.5, and 68.8 for the respective dose groups and 72.4 for all patients. Several MOCART items (surface of repair tissue, structure of repair tissue, signal intensity of repair tissue, subchondral bone, and synovitis) showed a more rapid response with the medium and high doses than with the low dose, suggesting a potential dose relationship. No significant correlation between the MOCART (overall and subscores) with clinical outcomes as assessed by the overall KOOS was detected at 3- and 12-month assessments. CONCLUSION This study reveals a trend toward earlier recovery after treatment with higher spheroid doses in terms of better defect filling for full-thickness cartilage defects of the knee, while outcomes after 12 months were similar in all dose groups. However, a correlation with clinical outcomes or the failure rate at 1 year after ACI was not found. A longer follow-up will be required for more definite conclusions on the clinical relevance of ACI cell density to be drawn. REGISTRATION NCT01225575 (ClinicalTrials.gov identifier); 2009-016816-20 (EudraCT number).
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Affiliation(s)
- Philipp Niemeyer
- Department of Orthopedic Surgery and Traumatology, Freiburg University Hospital, Freiburg, Germany
| | | | - Thilo John
- Clinic for Traumatology and Orthopedic Surgery, DRK Hospital Berlin Westend, Berlin, Germany
| | - Christoph Becher
- Department of Orthopedic Surgery, Medical University Annastift Hannover, Hannover, Germany
| | - Peter Diehl
- Department of Orthopedic Surgery, University of Rostock, Rostock, Germany
| | - Thomas Kolombe
- Traumatology and Reconstructive Surgery, DRK Hospital Luckenwalde, Luckenwalde, Germany
| | - Jakob Fay
- Department of Traumatology and Arthroscopic Surgery, Lubinus Clinicum Kiel, Kiel, Germany
| | - Rainer Siebold
- Center for Hip, Knee and Foot Surgery, ATOS Clinic Heidelberg, Heidelberg, Germany
| | - Milan Niks
- Department of Orthopedic Surgery and Traumatology, Mannheim University Hospital, Mannheim, Germany
| | | | - Wolfgang Zinser
- Department of Orthopedic Surgery and Traumatology, St Vinzenz-Hospital Dinslaken, Dinslaken, Germany
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Bornes TD, Jomha NM, Mulet-Sierra A, Adesida AB. Optimal Seeding Densities for In Vitro Chondrogenesis of Two- and Three-Dimensional-Isolated and -Expanded Bone Marrow-Derived Mesenchymal Stromal Stem Cells Within a Porous Collagen Scaffold. Tissue Eng Part C Methods 2016; 22:208-20. [PMID: 26651081 DOI: 10.1089/ten.tec.2015.0365] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Bone marrow-derived mesenchymal stromal stem cells (BMSCs) are a promising cell source for treating articular cartilage defects. The objective of this study was to assess the impact of cell seeding density within a collagen I scaffold on in vitro BMSC chondrogenesis following isolation and expansion in two-dimensional (2D) and three-dimensional (3D) environments. It was hypothesized that both expansion protocols would produce BMSCs capable of hyaline-like chondrogenesis with an optimal seeding density of 10 × 10(6) cells/cm(3). Ovine BMSCs were isolated in a 2D environment by plastic adherence, expanded to passage two in flasks containing an expansion medium, and seeded within collagen I scaffolds at densities of 50, 10, 5, 1, and 0.5 × 10(6) BMSCs/cm(3). For 3D isolation and expansion, aspirates containing known quantities of mononucleated cells (bone marrow-derived mononucleated cells [BMNCs]) were seeded on scaffolds at 50, 10, 5, 1, and 0.5 × 10(6) BMNCs/cm(3) and cultured in the expansion medium for an equivalent duration to 2D expansion. Constructs were differentiated in vitro in the chondrogenic medium for 21 days and assessed with reverse-transcription quantitative polymerase chain reaction, safranin O staining, histological scoring using the Bern Score, collagen immunofluorescence, and glycosaminoglycan (GAG) quantification. Two-dimensional-expanded BMSCs seeded at all densities were capable of proteoglycan production and displayed increased expressions of aggrecan and collagen II messenger RNA (mRNA) relative to predifferentiation controls. Collagen II deposition was apparent in scaffolds seeded at 0.5-10 × 10(6) BMSCs/cm(3). Chondrogenesis of 2D-expanded BMSCs was most pronounced in scaffolds seeded at 5-10 × 10(6) BMSCs/cm(3) based on aggrecan and collagen II mRNA, safranin O staining, Bern Score, total GAG, and GAG/deoxyribonucleic acid (DNA). For 3D-expanded BMSC-seeded scaffolds, increased aggrecan and collagen II mRNA expressions relative to controls were noted with all densities. Proteoglycan deposition was present in scaffolds seeded at 0.5-50 × 10(6) BMNCs/cm(3), while collagen II deposition occurred in scaffolds seeded at 10-50 × 10(6) BMNCs/cm(3). The highest levels of aggrecan and collagen II mRNA, Bern Score, total GAG, and GAG/DNA occurred with seeding at 50 × 10(6) BMNCs/cm(3). Within a collagen I scaffold, 2D- and 3D-expanded BMSCs are capable of hyaline-like chondrogenesis with optimal cell seeding densities of 5-10 × 10(6) BMSCs/cm(3) and 50 × 10(6) BMNCs/cm(3), respectively.
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Affiliation(s)
- Troy D Bornes
- Divisions of Orthopaedic Surgery and Surgical Research, Department of Surgery, University of Alberta , Edmonton, Canada
| | - Nadr M Jomha
- Divisions of Orthopaedic Surgery and Surgical Research, Department of Surgery, University of Alberta , Edmonton, Canada
| | - Aillette Mulet-Sierra
- Divisions of Orthopaedic Surgery and Surgical Research, Department of Surgery, University of Alberta , Edmonton, Canada
| | - Adetola B Adesida
- Divisions of Orthopaedic Surgery and Surgical Research, Department of Surgery, University of Alberta , Edmonton, Canada
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Pan Z, Duan P, Liu X, Wang H, Cao L, He Y, Dong J, Ding J. Effect of porosities of bilayered porous scaffolds on spontaneous osteochondral repair in cartilage tissue engineering. Regen Biomater 2015; 2:9-19. [PMID: 26813511 PMCID: PMC4669027 DOI: 10.1093/rb/rbv001] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 08/06/2014] [Indexed: 12/21/2022] Open
Abstract
Poly(lactide-co-glycolide)-bilayered scaffolds with the same porosity or different ones on the two layers were fabricated, and the porosity effect on in vivo repairing of the osteochondral defect was examined in a comparative way for the first time. The constructs of scaffolds and bone marrow-derived mesenchymal stem cells were implanted into pre-created osteochondral defects in the femoral condyle of New Zealand white rabbits. After 12 weeks, all experimental groups exhibited good cartilage repairing according to macroscopic appearance, cross-section view, haematoxylin and eosin staining, toluidine blue staining, immunohistochemical staining and real-time polymerase chain reaction of characteristic genes. The group of 92% porosity in the cartilage layer and 77% porosity in the bone layer resulted in the best efficacy, which was understood by more biomechanical mimicking of the natural cartilage and subchondral bone. This study illustrates unambiguously that cartilage tissue engineering allows for a wide range of scaffold porosity, yet some porosity group is optimal. It is also revealed that the biomechanical matching with the natural composite tissue should be taken into consideration in the design of practical biomaterials, which is especially important for porosities of a multi-compartment scaffold concerning connected tissues.
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Affiliation(s)
- Zhen Pan
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Advanced Materials Laboratory, Fudan University, Shanghai 200433, China; Department of Orthopaedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China; Department of Orthopaedic Surgery, Zhongshan Hospital, State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 200032, China
| | - Pingguo Duan
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Advanced Materials Laboratory, Fudan University, Shanghai 200433, China; Department of Orthopaedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China; Department of Orthopaedic Surgery, Zhongshan Hospital, State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 200032, China
| | - Xiangnan Liu
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Advanced Materials Laboratory, Fudan University, Shanghai 200433, China; Department of Orthopaedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China; Department of Orthopaedic Surgery, Zhongshan Hospital, State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 200032, China
| | - Huiren Wang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Advanced Materials Laboratory, Fudan University, Shanghai 200433, China; Department of Orthopaedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China; Department of Orthopaedic Surgery, Zhongshan Hospital, State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 200032, China
| | - Lu Cao
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Advanced Materials Laboratory, Fudan University, Shanghai 200433, China; Department of Orthopaedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China; Department of Orthopaedic Surgery, Zhongshan Hospital, State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 200032, China
| | - Yao He
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Advanced Materials Laboratory, Fudan University, Shanghai 200433, China; Department of Orthopaedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China; Department of Orthopaedic Surgery, Zhongshan Hospital, State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 200032, China
| | - Jian Dong
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Advanced Materials Laboratory, Fudan University, Shanghai 200433, China; Department of Orthopaedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China; Department of Orthopaedic Surgery, Zhongshan Hospital, State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 200032, China
| | - Jiandong Ding
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Advanced Materials Laboratory, Fudan University, Shanghai 200433, China; Department of Orthopaedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China; Department of Orthopaedic Surgery, Zhongshan Hospital, State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 200032, China
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Jeon JE, Vaquette C, Klein TJ, Hutmacher DW. Perspectives in Multiphasic Osteochondral Tissue Engineering. Anat Rec (Hoboken) 2013; 297:26-35. [DOI: 10.1002/ar.22795] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 09/13/2013] [Indexed: 12/25/2022]
Affiliation(s)
- June E. Jeon
- Institute of Health and Biomedical Innovation, Queensland University of Technology 60 Musk Ave., Kelvin Grove, QLD, 4059, Australia
| | - Cedryck Vaquette
- Institute of Health and Biomedical Innovation, Queensland University of Technology 60 Musk Ave., Kelvin Grove, QLD, 4059, Australia
| | - Travis J. Klein
- Institute of Health and Biomedical Innovation, Queensland University of Technology 60 Musk Ave., Kelvin Grove, QLD, 4059, Australia
| | - Dietmar W. Hutmacher
- Institute of Health and Biomedical Innovation, Queensland University of Technology 60 Musk Ave., Kelvin Grove, QLD, 4059, Australia
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, 315 Ferst Drive Atlanta, GA 30332, USA
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Tsuchida AI, Bekkers JEJ, Beekhuizen M, Vonk LA, Dhert WJA, Saris DBF, Creemers LB. Pronounced biomaterial dependency in cartilage regeneration using nonexpanded compared with expanded chondrocytes. Regen Med 2013; 8:583-95. [DOI: 10.2217/rme.13.44] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Aim: We aimed to investigate freshly isolated compared with culture-expanded chondrocytes with respect to early regenerative response, cytokine production and cartilage formation in response to four commonly used biomaterials. Materials & methods: Chondrocytes were both directly and after expansion to passage 2, incorporated into four biomaterials: Polyactive™, Beriplast®, HyStem® and a type II collagen gel. Early cartilage matrix gene expression, cytokine production and glycosaminoglycan (GAG) and DNA content in response to these biomaterials were evaluated. Results: HyStem induced more GAG production, compared with all other biomaterials (p ≤ 0.001). Nonexpanded cells did not always produce more GAGs than expanded chondrocytes, as this was biomaterial-dependent. Cytokine production and early gene expression were not predictive for final regeneration. Conclusion: For chondrocyte-based cartilage treatments, the biomaterial best supporting cartilage matrix production will depend on the chondrocyte differentiation state and cannot be predicted from early gene expression or cytokine profile.
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Affiliation(s)
- Anika I Tsuchida
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joris EJ Bekkers
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Michiel Beekhuizen
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lucienne A Vonk
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Wouter JA Dhert
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands
- Faculty of Veterinary Medicine, University of Utrecht, Utrecht, The Netherlands
| | - Daniël BF Saris
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands
- MIRA Institute, Tissue Regeneration, University Twente, Enschede, The Netherlands
| | - Laura B Creemers
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands
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Chiang H, Liao CJ, Hsieh CH, Shen CY, Huang YY, Jiang CC. Clinical feasibility of a novel biphasic osteochondral composite for matrix-associated autologous chondrocyte implantation. Osteoarthritis Cartilage 2013; 21:589-98. [PMID: 23333470 DOI: 10.1016/j.joca.2013.01.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 01/07/2013] [Accepted: 01/08/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Matrix-associated autologous chondrocyte implantation has been used to treat cartilage defects. We developed a biphasic cylindrical osteochondral composite construct for such use, and conducted this study to determine its feasibility for treating osteochondral lesions in human knees. METHOD Ten patients with symptomatic osteochondral lesions at femoral condyles were treated by replacing pathological tissue with the construct of dl-poly-lactide-co-glycolide, whose lower body was impregnated with β-tricalcium phosphate and served as osseous phase. The construct had a chamber to load double-minced autologous cartilage, serving as source of chondrocytes. Osteochondral lesion was drill-fashioned a pit of identical dimension as the construct. Chondrocyte-laden construct was press-fit to fill the pit. Postoperative outcome was evaluated using Knee Injury and Osteoarthritis Outcome Score (KOOS) scale up to 24 months. Magnetic resonance image was taken, and sample tissue was collected with second-look arthroscopic needle biopsy at 12 months. Outcome parameters were primarily safety of surgery, and secondarily postoperative change in KOOS and regeneration of hyaline cartilage and cancellous bone. RESULTS No patient experienced serious adverse events. Postoperative mean KOOS in "symptoms" subscale had not changed significantly from pre-operation until 24 months; whereas those in the other four subscales were significantly higher than pre-operation at 12 and 24 months. Second-look arthroscopy showed completely filled grafted sites, with regenerate cartilaginous surfaces flushed with surrounding native joint surface. Microscopically, regenerated cartilage appeared hyaline. CONCLUSION This novel construct for chondrocyte implantation is safe for surgical application in knee. It repairs osteochondral lesions of femoral condyles by successful regeneration of hyaline cartilage.
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Affiliation(s)
- H Chiang
- National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Leijten JC, Georgi N, Wu L, van Blitterswijk CA, Karperien M. Cell Sources for Articular Cartilage Repair Strategies: Shifting from Monocultures to Cocultures. TISSUE ENGINEERING PART B-REVIEWS 2013; 19:31-40. [DOI: 10.1089/ten.teb.2012.0273] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Jeroen C.H. Leijten
- Faculty of Science and Technology, Department of Developmental BioEngineering, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Nicole Georgi
- Faculty of Science and Technology, Department of Developmental BioEngineering, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Ling Wu
- Faculty of Science and Technology, Department of Developmental BioEngineering, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Clemens A. van Blitterswijk
- Faculty of Science and Technology, Department of Tissue Regeneration, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Marcel Karperien
- Faculty of Science and Technology, Department of Developmental BioEngineering, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
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Hansen OM, Foldager CB, Christensen BB, Everland H, Lind M. Increased chondrocyte seeding density has no positive effect on cartilage repair in an MPEG-PLGA scaffold. Knee Surg Sports Traumatol Arthrosc 2013; 21:485-93. [PMID: 22488013 DOI: 10.1007/s00167-012-1996-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2011] [Accepted: 03/27/2012] [Indexed: 11/24/2022]
Abstract
PURPOSE This study investigates the effect of cell seeding density on cartilage repair in matrix-assisted chondrocyte implantation in vitro and in vivo. METHODS In vitro: Four different cell seeding densities of human chondrocytes were seeded onto a porous methoxy-polyethylene glycol-polylactic-co-glycolic acid scaffold (MPEG-PLGA) polymer scaffold ASEED™ (1.2 × 10(6), 4.0 × 10(6), 1.2 × 10(7) and 2.0 × 10(7) cells/cm(3)). The cartilage repair response was evaluated by relative gene expression of the chondrogenic markers sox9, collagen types I, II and X, and aggrecan, total DNA content and sulphated glycosaminoglycan synthesis. In vivo: Using a New Zealand white rabbit intercondylar osteochondral defect model, three different cell seeding densities (1.2 × 10(6), 4.0 × 10(6) and 1.2 × 10(7) cells/cm(3)) were tested with an empty scaffold as control. The cartilage repair response was evaluated using O'Driscoll score. RESULTS In vitro: A significant difference (p < 0.05) in total DNA content was found at day 2 but not at day 7. The low cell seeding densities yielded the highest GAG content (p < 0.001) at day 7. Collagen type I was highest (p < 0.01) at the lowest density at day 7. In vivo: No significant difference was found between the 4 groups. CONCLUSIONS No positive effect on cartilage repair was found using increased cell seeding density. LEVEL OF EVIDENCE Controlled experimental study, Level II.
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Affiliation(s)
- Ole Møller Hansen
- Orthopaedic Research Laboratory, Aarhus University Hospital, Noerrebrogade 44 building. 1A, 1. floor, 8000, Århus C, Denmark.
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Vaquero J, Forriol F. Knee chondral injuries: clinical treatment strategies and experimental models. Injury 2012; 43:694-705. [PMID: 21733516 DOI: 10.1016/j.injury.2011.06.033] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Revised: 05/30/2011] [Accepted: 06/15/2011] [Indexed: 02/02/2023]
Abstract
Articular cartilage has a very limited capacity to repair and as such premature joint degeneration is often the end point of articular injuries. Patients with chondral injury have asymptomatic periods followed by others in which discomfort or pain is bearable. The repair of focal cartilage injuries requires a precise diagnosis, a completed knee evaluation to give the correct indication for surgery proportional to the damage and adapted to each patient. Many of the surgical techniques currently performed involve biotechnology. The future of cartilage repair should be based on an accurate diagnosis using new MRI techniques. Clinical studies would allow us to establish the correct indications and surgical techniques implanting biocompatible and biodegradable matrices with or without stem cells and growth factors. Arthroscopic techniques with the design of new instruments can facilitate repair of patella and tibial plateau lesions.
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Affiliation(s)
- Javier Vaquero
- Hospital Gregorio Marañon, Orthopaedic Surgery Department, Madrid, Spain
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12
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Foldager CB, Gomoll AH, Lind M, Spector M. Cell Seeding Densities in Autologous Chondrocyte Implantation Techniques for Cartilage Repair. Cartilage 2012; 3:108-17. [PMID: 26069624 PMCID: PMC4297130 DOI: 10.1177/1947603511435522] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Cartilage repair techniques have been among the most intensively investigated treatments in orthopedics for the past decade, and several different treatment modalities are currently available. Despite the extensive research effort within this field, the generation of hyaline cartilage remains a considerable challenge. There are many parameters attendant to each of the cartilage repair techniques that can affect the amount and types of reparative tissue generated in the cartilage defect, and some of the most fundamental of these parameters have yet to be fully investigated. For procedures in which in vitro-cultured autologous chondrocytes are implanted under a periosteal or synthetic membrane cover, or seeded onto a porous membrane or scaffold, little is known about how the number of cells affects the clinical outcome. Few published clinical studies address the cell seeding density that was employed. The principal objective of this review is to provide an overview of the cell seeding densities used in cell-based treatments currently available in the clinic for cartilage repair. Select preclinical studies that have informed the use of specific cell seeding densities in the clinic are also discussed.
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Affiliation(s)
- Casper Bindzus Foldager
- Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA,Veterans Affairs (VA) Boston Health Care System Boston, MA, USA,Orthopaedic Research Laboratory, Aarhus University Hospital, Aarhus, Denmark
| | | | - Martin Lind
- Sports Trauma Clinic, Aarhus University Hospital, Aarhus, Denmark
| | - Myron Spector
- Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA,Veterans Affairs (VA) Boston Health Care System Boston, MA, USA
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Kitamura N, Yasuda K, Ogawa M, Arakaki K, Kai S, Onodera S, Kurokawa T, Gong JP. Induction of spontaneous hyaline cartilage regeneration using a double-network gel: efficacy of a novel therapeutic strategy for an articular cartilage defect. Am J Sports Med 2011; 39:1160-9. [PMID: 21460067 DOI: 10.1177/0363546511399383] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND A double-network (DN) gel, which was composed of poly-(2-acrylamido-2-methylpropanesulfonic acid) and poly-(N,N'-dimetyl acrylamide) (PAMPS/PDMAAm), has the potential to induce chondrogenesis both in vitro and in vivo. PURPOSE To establish the efficacy of a therapeutic strategy for an articular cartilage defect using a DN gel. STUDY DESIGN Controlled laboratory study. METHODS A 4.3-mm-diameter osteochondral defect was created in rabbit trochlea. A DN gel plug was implanted into the defect of the right knee so that a defect 2 mm in depth remained after surgery. An untreated defect of the left knee provided control data. The osteochondral defects created were examined by histological and immunohistochemical evaluations, surface assessment using confocal laser scanning microscopy, and real-time polymerase chain reaction (PCR) analysis at 4 and 12 weeks. Samples were quantitatively evaluated with 2 scoring systems reported by Wayne et al and O'Driscoll et al. RESULTS The DN gel-implanted defect was filled with a sufficient volume of the hyaline cartilage tissue rich in proteoglycan and type 2 collagen. Quantitative evaluation using the grading scales revealed a significantly higher score in the DN gel-implanted defects compared with the untreated control at each period (P < .0001). The mean relative values of type 2 collagen mRNAs in the regenerated tissue were obviously higher in the DN gel-implanted defect than in the untreated control at each period. The mean surface roughness of the untreated control was significantly higher than the normal cartilage at 12 weeks (P = .0106), while there was no statistical difference between the DN gel-implanted and normal knees. CONCLUSION This study using the mature rabbit femoral trochlea osteochondral defect model demonstrated that DN gel implantation is an effective treatment to induce cartilage regeneration in vivo without any cultured cells or mammalian-derived scaffolds. CLINICAL RELEVANCE This study has prompted us to develop a potential innovative strategy to repair cartilage lesions in the field of joint surgery.
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Affiliation(s)
- Nobuto Kitamura
- Department of Sports Medicine and Joint Surgery, Hokkaido University, Kita-ku, Sapporo, 060-8638, Japan.
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