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Ma N, Wang H, Xu X, Wan Y, Liu Y, Wang M, Yu W, Dai Y, Peng J, Guo Q, Yu C, Lu S. Autologous-cell-derived, tissue-engineered cartilage for repairing articular cartilage lesions in the knee: study protocol for a randomized controlled trial. Trials 2017; 18:519. [PMID: 29110690 PMCID: PMC5674846 DOI: 10.1186/s13063-017-2251-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 10/07/2017] [Indexed: 12/22/2022] Open
Abstract
Background Spontaneous recovery from articular cartilage injury is difficult, and the ongoing progression of disease can eventually lead to osteoarthritis. Currently, there is no effective non-surgical treatment for articular cartilage injury. Arthroscopic debridement and microfracture surgery are performed for fibrocartilage repair. But fibrocartilage is different from normal articular cartilage, and functional recovery is not satisfactory. Therefore, it is necessary to develop more effective techniques for articular cartilage repair. Progress in material science, cell biology, biomechanics, and bioreactor technology has allowed the development of biomimetic, tissue-engineered osteochondral composites that have shown potential for the repair of damaged cartilage. We prepared biomimetic, tissue-engineered cartilage scaffolds optimized for biochemical composition and structural characteristics. Based on the experience of our pre-clinical studies on animals, a human articular cartilage acellular matrix scaffold was prepared and is in clinical use. The combination of autologous chondrocytes and scaffolds has shown satisfactory results in repairing cartilage defects in preliminary experiments. Methods This is a prospective randomized controlled trial. One hundred patients with full-thickness cartilage injury of the knee will be randomly divided into two groups to receive treatment with either tissue-engineered cartilage constructed using biomimetic cartilage extracellular-matrix-oriented scaffolds combined with autologous chondrocytes, or arthroscopic debridement and microfracture surgery. There will be five visiting time points: at baseline, then at 3, 6, 12, and 18 months postoperatively. The primary outcome will be therapeutic efficacy as assessed by the Lysholm score at 12 months postoperatively. The secondary outcomes will be the International Knee Documentation Committee score, Visual Analog Scale score, and cartilage injury and repair as assessed by magnetic resonance imaging as well as the incidence of postoperative adverse events. Discussion This trial will attempt to verify the use of tissue-engineered cartilage constructed using autologous chondrocytes combined with allogeneic, acellular cartilage matrix for the repair of cartilage defects, thereby providing favorable evidence for its use in clinical practice. Trial registration ClinicalTrials.gov, identifier: NCT02770209. Registered on 11 May 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2251-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ning Ma
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Hongxia Wang
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Xian Xu
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Yiqun Wan
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Yufeng Liu
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Mingjie Wang
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Wen Yu
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Yongjing Dai
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Jiang Peng
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Quanyi Guo
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China.
| | - Changlong Yu
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Shibi Lu
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
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Badri A, Burkhardt J. Arthroscopic debridement of unicompartmental arthritis: fact or fiction? Clin Sports Med 2014; 33:23-41. [PMID: 24274843 DOI: 10.1016/j.csm.2013.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Patients with recurrent or mechanical symptoms of unicompartmental knee arthritis that have failed conservative management are candidates for surgical intervention. Surgical options include debridement, lavage, chondroplasty, bone marrow-stimulating techniques, chondrocyte transfer, and chondrocyte implantation. These techniques have been well studied but it is still unclear which technique is superior. Various factors need to be accounted for when choosing the proper technique; among the factors discussed are the patient's age and the size of the articular cartilage defect.
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Affiliation(s)
- Ahmad Badri
- Department of Orthopedics, Jersey City Medical Center, 355 Grand Street, Jersey City, NJ 07032, USA; Department of Orthopedics, Meadowlands Hospital Medical Center, 55 Meadowlands Parkway, Secaucus, NJ, USA; Touro COM, Harlem, NY, USA.
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