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Mohseni M, Shokrollahi P, Barzin J. Gelatin/O-carboxymethyl chitosan injectable self-healing hydrogels for ibuprofen and naproxen dual release. Int J Biol Macromol 2024; 263:130266. [PMID: 38368982 DOI: 10.1016/j.ijbiomac.2024.130266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 02/11/2024] [Accepted: 02/15/2024] [Indexed: 02/20/2024]
Abstract
Recently, a significantly greater clinical benefit has been reported with a combination of glucosamine sulfate and nonsteroidal anti-inflammatory drugs (NSAIDs) compared to either treatment alone for the growing osteoarthritis (OA) disease. So, this study introduces hydrogels using O-carboxymethyl chitosan (O-CMC, structurally akin glucosamine glycan), and Gelatin type A (GA) in a 1:2 ratio with β-glycerophosphate (βGPh) at varying percentages (5 %, 12.5 %, and 15 %). We show that hydrogel properties, adaptable for drug delivery or tissue engineering, can be fine-tuned based on OCMC:βGPh ratio. CMC/GA/βGPh-12.5 exhibited a swelling rate of 189 %, compressive stress of 164 kPa, and compressive modulus of 3.4 kPa. The self-healing hydrogel also exhibited excellent injectability through a 21-gauge needle, requiring only 5 N of force. Ibuprofen and Naproxen release from CMC/GA/βGPh-12.5 and CMC/GA/βGPh-15 of designed dimensions (bi-layer structures of different diameter and height) were measured, and drug release kinetics were estimated using mathematical equations (MATLAB and polyfit program). CMC/GA/βGPh-12.5 demonstrated significant antibacterial effects against E. coli and S. aureus, a high cell survival rate of 89 % against L929 fibroblasts, and strong cell adhesion, all indicating biocompatibility. These findings underscore potential of these hydrogels as promising candidates for treating inflammatory diseases such as osteoarthritis.
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Affiliation(s)
- Mahshad Mohseni
- Department of Biomaterials, Faculty of Science, Iran Polymer and Petrochemical Institute (IPPI), Tehran 14975-112, Iran
| | - Parvin Shokrollahi
- Department of Biomaterials, Faculty of Science, Iran Polymer and Petrochemical Institute (IPPI), Tehran 14975-112, Iran.
| | - Jalal Barzin
- Department of Biomaterials, Faculty of Science, Iran Polymer and Petrochemical Institute (IPPI), Tehran 14975-112, Iran
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2
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Lineham B, van Duren B, Harwood P, Pandit H. The Feasibility of Hinged Knee Arthrodiastasis for Cartilage Regeneration: A Systematic Review of the Literature. Strategies Trauma Limb Reconstr 2023; 18:37-43. [PMID: 38033931 PMCID: PMC10682560 DOI: 10.5005/jp-journals-10080-1578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 04/20/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction Knee joint distraction (KJD) is a potential technique for cartilage regeneration in young patients with osteoarthritis of the knee. Static distraction has been utilised typically; however, a significant proportion of patients complain of knee stiffness post-distractor removal. The use of a hinged distractor may reduce the duration and severity of post-treatment knee stiffness by maintaining the range of motion during distraction. Furthermore, improved cartilage regeneration has been demonstrated in hinged ankle joint distraction as compared to static, and this may also be demonstrated at the knee. An evidence review was undertaken to inform further research and a potential change in practice. Aim A systematic review of all primary research on hinged knee joint distraction for cartilage regeneration. Methods An online systematic search of citation databases was conducted. Quality assessment and data extraction were undertaken by two separate researchers. Results The literature search returned a small number of relevant studies, of which 7 were included. Three of these were animal studies, two cadaveric and two case series. The study quality was low or very low. There was significant methodological heterogeneity with difficulties encountered in the transfer of constructs from animal and cadaveric studies to humans. Issues faced included difficulties with hinge placement and pin site pain in motion. Conclusion The feasibility of hinged knee joint distraction has yet to be proven. Any further research attempting to establish the benefits of hinged-over static knee distraction will have to take construct design considerations into account. How to cite this article Lineham B, van Duren B, Harwood P, et al. The Feasibility of Hinged Knee Arthrodiastasis for Cartilage Regeneration: A Systematic Review of the Literature. Strategies Trauma Limb Reconstr 2023;18(1):37-43.
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Affiliation(s)
- Beth Lineham
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, United Kingdom
| | - Bernard van Duren
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, United Kingdom
| | - Paul Harwood
- Department of Trauma and Orthopaedics, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Hemant Pandit
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, United Kingdom
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3
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Teunissen M, Meij B, Snel L, Coeleveld K, Popov-Celeketic J, Ludwig I, Broere F, Lafeber F, Tryfonidou M, Mastbergen S. The catabolic-to-anabolic shift seen in the canine osteoarthritic cartilage treated with knee joint distraction occurs after the distraction period. J Orthop Translat 2022; 38:44-55. [PMID: 36313973 PMCID: PMC9589009 DOI: 10.1016/j.jot.2022.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 11/25/2022] Open
Abstract
Background Methods Results Conclusion The Translational Potential of this Article
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Affiliation(s)
- M. Teunissen
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht the Netherlands
| | - B.P. Meij
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht the Netherlands
| | - L. Snel
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht the Netherlands
| | - K. Coeleveld
- Rheumatology & Clinical Immunology, UMC Utrecht, Utrecht University, Utrecht the Netherlands
| | - J. Popov-Celeketic
- Rheumatology & Clinical Immunology, UMC Utrecht, Utrecht University, Utrecht the Netherlands
| | - I.S. Ludwig
- Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht the Netherlands
| | - F. Broere
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht the Netherlands,Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht the Netherlands
| | - F.P.J.G. Lafeber
- Rheumatology & Clinical Immunology, UMC Utrecht, Utrecht University, Utrecht the Netherlands
| | - M.A. Tryfonidou
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht the Netherlands
| | - S.C. Mastbergen
- Rheumatology & Clinical Immunology, UMC Utrecht, Utrecht University, Utrecht the Netherlands,Corresponding author. Rheumatology & Clinical Immunology, UMC Utrecht, F02.127, PO Box 85500, 3508 GA Utrecht, the Netherlands.
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4
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Abstract
Ankle distraction arthroplasty (DA) is a joint-preserving option for the treatment of ankle osteoarthritis. The ideal patient is a young, active person who is compliant with follow-up and understands that clinical improvements may not be fully evident until 1 year after surgery. The procedure promotes cartilage healing and regeneration by removing mechanical stress at the joint surface through the application of a joint-spanning external fixator. There is an array of adjuvant procedures commonly performed to optimize healing potential-including microfracture, osteophyte removal, osteotomies, and soft tissue balancing procedures. Short- and intermediate-term studies have been promising, though there is a wide variance in reported failure and complication rates.
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Affiliation(s)
- Alirio J deMeireles
- Department of Orthopedic Surgery, Columbia University Irving Medical Center/New York-Presbyterian Hospital, 622 West 168th Street, PH 11 - 1102, New York, NY 10032-3720, USA
| | - Ettore Vulcano
- Department of Orthopedic Surgery, Columbia University Orthopedics at Mount Sinai Medical Center, 4302 Alton Road, Suite 220, Miami Beach, FL 33140, USA.
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5
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Bauza‐Mayol G, Quintela M, Brozovich A, Hopson M, Shaikh S, Cabrera F, Shi A, Niclot FB, Paradiso F, Combellack E, Jovic T, Rees P, Tasciotti E, Francis LW, Mcculloch P, Taraballi F. Biomimetic Scaffolds Modulate the Posttraumatic Inflammatory Response in Articular Cartilage Contributing to Enhanced Neoformation of Cartilaginous Tissue In Vivo. Adv Healthc Mater 2022; 11:e2101127. [PMID: 34662505 DOI: 10.1002/adhm.202101127] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/28/2021] [Indexed: 12/13/2022]
Abstract
Focal chondral lesions of the knee are the most frequent type of trauma in younger patients and are associated with a high risk of developing early posttraumatic osteoarthritis. The only current clinical solutions include microfracture, osteochondral grafting, and autologous chondrocyte implantation. Cartilage tissue engineering based on biomimetic scaffolds has become an appealing strategy to repair cartilage defects. Here, a chondrogenic collagen-chondroitin sulfate scaffold is tested in an orthotopic Lapine in vivo model to understand the beneficial effects of the immunomodulatory biomaterial on the full chondral defect. Using a combination of noninvasive imaging techniques, histological and whole transcriptome analysis, the scaffolds are shown to enhance the formation of cartilaginous tissue and suppression of host cartilage degeneration, while also supporting tissue integration and increased tissue regeneration over a 12 weeks recovery period. The results presented suggest that biomimetic materials could be a clinical solution for cartilage tissue repair, due to their ability to modulate the immune environment in favor of regenerative processes and suppression of cartilage degeneration.
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Affiliation(s)
- Guillermo Bauza‐Mayol
- Center for Musculoskeletal Regeneration Houston Methodist Research Institute 6670 Bertner Ave. Houston TX 77030 USA
- Orthopedics & Sports Medicine Houston Methodist Hospital 6550 Fannin St. Houston TX 77030 USA
- Reproductive Biology and Gynaecological Oncology Group Swansea University Medical School Singleton Park Swansea SA2 8PP UK
| | - Marcos Quintela
- Reproductive Biology and Gynaecological Oncology Group Swansea University Medical School Singleton Park Swansea SA2 8PP UK
| | - Ava Brozovich
- Center for Musculoskeletal Regeneration Houston Methodist Research Institute 6670 Bertner Ave. Houston TX 77030 USA
- Orthopedics & Sports Medicine Houston Methodist Hospital 6550 Fannin St. Houston TX 77030 USA
- Texas A&M College of Medicine Bryan TX 77807 USA
| | - Michael Hopson
- Orthopedics & Sports Medicine Houston Methodist Hospital 6550 Fannin St. Houston TX 77030 USA
| | - Shazad Shaikh
- Orthopedics & Sports Medicine Houston Methodist Hospital 6550 Fannin St. Houston TX 77030 USA
| | - Fernando Cabrera
- Center for Musculoskeletal Regeneration Houston Methodist Research Institute 6670 Bertner Ave. Houston TX 77030 USA
- Orthopedics & Sports Medicine Houston Methodist Hospital 6550 Fannin St. Houston TX 77030 USA
| | - Aaron Shi
- Center for Musculoskeletal Regeneration Houston Methodist Research Institute 6670 Bertner Ave. Houston TX 77030 USA
- Orthopedics & Sports Medicine Houston Methodist Hospital 6550 Fannin St. Houston TX 77030 USA
| | - Federica Banche Niclot
- Center for Musculoskeletal Regeneration Houston Methodist Research Institute 6670 Bertner Ave. Houston TX 77030 USA
- Polytechnic of Turin Department of Applied Science and Technology Corso Duca degli Abruzzi 24 Torino 10129 Italy
| | - Francesca Paradiso
- Center for Musculoskeletal Regeneration Houston Methodist Research Institute 6670 Bertner Ave. Houston TX 77030 USA
- Orthopedics & Sports Medicine Houston Methodist Hospital 6550 Fannin St. Houston TX 77030 USA
- Reproductive Biology and Gynaecological Oncology Group Swansea University Medical School Singleton Park Swansea SA2 8PP UK
| | - Emman Combellack
- Reconstructive Surgery and Regenerative Medicine Research Group Swansea University Medical School Singleton Park Swansea SA2 8PP UK
| | - Tom Jovic
- Reconstructive Surgery and Regenerative Medicine Research Group Swansea University Medical School Singleton Park Swansea SA2 8PP UK
| | - Paul Rees
- Orthopedics & Sports Medicine Houston Methodist Hospital 6550 Fannin St. Houston TX 77030 USA
| | - Ennio Tasciotti
- IRCCS San Raffaele Pisana Via della Pisana 235 Rome 00163 Italy
| | - Lewis W. Francis
- Center for Musculoskeletal Regeneration Houston Methodist Research Institute 6670 Bertner Ave. Houston TX 77030 USA
| | - Patrick Mcculloch
- Orthopedics & Sports Medicine Houston Methodist Hospital 6550 Fannin St. Houston TX 77030 USA
| | - Francesca Taraballi
- Center for Musculoskeletal Regeneration Houston Methodist Research Institute 6670 Bertner Ave. Houston TX 77030 USA
- Orthopedics & Sports Medicine Houston Methodist Hospital 6550 Fannin St. Houston TX 77030 USA
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Tanideh N, Ashkani-Esfahani S, Sadeghi F, Koohi-Hosseinabadi O, Irajie C, Iraji A, Lubberts B, Mohammadi Samani S. The protective effects of grape seed oil on induced osteoarthritis of the knee in male rat models. J Orthop Surg Res 2020; 15:400. [PMID: 32912277 PMCID: PMC7488061 DOI: 10.1186/s13018-020-01932-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 08/31/2020] [Indexed: 12/15/2022] Open
Abstract
Background Osteoarthritis (OA), though being treated via various methods and medicines, is still a major healthcare concern mostly due to the increase in diagnosis of these age-related diseases. The present study aimed at investigating the effects of oral and intra articular injection of grape seed oil on OA in male rat models. Methods and materials Seventy male rats were selected and their anterior cruciate ligament was cut to induce OA. They were divided into 7 groups (n = 10): C1, no treatment; C2, receiving 300 mg/day of Piascledine per os (PO); C3, 1 mg sodium hyaluronate intra-articularly in days 1, 7, 14; C4, 1 mg methyl-prednisolone acetate intra-articularly; E1, avocado and grape seed oil combination (2:1, 300 mg/day) PO; E2, 500 mg/day of grape seed oil PO; E3, 200 mg/day grape seed oil intra-articularly. After 10 weeks, the rats were anesthetized and evaluated radiologically and histopathologically. P value ≤ 0.05 was considered as statistically significant. Results All the groups made significant differences with C1 regarding all inspected radiological criteria (P ≤ 0.05). E1 and E3 showed significantly better effects on medial femoral condyle, medial tibial condyle, joint space width, total osteophyte, and OA scores (P ≤ 0.04). Joint surface, matrix, cell distribution, cell population viability, calcification, and subchondral bone in treatment groups had significantly better scores versus C1 (P ≤ 0.04). E1 and E3 had significantly superior results regarding joint surface, cell viability, and calcification (P ≤ 0.04). Conclusions Grape seed oil has protective effects, both in injectable form and PO in combination with avocado, on OA in rats. Further clinical trials are necessary.
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Affiliation(s)
- Nader Tanideh
- Stem cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Pharmacology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soheil Ashkani-Esfahani
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. .,Foot and Ankle Research and Innovation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Farid Sadeghi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Omid Koohi-Hosseinabadi
- Stem cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Central Research Laboratory, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Cambyz Irajie
- Department of Medical Biotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Aida Iraji
- Central Research Laboratory, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bart Lubberts
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Foot and Ankle Research and Innovation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Soleiman Mohammadi Samani
- Center of Nanotechnology in Drug Delivery, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
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7
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Hypoxic mesenchymal stem cell-derived exosomes promote bone fracture healing by the transfer of miR-126. Acta Biomater 2020; 103:196-212. [PMID: 31857259 DOI: 10.1016/j.actbio.2019.12.020] [Citation(s) in RCA: 213] [Impact Index Per Article: 53.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/05/2019] [Accepted: 12/13/2019] [Indexed: 02/07/2023]
Abstract
Increasing evidence has suggested that paracrine mechanisms might be involved in the underlying mechanism of mesenchymal stem cells (MSCs) transplantation, and exosomes are an important component of this paracrine role. However, MSCs are usually exposed to normoxia (21% O2) in vitro but experience large differences in oxygen concentration in the body under hypoxia. Indeed, hypoxic precondition of MSCs can enhance their paracrine effects. The main purpose of this study was to determine whether exosomes derived from MSCs under hypoxia (Hypo-Exos) exhibit greater effects on bone fracture healing than those under normoxia (Exos). Using in vivo bone fracture model and in vitro experiments including cell proliferation assay, cell migration assay and so on, we confirmed that Hypo-Exos administration promoted angiogenesis, proliferation and migration to a greater extent when compared to Exos. Furthermore, utilizing a series in vitro and in vivo gain and loss of function experiments, we confirmed a functional role for exosomal miR-126 in the process of bone fracture healing. Meanwhile, we found that knockdown of hypoxia inducible factor 1 (HIF-1α) resulted in a significant decrease of miR-126 in MSCs and exosomes, thereby abolishing the effects of Hypo-Exos. In conclusion, our results demonstrated a mechanism by which Hypo-Exos promote bone fracture healing through exosomal miR-126. Moreover, hypoxia preconditioning mediated enhanced production of exosomal miR-126 through the activation of HIF-1α. Hypoxia preconditioning represents an effective and promising method for the optimization of the therapeutic actions of MSC-derived exosomes for bone fracture healing. STATEMENT OF SIGNIFICANCE: Studies have confirmed that transplantation of exosomes exhibit similar therapeutic effects and functional properties to directly-transplanted stem cells but have less significant adverse effects. However, during in vitro culture conditions, MSCs are usually exposed to normoxia (21% O2) which is very different to the oxygen concentrations found in the body under natural physiological conditions. Our results demonstrated a mechanism by which Hypo-Exos promote bone fracture healing through exosomal miR-126 and the SPRED1/Ras/Erk signaling pathway. Moreover, hypoxia preconditioning mediated enhanced production of exosomal miR-126 through the activation of HIF-1α. Hypoxia preconditioning represents an effective and promising method for the optimization of the therapeutic actions of MSC-derived exosomes for bone fracture healing.
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8
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Haleem AM, Galal S, Nwawka OK, Balagadde A, Borst EW, Do HT, Mintz DN, Fragomen AT, Rozbruch SR. Short-term Results of Magnetic Resonance Imaging after Ankle Distraction Arthroplasty. Strategies Trauma Limb Reconstr 2020; 15:157-162. [PMID: 34025796 PMCID: PMC8121115 DOI: 10.5005/jp-journals-10080-1512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Ankle distraction arthroplasty has emerged as an alternative treatment for ankle arthritis. There are few reports on the magnetic resonance imaging (MRI) findings after distraction arthroplasty. This study sought to determine whether there are positive changes on MRI after ankle distraction and improvements on X-ray. Additionally, patient-reported outcomes and joint range of motion (ROM) after ankle distraction are described. Materials and methods Thirty-two patients (mean age 49 years) who underwent ankle distraction had pre-operative and one-year postoperative MRIs, which were graded using a modified whole-organ magnetic resonance imaging score (WORMS). Ankle joint space and ROM were measured. A non-validated three-item questionnaire was administered to assess functional outcomes. Results Although the anterior quadrant of the ankle showed a trend to improvement in cartilage morphology on the postoperative MRI, the WORMS did not demonstrate a significant difference in any of its subcategories. While reduction in joint osteophytes was observed and maintained short term, this was mainly due to resection intraoperatively. X-rays revealed a significant increase in joint space, and there was a significant increase in ankle dorsiflexion. Eight-seven percent of the patients were satisfied with their functional outcome. Conclusion At short-term follow-up, MRI scores after ankle distraction arthroplasty did not demonstrate significant improvement despite positive changes on X-ray and improved clinical outcomes and ankle ROM. Further study on larger patient numbers with longer follow-up is required. Level of evidence IV, Case Series How to cite this article Haleem AM, Galal S, Nwawka OK, et al. Short-term Results of Magnetic Resonance Imaging after Ankle Distraction Arthroplasty. Strategies Trauma Limb Reconstr 2020;15(3):157–162.
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Affiliation(s)
| | | | - Ogonna K Nwawka
- Department of Radiology and Imaging, Hospital for Special Surgery, Weill Cornell Medical College, Cornell University, New York, United States
| | | | - Eugene W Borst
- Limb Lengthening and Complex Reconstruction Service, Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Cornell Medical College, Cornell University, New York, United States
| | - Huong T Do
- Department of Clinical Data Core, Healthcare Research Institute, Hospital for Special Surgery, New York, United States
| | - Douglas N Mintz
- Department of Radiology and Imaging, Hospital for Special Surgery, Weill Cornell Medical College, Cornell University, New York, United States
| | - Austin T Fragomen
- Limb Lengthening and Complex Reconstruction Service, Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Cornell Medical College, Cornell University, New York, United States
| | - S Robert Rozbruch
- Limb Lengthening and Complex Reconstruction Service, Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Cornell Medical College, Cornell University, New York, United States
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9
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Spitters TW, Stamatialis D, Petit A, Leeuw MGD, Karperien M. In Vitro Evaluation of Small Molecule Delivery into Articular Cartilage: Effect of Synovial Clearance and Compressive Load. Assay Drug Dev Technol 2019; 17:191-200. [DOI: 10.1089/adt.2018.907] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Tim W.G.M. Spitters
- Department of Developmental BioEngineering, MIRA Institute, University of Twente, Enschede, The Netherlands
| | - Dimitrios Stamatialis
- Biomaterials Science and Technology Group, MIRA Institute, University of Twente, Enschede, The Netherlands
| | | | | | - Marcel Karperien
- Department of Developmental BioEngineering, MIRA Institute, University of Twente, Enschede, The Netherlands
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10
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Ewalefo SO, Dombrowski M, Hirase T, Rocha JL, Weaver M, Kline A, Carney D, Hogan MV. Management of Posttraumatic Ankle Arthritis: Literature Review. Curr Rev Musculoskelet Med 2018; 11:546-557. [PMID: 30327933 PMCID: PMC6220012 DOI: 10.1007/s12178-018-9525-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW Trauma is the principle cause of osteoarthritis in the ankle, which is associated with significant morbidity. This review highlights the current literature for the purpose of bringing the reader up-to-date on the management of posttraumatic ankle arthritis, describing treatment efficacy, indications, contraindications, and complications. RECENT FINDINGS Recent studies on osteoarthritis have demonstrated variability among anatomic locations regarding the mechanisms and rates of development for posttraumatic osteoarthritis, which are attributed to newly discovered biological differences intrinsic to each joint. Regarding surgical management of posttraumatic ankle arthritis, osteochondral allograft transplantation of the talus, and supramalleolar osteotomies have demonstrated promising results. Additionally, the outpatient setting was found to be appropriate for managing pain following total ankle arthroplasty, associated with low complication rates and no readmission. Management for posttraumatic ankle arthritis is generally progressive. Initial treatment entails nonpharmacologic options with surgery reserved for posttraumatic ankle arthritis refractory to conservative treatment. Patient demographics and lifestyles should be carefully considered when formulating a management strategy, as outcomes are dependent upon the satisfaction of each set of respective criteria. Ultimately, the management of posttraumatic ankle arthritis should be individualized to satisfy the needs and desires, which are specific to each patient.
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Affiliation(s)
- Samuel O Ewalefo
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
- Texas A&M College of Medicine, Bryan, TX, USA.
| | - Malcolm Dombrowski
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Takashi Hirase
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, TX, USA
| | - Jorge L Rocha
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Mitchell Weaver
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Alex Kline
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Dwayne Carney
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - MaCalus V Hogan
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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11
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Park IS, Jin RL, Oh HJ, Truong MD, Choi BH, Park SH, Park DY, Min BH. Sizable Scaffold-Free Tissue-Engineered Articular Cartilage Construct for Cartilage Defect Repair. Artif Organs 2018; 43:278-287. [PMID: 30374978 DOI: 10.1111/aor.13329] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 06/25/2018] [Accepted: 07/05/2018] [Indexed: 12/21/2022]
Abstract
This study introduces an implantable scaffold-free cartilage tissue construct (SF) that is composed of chondrocytes and their self-produced extracellular matrix (ECM). Chondrocytes were grown in vitro for up to 5 weeks and subjected to various assays at different time points (1, 7, 21, and 35 days). For in vivo implantation, full-thickness defects (n = 5) were manually created on the trochlear groove of the both knees of rabbits (16-week old) and 3 week-cultured SF construct was implanted as an allograft for a month. The left knee defects were implanted with 1, 7, and 21 days in vitro cultured scaffold-free engineered cartilages. (group 2, 3, and 4, respectively). The maturity of the engineered cartilages was evaluated by histological, chemical and mechanical assays. The repair of damaged cartilages was also evaluated by gross images and histological observations at 4, 8, and 12 weeks postsurgery. Although defect of groups 1, 2, and 3 were repaired with fibrocartilage tissues, group 4 (21 days) showed hyaline cartilage in the histological observation. In particular, mature matrix and columnar organization of chondrocytes and highly expressed type II collagen were observed only in 21 days in vitro cultured SF cartilage (group 4) at 12 weeks. As a conclusion, cartilage repair with maturation was recapitulated when implanted the 21 day in vitro cultured scaffold-free engineered cartilage. When implanting tissue-engineered cartilage, the maturity of the cartilage tissue along with the cultivation period can affect the cartilage repair.
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Affiliation(s)
- In-Su Park
- Cell Therapy Center, Ajou University Medical center, Suwon, Korea
| | - Ri Long Jin
- Department of Orthopaedic Surgery, Ajou University, Suwon, Korea
| | - Hyun Ju Oh
- Department of Molecular Science and Technology, Ajou University, Suwon, Korea
| | - Minh-Dung Truong
- Cell Therapy Center, Ajou University Medical center, Suwon, Korea
| | - Byung Hyune Choi
- Division of Biomedical Sciences, Inha University, Incheon, Korea
| | - Sang-Hyug Park
- Department of Biomedical Engineering, Pukyong National University, Busan, Korea
| | - Do Young Park
- Cell Therapy Center, Ajou University Medical center, Suwon, Korea.,Department of Orthopaedic Surgery, Ajou University, Suwon, Korea
| | - Byoung-Hyun Min
- Cell Therapy Center, Ajou University Medical center, Suwon, Korea.,Department of Orthopaedic Surgery, Ajou University, Suwon, Korea.,Department of Molecular Science and Technology, Ajou University, Suwon, Korea
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12
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Ruta DJ, Villarreal AD, Richardson DR. Orthopedic Surgical Options for Joint Cartilage Repair and Restoration. Phys Med Rehabil Clin N Am 2018; 27:1019-1042. [PMID: 27788899 DOI: 10.1016/j.pmr.2016.06.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The limited natural capacity for articular cartilage to regenerate has led to a continuously broadening array of surgical interventions. Used once patients' symptoms are not relieved by nonoperative management, these share the goals of joint preservation and restoration. Techniques include bone marrow stimulation, whole-tissue transplantation, and cell-based strategies, each with its own variations. Many of these interventions are performed arthroscopically or with extended-portal techniques. Indications, operative techniques, unique benefits, and limitations are presented.
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Affiliation(s)
- David J Ruta
- St. Luke's Department of Orthopedics & Sports Medicine, Duluth, MN, USA.
| | - Arturo D Villarreal
- Department of Orthopaedic Surgery & Biomedical Engineering, University of Tennessee-Campbell Clinic, Memphis, TN, USA
| | - David R Richardson
- Department of Orthopaedic Surgery & Biomedical Engineering, University of Tennessee-Campbell Clinic, Memphis, TN, USA
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13
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Abstract
Ankle distraction is an alternative to ankle arthrodesis or total ankle arthroplasty in younger patients with arthritis. Ankle distraction involves the use of external fixation to mechanically unload the ankle joint, which allows for stable, congruent range of motion in the setting of decreased mechanical loading, potentially promoting cartilage repair. Adjunct surgical procedures are frequently done to address lower-extremity malalignment, ankle equinus contractures, and impinging tibiotalar osteophytes. Patients can bear full weight during the treatment course. The distraction frame frequently uses a hinge, and patients are encouraged to do daily range-of-motion exercises. Although the initial goal of the procedure is to delay arthrodesis, many patients achieve lasting clinical benefits, obviating the need for total ankle arthroplasty or fusion. Complications associated with external fixation are common, and patients should be counseled that clinical improvements occur slowly and often are not achieved until at least 1 year after frame removal.
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14
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Eleotério RB, Sepúlveda RV, Reis EC, Valente FL, Borges AP. Isolation, expansion and differentiation of mesenchymal stromal cells from rabbits' bone marrow. PESQUISA VETERINARIA BRASILEIRA 2016. [DOI: 10.1590/s0100-736x2016000500012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Abstract: Tissue engineering has been a fundamental technique in the regenerative medicine field, once it permits to build tri-dimensional tissue constructs associating undifferentiated mesenchymal cells (or mesenchymal stromal cells - MSCs) and scaffolds in vitro. Therefore, many studies have been carried out using these cells from different animal species, and rabbits are often used as animal model for in vivo tissue repair studies. However, most of the information available about MSCs harvesting and characterization is about human and murine cells, which brings some doubts to researchers who desire to work with a rabbit model in tissue repair studies based on MSCs. In this context, this study aimed to add and improve the information available in the scientific literature providing a complete technique for isolation, expansion and differentiation of MSCs from rabbits. Bone marrow mononuclear cells (BMMCs) from humerus and femur of rabbits were obtained and to evaluate their proliferation rate, three different culture media were tested, here referred as DMEM-P, DMEM´S and α-MEM. The BMMCs were also cultured in osteogenic, chondrogenic and adipogenic induction media to prove their multipotentiality. It was concluded that the techniques suggested in this study can provide a guideline to harvest and isolate MSCs from bone marrow of rabbits in enough amount to allow their expansion and, based on the laboratory experience where the study was developed, it is also suggested a culture media formulation to provide a better cell proliferation rate with multipotentiality preservation.
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15
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Szivek JA, Ruth JT, Heden GJ, Martinez MA, Diggins NH, Wenger KH. Determination of joint loads using new sensate scaffolds for regenerating large cartilage defects in the knee. J Biomed Mater Res B Appl Biomater 2016; 105:1409-1421. [DOI: 10.1002/jbm.b.33677] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 01/14/2016] [Accepted: 03/20/2016] [Indexed: 11/09/2022]
Affiliation(s)
- John A. Szivek
- Orthopaedic Research Lab; University of Arizona; Tucson Arizona
| | - John T. Ruth
- Orthopaedic Research Lab; University of Arizona; Tucson Arizona
| | - Greg J. Heden
- Orthopaedic Research Lab; University of Arizona; Tucson Arizona
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16
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Madonna V, Condello V, Piovan G, Screpis D, Zorzi C. Use of the KineSpring system in the treatment of medial knee osteoarthritis: preliminary results. JOINTS 2016; 3:129-35. [PMID: 26889469 DOI: 10.11138/jts/2015.3.3.129] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE the purpose of this study was to analyze our preliminary results obtained with the KineSpring system in patients suffering from medial compartment knee osteoarthritis (OA). METHODS between September 2012 and May 2014, 53 patients underwent treatment with the KineSpring system. Patient self-assessment was performed pre-operatively and at 3, 6 and 12 months postoperatively, and included the KOOS, Tegner activity score, Lysholm functional knee score, VAS knee pain score, and IKDC score. Device- and procedure-related adverse events were recorded. RESULTS mean KOOS subscales, except for the Sport/Recreation subscale at six months, improved over time. Mean WOMAC Pain and Function domains, Lysholm score, IKDC score and VAS knee pain score improved over the follow-up period and were significantly improved at 3, 6 and 12 months postoperatively compared to baseline. Mean Tegner score improved slightly over time. In 5 of the 53 (9.4%) patients re-operation was necessary. In 3 patients the device was removed due to infection (one case) or persistent knee pain (two cases). Surgical arthrolysis was performed in two patients. CONCLUSIONS in our preliminary experience, the KineSpring system gave good short-term clinical results. LEVEL OF EVIDENCE Level IV, therapeutic case series.
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Affiliation(s)
- Vincenzo Madonna
- Department of Orthopaedics, Sacro Cuore Don Calabria Hospital, Negrar (VR), Italy
| | - Vincenzo Condello
- Department of Orthopaedics, Sacro Cuore Don Calabria Hospital, Negrar (VR), Italy
| | | | | | - Claudio Zorzi
- Department of Orthopaedics, Sacro Cuore Don Calabria Hospital, Negrar (VR), Italy
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17
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Moran CJ, Ramesh A, Brama PAJ, O'Byrne JM, O'Brien FJ, Levingstone TJ. The benefits and limitations of animal models for translational research in cartilage repair. J Exp Orthop 2016; 3:1. [PMID: 26915001 PMCID: PMC4703594 DOI: 10.1186/s40634-015-0037-x] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 12/28/2015] [Indexed: 12/31/2022] Open
Abstract
Much research is currently ongoing into new therapies for cartilage defect repair with new biomaterials frequently appearing which purport to have significant regenerative capacity. These biomaterials may be classified as medical devices, and as such must undergo rigorous testing before they are implanted in humans. A large part of this testing involves in vitro trials and biomechanical testing. However, in order to bridge the gap between the lab and the clinic, in vivo preclinical trials are required, and usually demanded by regulatory approval bodies. This review examines the in vivo models in current use for cartilage defect repair testing and the relevance of each in the context of generated results and applicability to bringing the device to clinical practice. Some of the preclinical models currently used include murine, leporine, ovine, caprine, porcine, canine, and equine models. Each of these has advantages and disadvantages in terms of animal husbandry, cartilage thickness, joint biomechanics and ethical and licencing issues. This review will examine the strengths and weaknesses of the various animal models currently in use in preclinical studies of cartilage repair.
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Affiliation(s)
- Conor J Moran
- Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland.,Trinity Centre for Bioengineering, Trinity College Dublin, Dublin 2, Ireland.,Advanced Materials and Bioengineering Research (AMBER) Centre, RCSI & TCD, Dublin, Ireland
| | - Ashwanth Ramesh
- Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland.,Trinity Centre for Bioengineering, Trinity College Dublin, Dublin 2, Ireland.,Advanced Materials and Bioengineering Research (AMBER) Centre, RCSI & TCD, Dublin, Ireland
| | - Pieter A J Brama
- Section of Veterinary Clinical Sciences, School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - John M O'Byrne
- Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland.,Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland
| | - Fergal J O'Brien
- Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland.,Trinity Centre for Bioengineering, Trinity College Dublin, Dublin 2, Ireland.,Advanced Materials and Bioengineering Research (AMBER) Centre, RCSI & TCD, Dublin, Ireland
| | - Tanya J Levingstone
- Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland. .,Trinity Centre for Bioengineering, Trinity College Dublin, Dublin 2, Ireland. .,Advanced Materials and Bioengineering Research (AMBER) Centre, RCSI & TCD, Dublin, Ireland.
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18
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Chen Y, Sun Y, Pan X, Ho K, Li G. Joint distraction attenuates osteoarthritis by reducing secondary inflammation, cartilage degeneration and subchondral bone aberrant change. Osteoarthritis Cartilage 2015; 23:1728-35. [PMID: 26028135 DOI: 10.1016/j.joca.2015.05.018] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Revised: 05/15/2015] [Accepted: 05/21/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Osteoarthritis (OA) is a progressive joint disorder. To date, there is not effective medical therapy. Joint distraction has given us hope for slowing down the OA progression. In this study, we investigated the benefits of joint distraction in OA rat model and the probable underlying mechanisms. METHODS OA was induced in the right knee joint of rats through anterior cruciate ligament transaction (ACLT) plus medial meniscus resection. The animals were randomized into three groups: two groups were treated with an external fixator for a subsequent 3 weeks, one with and one without joint distraction; and one group without external fixator as OA control. Serum interleukin-1β level was evaluated by ELISA; cartilage quality was assessed by histology examinations (gross appearance, Safranin-O/Fast green stain) and immunohistochemistry examinations (MMP13, Col X); subchondral bone aberrant changes was analyzed by micro-CT and immunohistochemistry (Nestin, Osterix) examinations. RESULTS Characters of OA were present in the OA group, contrary to in general less severe damage after distraction treatment: firstly, IL-1β level was significantly decreased; secondly, cartilage degeneration was attenuated with lower histologic damage scores and the lower percentage of MMP13 or Col X positive chondrocytes; finally, subchondral bone abnormal change was attenuated, with reduced bone mineral density (BMD) and bone volume/total tissue volume (BV/TV) and the number of Nestin or Osterix positive cells in the subchondral bone. CONCLUSION In the present study, we demonstrated that joint distraction reduced the level of secondary inflammation, cartilage degeneration and subchondral bone aberrant change, joint distraction may be a strategy for slowing OA progression.
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Affiliation(s)
- Y Chen
- Department of Orthopaedics & Traumatology, Li Ka Shing Institute of Health Sciences and Lui Che Woo Institute of Innovative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, PR China; The CUHK-ACC Space Medicine Centre on Health Maintenance of Musculoskeletal System, The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, PR China
| | - Y Sun
- Department of Orthopaedics & Traumatology, Li Ka Shing Institute of Health Sciences and Lui Che Woo Institute of Innovative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, PR China; The CUHK-ACC Space Medicine Centre on Health Maintenance of Musculoskeletal System, The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, PR China
| | - X Pan
- Department of Orthopaedics and Traumatology, Bao-An District People's Hospital, Shenzhen, PR China
| | - K Ho
- Department of Orthopaedics & Traumatology, Li Ka Shing Institute of Health Sciences and Lui Che Woo Institute of Innovative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, PR China; The CUHK-ACC Space Medicine Centre on Health Maintenance of Musculoskeletal System, The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, PR China.
| | - G Li
- Department of Orthopaedics & Traumatology, Li Ka Shing Institute of Health Sciences and Lui Che Woo Institute of Innovative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, PR China; The CUHK-ACC Space Medicine Centre on Health Maintenance of Musculoskeletal System, The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, PR China; Key Laboratory for Regenerative Medicine, Ministry of Education, School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, PR China.
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19
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Harada Y, Nakasa T, Mahmoud EE, Kamei G, Adachi N, Deie M, Ochi M. Combination therapy with intra-articular injection of mesenchymal stem cells and articulated joint distraction for repair of a chronic osteochondral defect in the rabbit. J Orthop Res 2015; 33:1466-73. [PMID: 26174695 DOI: 10.1002/jor.22922] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 04/07/2015] [Indexed: 02/04/2023]
Abstract
The present study investigated intra-articular injection of bone-marrow-derived mesenchymal stem cells (MSCs) combined with articulated joint distraction as treatment for osteochondral defects. Large osteochondral defects were created in the weight-bearing area of the medial femoral condyle in rabbit knees. Four weeks after defect creation, rabbits were divided into six groups: control group, MSC group, distraction group, distraction + MSC group, temporary distraction group, and temporary distraction + MSC group. Groups with MSC received intra-articular injection of MSCs. Groups with distraction underwent articulated distraction arthroplasty. Groups with temporary distraction discontinued the distraction after 4 weeks. The rabbits were euthanized at 4, 8, and 12 weeks after treatment except temporary distraction groups which were euthanized at only 12 weeks. Histological scores in the distraction + MSC group were significantly better than in the control, MSC group or distraction group at 4 and 8 weeks, but showed no further improvement. At 12 weeks, the temporary distraction + MSC group showed the best results, demonstrating hyaline cartilage repair with regeneration of the osteochondral junction. In conclusion, joint distraction with intra-articular injection of MSCs promotes early cartilage repair, and compressive loading of the repair tissue after temporary distraction stimulates articular cartilage regeneration.
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Affiliation(s)
- Yohei Harada
- Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Tomoyuki Nakasa
- Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Elhussein Elbadry Mahmoud
- Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Goki Kamei
- Department of Orthopaedic Surgery, Miyoshi Central Hospital, 531 Higashisakeyamachi, Miyoshi, Hiroshima, 728-8502, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Masataka Deie
- Department of Musculoskeletal Functional Research and Regeneration, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Mitsuo Ochi
- Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
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20
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Vilela CA, Correia C, Oliveira JM, Sousa RA, Espregueira-Mendes J, Reis RL. Cartilage Repair Using Hydrogels: A Critical Review of in Vivo Experimental Designs. ACS Biomater Sci Eng 2015; 1:726-739. [DOI: 10.1021/acsbiomaterials.5b00245] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- C. A. Vilela
- 3B’s
Research Group, University of Minho, Guimarães, Portugal
- ICVS/3B’s−PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Life
and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
- Orthopaedic
Department, Centro Hospitalar do Alto Ave, Guimarães, Portugal
| | - C. Correia
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Guimarães, Portugal
| | - J. M. Oliveira
- 3B’s
Research Group, University of Minho, Guimarães, Portugal
- ICVS/3B’s−PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - R. A. Sousa
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Guimarães, Portugal
| | - J. Espregueira-Mendes
- 3B’s
Research Group, University of Minho, Guimarães, Portugal
- ICVS/3B’s−PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Life
and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
- Clínica
do Dragão, Espregueira-Mendes Sports Centre, Porto, Portugal
| | - R. L. Reis
- 3B’s
Research Group, University of Minho, Guimarães, Portugal
- ICVS/3B’s−PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Guimarães, Portugal
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21
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Hopper N, Wardale J, Brooks R, Power J, Rushton N, Henson F. Peripheral Blood Mononuclear Cells Enhance Cartilage Repair in in vivo Osteochondral Defect Model. PLoS One 2015; 10:e0133937. [PMID: 26252391 PMCID: PMC4529143 DOI: 10.1371/journal.pone.0133937] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 07/02/2015] [Indexed: 02/07/2023] Open
Abstract
This study characterized peripheral blood mononuclear cells (PBMC) in terms of their potential in cartilage repair and investigated their ability to improve the healing in a pre-clinical large animal model. Human PBMCs were isolated with gradient centrifugation and adherent PBMC’s were evaluated for their ability to differentiate into adipogenic, chondrogenic and osteogenic lineages and also for their expression of musculoskeletal genes. The phenotype of the PBMCs was evaluated using Stro-1, CD34, CD44, CD45, CD90, CD106, CD105, CD146 and CD166 cell surface markers. Osteochondral defects were created in the medial femoral condyle (MFC) of 24 Welsh mountain sheep and evaluated at a six month time point. Four cell treatment groups were evaluated in combination with collagen-GAG-scaffold: (1) MSC alone; (2) MSCs and PBMCs at a ratio of 20:1; (3) MSCs and PBMC at a ratio of 2:1 and (4) PBMCs alone. Samples from the surgical site were evaluated for mechanical properties, ICRS score and histological repair. Fresh PBMC samples were 90% positive for hematopoietic cell surface markers and negative for the MSC antibody panel (<1%, p = 0.006). However, the adherent PBMC population expressed mesenchymal stem cell markers in hypoxic culture and lacked CD34/45 positive cells (<0.2%). This finding demonstrated that the adherent cells had acquired an MSC-like phenotype and transformed in hypoxia from their original hematopoietic lineage. Four key genes in muskuloskeletal biology were significantly upregulated in adherent PBMCs by hypoxia: BMP2 4.2-fold (p = 0.0007), BMP6 10.7-fold (p = 0.0004), GDF5 2.0-fold (p = 0.002) and COL1 5.0-fold (p = 0.046). The monolayer multilineage analysis confirmed the trilineage mesenchymal potential of the adherent PBMCs. PBMC cell therapy was equally good as bone marrow MSC therapy for defects in the ovine large animal model. Our results show that PBMCs support cartilage healing and oxygen tension of the environment was found to have a key effect on the derivation of a novel adherent cell population with an MSC-like phenotype. This study presents a novel and easily attainable point-of-care cell therapy with PBMCs to treat osteochondral defects in the knee avoiding any cell manipulations outside the surgical room.
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Affiliation(s)
- Niina Hopper
- Division of Trauma and Orthopaedic Surgery, University of Cambridge, Addenbrooke's Hospital, Cambridge, BC2 0QQ, the United Kingdom
- * E-mail:
| | - John Wardale
- Division of Trauma and Orthopaedic Surgery, University of Cambridge, Addenbrooke's Hospital, Cambridge, BC2 0QQ, the United Kingdom
| | - Roger Brooks
- Division of Trauma and Orthopaedic Surgery, University of Cambridge, Addenbrooke's Hospital, Cambridge, BC2 0QQ, the United Kingdom
| | - Jonathan Power
- Department of Biological Sciences, University of Chester, Chester, CH1 4BJ, the United Kingdom
| | - Neil Rushton
- Division of Trauma and Orthopaedic Surgery, University of Cambridge, Addenbrooke's Hospital, Cambridge, BC2 0QQ, the United Kingdom
| | - Frances Henson
- Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, the United Kingdom
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22
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Wiegant K, Intema F, Roermund PM, Barten‐van Rijbroek AD, Doornebal A, Hazewinkel HAW, Lafeber FPJG, Mastbergen SC. Evidence of Cartilage Repair by Joint Distraction in a Canine Model of Osteoarthritis. Arthritis Rheumatol 2015; 67:465-74. [DOI: 10.1002/art.38906] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 10/02/2014] [Indexed: 12/24/2022]
Affiliation(s)
- Karen Wiegant
- University Medical Center UtrechtUtrechtThe Netherlands
| | - Femke Intema
- University Medical Center UtrechtUtrechtThe Netherlands
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23
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Effect of intra-articular injection of mesenchymal stem cells in cartilage repair in experimental animals. EGYPTIAN RHEUMATOLOGIST 2014. [DOI: 10.1016/j.ejr.2014.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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24
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Ugaji S, Watanabe K, Matsubara H, Nomura I, Aikawa T, Tsuchiya H. Simultaneous arthrodiastasis and deformity correction for a patient with ankle osteoarthritis and lower limb deformity: a case report. Foot Ankle Surg 2014; 20:74-8. [PMID: 24480506 DOI: 10.1016/j.fas.2013.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 10/23/2013] [Indexed: 02/04/2023]
Abstract
We here report a case of a 50-year-old male with ankle osteoarthritis and lower limb deformity, for which simultaneous deformity correction and arthrodiastasis were performed. The patient initially experienced an open fracture on the left tibia at 19 years, but it was malunited. The Japanese Society for Surgery score of the foot for the left ankle was 53 points. X-ray and CT imaging showed rotational and angular tibial deformities with shortening by 1.6cm and end-stage osteoarthritis of the left ankle. An external fixator was applied to correct the lower limb deformity, and ankle arthrodiastasis was performed. A good result was achieved in alignment correction and joint function. The patient had an improved clinical score of 98 points at a 2-year followup. We found that external fixation was useful because external fixator is the only appropriate instrument by which arthrodiastasis and deformity correction for ankle osteoarthritis can be simultaneously performed.
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Affiliation(s)
- Shuhei Ugaji
- Department of Orthopedic Surgery, Kanazawa University Hospital, Kanazawa, Japan
| | - Koji Watanabe
- Department of Orthopedic Surgery, Kanazawa University Hospital, Kanazawa, Japan.
| | - Hidenori Matsubara
- Department of Orthopedic Surgery, Kanazawa University Hospital, Kanazawa, Japan
| | - Issei Nomura
- Department of Orthopedic Surgery, Kanazawa University Hospital, Kanazawa, Japan
| | - Takao Aikawa
- Department of Orthopedic Surgery, Kanazawa University Hospital, Kanazawa, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopedic Surgery, Kanazawa University Hospital, Kanazawa, Japan
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25
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Szivek JA, Heden GJ, Geffre CP, Wenger KH, Ruth JT. In vivotelemetric determination of shear and axial loads on a regenerative cartilage scaffold following ligament disruption. J Biomed Mater Res B Appl Biomater 2014; 102:1415-25. [DOI: 10.1002/jbm.b.33120] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 12/03/2013] [Accepted: 01/30/2014] [Indexed: 01/01/2023]
Affiliation(s)
- John A. Szivek
- Orthopaedic Research Lab; Orthopaedic Surgery, University of Arizona; Tucson Arizona
| | - Gregory J. Heden
- Orthopaedic Research Lab; Orthopaedic Surgery, University of Arizona; Tucson Arizona
| | - Christopher P. Geffre
- Orthopaedic Research Lab; Orthopaedic Surgery, University of Arizona; Tucson Arizona
| | | | - John T. Ruth
- Orthopaedic Research Lab; Orthopaedic Surgery, University of Arizona; Tucson Arizona
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26
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Abstract
For select patients, distraction ankle arthroplasty may be a promising treatment approach for ankle osteoarthritis; however, there is still limited literature addressing its efficacy and clinical long-term results. In this article, the literature regarding the outcome after ankle distraction arthroscopy is reviewed, the indications and contraindication for this procedure are listed, our surgical technique is described, and our preliminary results with this procedure are presented.
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Affiliation(s)
- Alexej Barg
- Orthopaedic Department, University Hospital of Basel, University of Basel, Spitalstrasse 21, Basel CH-4031, Switzerland
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27
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Kamisan N, Naveen SV, Ahmad RE, Kamarul T, Tunku K. Chondrocyte density, proteoglycan content and gene expressions from native cartilage are species specific and not dependent on cartilage thickness: a comparative analysis between rat, rabbit and goat. BMC Vet Res 2013; 9:62. [PMID: 23547659 PMCID: PMC3648397 DOI: 10.1186/1746-6148-9-62] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 03/27/2013] [Indexed: 11/17/2022] Open
Abstract
Background In many pre-clinical studies of cartilage tissue, it has been generally assumed that the major difference of the tissue between the species is the tissue thickness, which is related to the size of the animal itself. At present, there appear to be lack of studies demonstrating the relationship between chondrocyte densities, protein content, gene expressions and cartilage thickness in the various animal models that are commonly used. The present study was conducted to determine whether or not chondrocyte density, proteoglycan/protein content and selective chondrocyte gene expression are merely related to the cartilage thickness (thus animal size), and not the intrinsic nature of the species being investigated. Mature animals (rabbit, rats and goats) were sacrificed for their hind knee cartilages. Image analyses were performed on five consecutive histological sections, sampled from three pre-defined locations at the lateral and medial femoral condyles. Cartilage thickness, chondrocyte density, Glycosaminoglycan (GAGs)/protein content and gene expression levels for collagen II and SOX-9 were compared across the groups. Correlation analysis was done between cartilage thickness and the other variables. Results The mean cartilage thickness of rats, rabbits and goats were 166.5 ± 10.9, 356.2 ± 25.0 907.5 ± 114.6 μm, respectively. The mean cartilage cell densities were 3.3 ± 0.4×10-3 for rats, 2.6 ± 0.3×10-3 for rabbits and 1.3 ± 0.2×10-3 cells/μm2 for goats. The mean μg GAG/mg protein content were 23.8 ± 8.6 in rats, 20.5 ± 5.3 in rabbits and 328.7 ± 64.5 in goats; collagen II gene expressions were increased by 0.5 ± 0.1 folds in rats; 0.6 ± 0.1 folds in rabbits, and 0.1 ± 0.1 folds in goats, whilst the fold increase of SOX-9 gene expression was 0.5 ± 0.1 in rats, 0.7 ± 0.1 in rabbits and 0.1 ± 0.0 in goats. Cartilage thickness correlated positively with animals’ weight (R2 =0.9856, p = 0.001) and GAG/protein content (R2 =0.6163, p = <0.001). Whereas, it correlates negatively with cell density (R2 = 0.7981, p < 0.001) and cartilage gene expression levels (R2 = 0.6395, p < 0.001). Conclusion There are differences in the composition of the articular cartilage in diverse species, which are not directly dependent on the cartilage thickness of these animals but rather the unique characteristics of that species. Therefore, the species-specific nature of the cartilage tissue should be considered during any data interpretation.
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Kamei G, Ochi M, Okuhara A, Fujimiya M, Deie M, Adachi N, Nakamae A, Nakasa T, Ohkawa S, Takazawa K, Eguchi A, Katou T, Takada T, Usman MA. A new distraction arthroplasty device using magnetic force; a cadaveric study. Clin Biomech (Bristol, Avon) 2013; 28:423-8. [PMID: 23498961 DOI: 10.1016/j.clinbiomech.2013.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 01/09/2013] [Accepted: 02/07/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND It is difficult for an articular cartilage injury to repair spontaneously. There are many procedures for treating cartilage injury, however there is no standard procedure for middle-aged patients who have diffuse knee osteoarthritis, especially of the lateral compartment. Therefore, Ochi developed a new distraction device that uses magnetic power to enlarge a joint space and promote cartilage regeneration with microfracture. The purpose of this study is to evaluate this new distraction arthroplasty system by using the cadaveric knee. METHODS This study used ten knees from six cadavers that were embalmed by Thiel's methods. The medial and lateral joint space was measured by AP radiographic view before and after distraction, and after weight-bearing to evaluate the joint distraction. The contact pressure of the medial and lateral compartments at the knee extension position by using a prescale film system was measured before and after weight-bearing with a 15 or 30-kg weight-bearing load to evaluate the effectiveness of this device. FINDINGS The lateral joint space significantly increased from the pre-distraction to the post-distraction; however, it did not change significantly between post-distraction and post-weight-bearing. With a 15 or 30-kg weight-bearing load, the contact pressure of the lateral compartment significantly decreased from the pre-distraction to the post-distraction. INTERPRETATION The most important advantage of this device is that it maintains a continuous distraction tension and enables almost the full range of motion of the knee. We believe that joint distraction by using magnetic force can be a promising option for cartilage injury in middle-aged patients.
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Affiliation(s)
- Goki Kamei
- Department of Orthopaedic surgery, Graduated School of Biomedical Science, Hiroshima University, Japan.
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Functional articular cartilage repair: here, near, or is the best approach not yet clear? Nat Rev Rheumatol 2013; 9:277-90. [DOI: 10.1038/nrrheum.2013.29] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Saha S, Kirkham J, Wood D, Curran S, Yang XB. Informing future cartilage repair strategies: a comparative study of three different human cell types for cartilage tissue engineering. Cell Tissue Res 2013; 352:495-507. [PMID: 23474783 PMCID: PMC3663993 DOI: 10.1007/s00441-013-1586-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 02/07/2013] [Indexed: 01/22/2023]
Abstract
A major clinical need exists for cartilage repair and regeneration. Despite many different strategies having been pursued, the identification of an optimised cell type and of pre-treatment conditions remains a challenge. This study compares the cartilage-like tissue generated by human bone marrow stromal cells (HBMSCs) and human neonatal and adult chondrocytes cultured on three-dimensional (3D) scaffolds under various conditions in vitro and in vivo with the aim of informing future cartilage repair strategies based upon tissue-engineering approaches. After 3 weeks in vitro culture, all three cell types showed cartilage-like tissue formation on 3D poly (lactide-co-glycolide) acid scaffolds only when cultured in chondrogenic medium. After 6 weeks of chondro-induction, neonatal chondrocyte constructs revealed the most cartilage-like tissue formation with a prominent superficial zone-like layer, a middle zone-like structure and the thinnest fibrous capsule. HBMSC constructs had the thickest fibrous capsule formation. Under basal culture conditions, neonatal articular chondrocytes failed to form any tissue, whereas HBMSCs and adult chondrocytes showed thick fibrous capsule formation at 6 weeks. After in vivo implantation, all groups generated more compact tissues compared with in vitro constructs. Pre-culturing in chondrogenic media for 1 week before implantation reduced fibrous tissue formation in all cell constructs at week 3. After 6 weeks, only the adult chondrocyte group pre-cultured in chondrogenic media was able to maintain a more chondrogenic/less fibrocartilaginous phenotype. Thus, pre-culture under chondrogenic conditions is required to maintain a long-term chondrogenic phenotype, with adult chondrocytes being a more promising cell source than HBMSCs for articular cartilage tissue engineering.
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Affiliation(s)
- Sushmita Saha
- Biomaterials and Tissue Engineering Group, Leeds Dental Institute, University of Leeds, Leeds, LS2 9LU, UK
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31
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A review of the treatment methods for cartilage defects. Vet Comp Orthop Traumatol 2012; 25:263-72. [PMID: 22286150 DOI: 10.3415/vcot-11-05-0070] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Accepted: 01/12/2012] [Indexed: 11/17/2022]
Abstract
The purpose of this article is to provide a broad review of the literature related to the treatment of cartilage defects and degenerated cartilage in animals with some inferences to the treatment in humans. Methods range from the insertion of osteochondral tissue or cells to the application of radio frequency or insertion of scaffolds and growth factors alone or in combination. Debridement, microfracture, radio frequency, and chondrocyte implantation are all methods normally utilized when treating smaller articular cartilage defects. Scaffolds and mosaicplasty are examples of methods to treat larger defects. This review will cover all major treatment methods currently used to treat articular cartilage defects.
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Waller C, Hayes D, Block JE, London NJ. Unload it: the key to the treatment of knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2011; 19:1823-9. [PMID: 21298256 DOI: 10.1007/s00167-011-1403-6] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Accepted: 01/13/2011] [Indexed: 12/27/2022]
Abstract
Osteoarthritis (OA) of the knee is a major public health problem whose prevalence is expected to grow dramatically commensurate with the aging of the population and increasing rates of obesity. Unfortunately, little progress has been made therapeutically to avert this epidemic. We hypothesize that the lack of effective interventions is due, in large part, to an overemphasis on pharmacotherapy and direct chondral repair. Instead, we propose that research and development efforts be aimed at addressing the aberrant biomechanics that are the primary driver in the progression of knee OA. In particular, technologies that "unload" the joint may reverse the structural damage, which is the cardinal feature of this disease. Re-establishing a favorable local mechanical environment may not only delay the requirement for an invasive joint reconstruction procedure but obviate the need entirely.
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Affiliation(s)
- Craig Waller
- St. Vincent's Clinic, Level 4, 438 Victoria Street, Darlinghurst, NSW 2010, Australia
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Tanideh N, Dehghani Nazhvani S, Mojtahed Jaberi F, Mehrabani D, Rezazadeh S, Pakbaz S, Tamadon A, Nikahval B. The healing effect of bioglue in articular cartilage defect of femoral condyle in experimental rabbit model. IRANIAN RED CRESCENT MEDICAL JOURNAL 2011; 13:629-33. [PMID: 22737537 PMCID: PMC3372013 DOI: 10.5812/kowsar.20741804.2254] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Accepted: 04/25/2011] [Indexed: 11/16/2022]
Abstract
Background The full-thickness articular cartilage defects of knee have a poor healing capacity that may progress to osteoarthritis and need a knee replacement. This study determines the healing effect of bioglue in fullthickness articular cartilage defect of femoral condyle in rabbit. Methods Forty-eight male rabbits were randomly divided into four equal groups. In group A, 4 mm articular cartilage defects were created in the right and left medial femoral condyles. Then a graft from xiphoid cartilage was transferred into the defect together with a designed bioglue and the knees were closed. In group B, an articular cartilage defect was created identical to group A, but the defect size was 6 mm. In group C, 4 and 6 mm articular cartilage defects were created in the right and left medial femoral condyles respectively. The graft was transferred into the defect and the knees were stitched. In group D, articular cartilage defects were created similar to group C, just filled with bioglue and closed. The rabbits were euthanized and subgroups were defined as A1, B1, C1 and D1 after 30 days and A2, B2, C2 and D2 after 60 days. The cartilages were macroscopically and histologically investigated for any changes. Results Microscopic and macroscopic investigations showed that bioglue had a significant healing effect in the femoral condyle. Conclusion Addition of bioglue can effectively promote the healing of articular cartilage defects.
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Affiliation(s)
- N Tanideh
- Stem Cell and Transgenic Technology Research Center, Department of Pharmacology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - S Dehghani Nazhvani
- Department of Veterinary Surgery, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
- Correspondence: Seyfollah Dehghani Nazhvani, PhD, Department of Veterinary Surgery, School of Veterinary Medicine, Shiraz University, Shiraz, Iran. Tel.: +98-711-2286950, Fax: +98-711-2286940, E-mail:
| | - F Mojtahed Jaberi
- Stem Cell and Transgenic Technology Research Center, Department of Orthopedic Surgery, Shiraz, Iran
| | - D Mehrabani
- Stem Cell and Transgenic Technology Research Center, Department of Pathology, Shiraz, Iran
| | - S Rezazadeh
- Stem Cell and Transgenic Technology Research Center, Department of Orthopedic Surgery, Shiraz, Iran
| | - S Pakbaz
- Stem Cell and Transgenic Technology Research Center, Department of Orthopedic Surgery, Shiraz, Iran
| | - A Tamadon
- Division of Animal Health Management, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - B Nikahval
- Department of Veterinary Surgery, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
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Abstract
Osteoarthritic disease is the result of mechanical and biological events that destabilize the normal processes of degradation and synthesis of articular cartilage chondrocytes, extracellular matrix, and subchondral bone. Osteoarthritis of the knee can cause symptoms ranging from mild to disabling. Initial management of most patients should be nonoperative, but because of the progressive nature of the disease, many patients with osteoarthritis of the knee eventually benefit from operative treatment. Various procedures have been described for treatment of the osteoarthritic knee, ranging from arthroscopic lavage and debridement to total knee arthroplasty. The aim of this study was to evaluate the clinical results of distraction arthroplasty combined with arthroscopic lavage and drilling of cartilage defects for treatment of osteoarthritis of the knee. Nineteen patients (15 women and 4 men; age range, 39-65 years) were operated on. Pre- and postoperative findings were compared. A control group comprising 42 patients treated with only arthroscopic procedures was evaluated for comparison. Follow-up ranged from 3 to 5 years. Results were evaluated both clinically and radiologically postoperatively and throughout the follow-up period. Clinically, pain and walking capacity improved in most patients. Radiologically, joint space widening and improvement of the tibiofemoral angle was noted in nearly all patients.
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Affiliation(s)
- Tarek A Aly
- Department of Orthopedics, Tanta University Medical School, Tanta, Egypt.
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BMP7 induces the differentiation of bone marrow-derived mesenchymal cells into chondrocytes. Med Biol Eng Comput 2011; 49:687-92. [DOI: 10.1007/s11517-010-0729-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2010] [Accepted: 12/21/2010] [Indexed: 10/18/2022]
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Nishino T, Chang F, Ishii T, Yanai T, Mishima H, Ochiai N. Joint distraction and movement for repair of articular cartilage in a rabbit model with subsequent weight-bearing. ACTA ACUST UNITED AC 2010; 92:1033-40. [DOI: 10.1302/0301-620x.92b7.23200] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We have previously shown that joint distraction and movement with a hinged external fixation device for 12 weeks was useful for repairing a large articular cartilage defect in a rabbit model. We have now investigated the results after six months and one year. The device was applied to 16 rabbits who underwent resection of the articular cartilage and subchondral bone from the entire tibial plateau. In group A (nine rabbits) the device was applied for six months. In group B (seven rabbits) it was in place for six months, after which it was removed and the animals were allowed to move freely for an additional six months. The cartilage remained sound in all rabbits. The areas of type II collagen-positive staining and repaired soft tissue were larger in group B than in group A. These findings provide evidence of long-term persistence of repaired cartilage with this technique and that weight-bearing has a positive effect on the quality of the cartilage.
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Affiliation(s)
- T. Nishino
- Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - F. Chang
- Department of Orthopaedic Surgery China-Japan Union Hospital of Jilin University, 126 Xian Tai Street, Changchun, Jilin 130033, China
| | - T. Ishii
- Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - T. Yanai
- Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - H. Mishima
- Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - N. Ochiai
- Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
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McCann RM, Marsh DR, Horner A, Clarke SA. Body mass index is more predictive of progenitor number in bone marrow stromal cell population than age in men: expanding the predictors of the progenitor compartment. Tissue Eng Part A 2010; 16:889-96. [PMID: 19814585 DOI: 10.1089/ten.tea.2009.0346] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Research has focused on in vitro expansion of bone marrow stromal cells with the aim of developing cell-based therapies or tissue-engineered constructs. There is debate over whether there is a reduction in stem cells/osteoprogenitors in the bone marrow compartment with increasing age. The aim of this study was to investigate patient factors that affect the progenitor pool in bone marrow samples. Six milliliters of marrow aspirate was obtained from the femoral canal of 38 primary hip replacement patients (aged 28-91). Outcome measures were total nucleated cell count, colony-forming efficiency, alkaline phosphatase expression, and expression of stem cell markers. There was a nonsignificant negative correlation between age and both colony-forming efficiency and stem cell marker expression. However, body mass index showed a positive, significant correlation with colony area and number in men-accounting for up to 75% of the variation. In conclusion, body mass index, not age, was highly predictive of the number of progenitors found in bone marrow, and this relationship was sex specific. These results may inform the clinician's treatment choice when considering bone marrow-based therapies. Further, it highlights the need to widen research into patient factors that affect the adult stem cell population beyond age and reinforces the need to consider sexes separately.
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Nishino T, Ishii T, Chang F, Yanai T, Watanabe A, Ogawa T, Mishima H, Nakai K, Ochiai N. Effect of gradual weight-bearing on regenerated articular cartilage after joint distraction and motion in a rabbit model. J Orthop Res 2010; 28:600-6. [PMID: 19890991 DOI: 10.1002/jor.21016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The purpose of this study was to clarify the effect of gradual weight bearing (GWB) on regenerating cartilage. We developed a novel external fixation device (EFD) with a controllable weight-bearing system and continuous passive motion (CPM). A full-thickness defect was created by resection of the entire articular surface of the tibial plateau after the EFD was fixed in the rabbit's left knee. In the GWB group (n=6), GWB was started 6 weeks after surgery. In the CPM group (n=6), CPM with EFD was applied in the same manner without GWB. The control group (n=5) received only joint distraction. All rabbits were sacrificed 9 weeks after surgery. The central one-third of the regenerated tissue was assessed and scored blindly using a grading scale modified from the International Cartilage Repair Society visual histological assessment scale. The areas stained by Safranin-O and type II collagen antibody were measured, and the percentage of each area was calculated. There was no significant difference in the histological assessment scale among the groups. The percentage of the type II collagen-positive area was significantly larger in the GWB group than in the CPM group. The present study suggests that optimal mechanical stress, such as GWB, may affect regeneration of cartilage, in vivo.
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Affiliation(s)
- Tomofumi Nishino
- University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
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Revell CM, Athanasiou KA. Success rates and immunologic responses of autogenic, allogenic, and xenogenic treatments to repair articular cartilage defects. TISSUE ENGINEERING PART B-REVIEWS 2009; 15:1-15. [PMID: 19063664 DOI: 10.1089/ten.teb.2008.0189] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
This review examines current approaches available for articular cartilage repair, not only in terms of their regeneration potential, but also as a function of immunologic response. Autogenic repair techniques, including osteochondral plug transplantation, chondrocyte implantation, and microfracture, are the most widely accepted clinical treatment options due to the lack of immunogenic reactions, but only moderate graft success rates have been reported. Although suspended allogenic chondrocytes are shown to evoke an immune response upon implantation, allogenic osteochondral plugs and tissue-engineered grafts using allogenic chondrocytes exhibit a tolerable immunogenic response. Additionally, these repair techniques produce neotissue with success rates approaching those of currently available autogenic repair techniques, while simultaneously obviating their major hindrance of donor tissue scarcity. To date, limited research has been performed with xenogenic tissue, although several studies demonstrate the potential for its long-term success. This article focuses on the various treatment options for cartilage repair and their associated success rates and immunologic responses.
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Mimura T, Imai S, Kubo M, Isoya E, Ando K, Okumura N, Matsusue Y. A novel exogenous concentration-gradient collagen scaffold augments full-thickness articular cartilage repair. Osteoarthritis Cartilage 2008; 16:1083-91. [PMID: 18378169 DOI: 10.1016/j.joca.2008.02.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2007] [Accepted: 02/01/2008] [Indexed: 02/02/2023]
Abstract
OBJECTIVES A collagen scaffold has been long used in order to enhance the regeneration of articular cartilage. In the present study, we investigate the effectiveness of a concentration-gradient (CG) collagen that is designed to recruit efficiently the mesenchymal stem cells (MSCs) to the central region of the full-thickness cartilage defects via haptotaxis. METHODS The present study used Cellmatrix (0.3% type I collagen; Nitta gelatin, Osaka, Japan) as the collagen material. We prepared 33%CG collagen gel and 50%CG collagen gel. No gradient collagen gel served as negative control. Full-thickness cartilage defects were created at the patella groove of the rabbit knee, to which the three different collagen gels were transplanted. Bromodeoxyuridine (BrdU) positive, proliferating cells were enumerated and localized, whereas the histological grading score for cartilage regeneration was counted. The expression of type I and type II collagens was evaluated by immunohistochemistry. We also confirmed that the MSCs migrate toward the collagen substrate of higher concentration in a stringently in vitro haptotactic manner. RESULTS Enumeration of the BrdU-positive cells demonstrated that 33%CG collagen gel recruited a significantly larger number of proliferating cells to the central region of the cartilage defect. The histological grading score for the regenerated cartilage treated with 33%CG collagen gel was superior to the other groups. CONCLUSIONS CG collagen scaffold recruits effectively the MSCs to the center of full-thickness cartilage defect and enhances regeneration of the full-thickness cartilage defect.
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Affiliation(s)
- T Mimura
- Department of Orthopedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga 520-2192, Japan.
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Chang F, Ishii T, Yanai T, Mishima H, Akaogi H, Ogawa T, Ochiai N. Repair of large full-thickness articular cartilage defects by transplantation of autologous uncultured bone-marrow-derived mononuclear cells. J Orthop Res 2008; 26:18-26. [PMID: 17724730 DOI: 10.1002/jor.20470] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The objective of this study was to investigate the feasibility of autologous uncultured bone marrow-derived mononuclear cell transplantation in large full-thickness cartilage regeneration. After fixing with a hinged external fixator, the entire surface of the left tibial plateau was resected and large full-thickness cartilage defects were formed in 48 rabbits. Animals were divided into four groups: autologous uncultured bone marrow-derived mononuclear cells with fibrin gel (BMC), autologous uncultured peripheral blood-derived mononuclear cells with fibrin gel (PBC), fibrin gel alone (GEL), or nothing (CON) transplanted to the articular cavity 7 days after the operation. The rabbits were killed 8 or 12 weeks after the operation. The repair of defects was investigated histologically and scored using a histological and histochemical grading scale that was modified from the International Cartilage Repair Society Visual Histological Assessment Scale. To evaluate the regenerated cartilage, we also morphometrically measured the staining area positive for Safranin-O or type II collagen and calculated the percentages of the positive staining areas with respect to the regenerated soft tissue area. Histological findings showed that the BMC group had superior cartilage repair compared with the other groups, and that the PBC and CON group showed better cartilage repair than did the GEL group. Histological scores and morphometrical measurements also showed the same results quantitively. The transplantation of autologous uncultured bone marrow-derived mononuclear cells contributes to articular cartilage repair. The easy and safe method used in this study is potentially viable for clinical application.
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Affiliation(s)
- Fei Chang
- Department of Orthopaedic Surgery, Institute of Clinical Medicine, Graduate School of Human Comprehensive Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
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Yoshioka T, Mishima H, Ohyabu Y, Sakai S, Akaogi H, Ishii T, Kojima H, Tanaka J, Ochiai N, Uemura T. Repair of large osteochondral defects with allogeneic cartilaginous aggregates formed from bone marrow-derived cells using RWV bioreactor. J Orthop Res 2007; 25:1291-8. [PMID: 17549704 DOI: 10.1002/jor.20426] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Our objective was to examine the technique of regenerating cartilage tissue from bone marrow-derived cells by three-dimensional (3D) culture using the rotating wall vessel (RWV) bioreactor. Three-dimensional and cylindrical aggregates of allogeneic cartilage with dimensions of 10 x 5 mm (height x diameter) formed by the RWV bioreactor were transplanted into osteochondral defects of Japanese white rabbits (Group T, n = 15). For the control, some osteochondral defects were left empty (Group C, n = 18). At 4, 8, and 12 weeks postimplantation, the reparative tissues were evaluated macroscopically, histologically, and biochemically. In Group T at as early as 4 weeks, histological observation, especially via safranin-O staining, suggested that the reparative tissues resembled hyaline cartilage. And we observed no fibrous tissues between reparative tissue and adjacent normal tissues. In the deeper portion of the bony compartment, the osseous tissues were well remodeled. At 4 and 8 weeks postimplantation, the mean histological score of Group T was significantly better than that of Group C (p < 0.05). The glycosaminoglycans (GAG)/DNA ratio in both groups increased gradually from 4 to 8 weeks and then decreased from 8 to 12 weeks. We herein report the first successful regeneration of cartilage in osteochondral defects in vivo using allogeneic cartilaginous aggregates derived from bone marrow-derived cells by 3D culture using the RWV bioreactor.
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Affiliation(s)
- Tomokazu Yoshioka
- Department of Orthopaedic Surgery, Control of Musculoskeletal System, Advanced Biomedical Applications, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
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Lafeber FPJG, Intema F, Van Roermund PM, Marijnissen ACA. Unloading joints to treat osteoarthritis, including joint distraction. Curr Opin Rheumatol 2006; 18:519-25. [PMID: 16896294 DOI: 10.1097/01.bor.0000240366.54960.a1] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Patients are increasingly becoming interested in nonpharmacologic approaches to manage their osteoarthritis. This review examines the recent literature on the potential beneficial effects of unloading joints in the treatment of osteoarthritis, with a focus on joint distraction. RECENT FINDINGS Mechanical factors are involved in the development and progression of osteoarthritis. If "loading" is a major cause in development and progression of osteoarthritis, then "unloading" may be able to prevent progression. There is evidence that unloading may be effective in reducing pain and slowing down structural damage. This review describes unloading by footwear and bracing (nonsurgical), unloading by osteotomy (surgical), and has a focus on unloading by joint distraction. Excellent reviews in all these three fields have been published over the past few years. Recent studies argue for the usefulness of a biomechanical approach to improve function and possibly reduce disease progression in osteoarthritis. SUMMARY To improve patient function and possibly reduce disease progression, a biomechanical approach should be considered in treating patients with osteoarthritis. Further research (appropriate high-quality clinical trials) and analysis (clinical as well as preclinical and fundamental) are still necessary, however, to understand, validate, and refine the different approaches of unloading to treat osteoarthritis.
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Affiliation(s)
- Floris P J G Lafeber
- Department of Rheumatology and Clinical Immunology, University Medical Centre Utrecht, 3508 GA Utrecht, The Netherlands.
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