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Briem T, Stephan A, Stadelmann VA, Fischer MA, Pfirrmann CWA, Rüdiger HA, Leunig M. Mid-term results of autologous matrix-induced chondrogenesis for large chondral defects in hips with femoroacetabular impingement syndrome. Bone Joint J 2024; 106-B:32-39. [PMID: 38688500 DOI: 10.1302/0301-620x.106b5.bjj-2023-0864.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Aims The purpose of this study was to evaluate the mid-term outcomes of autologous matrix-induced chondrogenesis (AMIC) for the treatment of larger cartilage lesions and deformity correction in hips suffering from symptomatic femoroacetabular impingement (FAI). Methods This single-centre study focused on a cohort of 24 patients with cam- or pincer-type FAI, full-thickness femoral or acetabular chondral lesions, or osteochondral lesions ≥ 2 cm2, who underwent surgical hip dislocation for FAI correction in combination with AMIC between March 2009 and February 2016. Baseline data were retrospectively obtained from patient files. Mid-term outcomes were prospectively collected at a follow-up in 2020: cartilage repair tissue quality was evaluated by MRI using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score. Patient-reported outcome measures (PROMs) included the Oxford Hip Score (OHS) and Core Outcome Measure Index (COMI). Clinical examination included range of motion, impingement tests, and pain. Results A total of 12 hips from 11 patients were included (ten males, one female, mean age 26.8 years (SD 5.0), mean follow-up 6.2 years (SD 5.2 months)). The mean postoperative MOCART score was 66.3 (SD 16.3). None of the patients required conversion to total hip arthroplasty. Two patients had anterior impingement. External hip rotation was moderately limited in four patients. There was a correlation between MOCART and follow-up time (rs = -0.61; p = 0.035), but not with initial cartilage damage, age, BMI, or imaging time delay before surgery. PROMs improved significantly: OHS from 37.4 to 42.7 (p = 0.014) and COMI from 4.1 to 1.6 (p = 0.025). There was no correlation between MOCART and PROMs. Conclusion Based on the reported mid-term results, we consider AMIC as an encouraging treatment option for large cartilage lesions of the hip. Nonetheless, the clinical evidence of AMIC in FAI patients remains to be determined, ideally in the context of randomized controlled trials.
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Affiliation(s)
- Tim Briem
- Ortho Clinic Zürich, Zürich, Switzerland
| | - Anika Stephan
- Department of Research and Development, Schulthess Klinik, Zürich, Switzerland
| | | | | | | | - Hannes A Rüdiger
- Department of Hip and Knee Surgery, Schulthess Klinik, Zürich, Switzerland
| | - Michael Leunig
- Department of Hip and Knee Surgery, Schulthess Klinik, Zürich, Switzerland
- Department of Health Sciences and Technology (ETH Zürich), Schulthess Klinik, Zürich, Switzerland
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Dias IE, Viegas CA, Requicha JF, Saavedra MJ, Azevedo JM, Carvalho PP, Dias IR. Mesenchymal Stem Cell Studies in the Goat Model for Biomedical Research—A Review of the Scientific Literature. BIOLOGY 2022; 11:biology11091276. [PMID: 36138755 PMCID: PMC9495984 DOI: 10.3390/biology11091276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/18/2022] [Accepted: 08/24/2022] [Indexed: 12/02/2022]
Abstract
Simple Summary This review article aims to compile the works published in the scientific literature, over the last two decades, that use the goat as an animal model in preclinical studies using stem cells, alone or associated with biomaterials, for the treatment of injury or disease in divers organ systems. These preclinical studies are performed prior to human clinical trials for the implementation of new medical or surgical therapies in clinical practice. Thus, it appears that, in the area of tissue engineering and regenerative medicine, the caprine model is particularly used in studies using stem cells in the musculoskeletal system but, although in a more limited way, also in the field of dermatology, ophthalmology, dentistry, pneumology, cardiology, and urology. It appears that the goat represents a particularly useful animal model for studies related to the locomotor system because of its size, and also because they have a more active behavior than sheep, being more similar to the human species in this aspect. Additionally, the goat knee anatomy and the thickness of the cartilage that covers this joint are closer to that of humans than that of other large animal models commonly used in orthopedic research. Abstract Mesenchymal stem cells (MSCs) are multipotent cells, defined by their ability to self-renew, while maintaining the capacity to differentiate into different cellular lineages, presumably from their own germinal layer. MSCs therapy is based on its anti-inflammatory, immunomodulatory, and regenerative potential. Firstly, they can differentiate into the target cell type, allowing them to regenerate the damaged area. Secondly, they have a great immunomodulatory capacity through paracrine effects (by secreting several cytokines and growth factors to adjacent cells) and by cell-to-cell contact, leading to vascularization, cellular proliferation in wounded tissues, and reducing inflammation. Currently, MSCs are being widely investigated for numerous tissue engineering and regenerative medicine applications. Appropriate animal models are crucial for the development and evaluation of regenerative medicine-based treatments and eventual treatments for debilitating diseases with the hope of application in upcoming human clinical trials. Here, we summarize the latest research focused on studying the biological and therapeutic potential of MSCs in the goat model, namely in the fields of orthopedics, dermatology, ophthalmology, dentistry, pneumology, cardiology, and urology fields.
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Affiliation(s)
- Inês E. Dias
- CITAB—Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Universidade de Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5000-801 Vila Real, Portugal
- Inov4Agro—Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production, 5000-801 Vila Real, Portugal
| | - Carlos A. Viegas
- CITAB—Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Universidade de Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5000-801 Vila Real, Portugal
- Inov4Agro—Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production, 5000-801 Vila Real, Portugal
- Department of Veterinary Sciences, School of Agricultural and Veterinary Sciences (ECAV), UTAD, Quinta de Prados, 5000-801 Vila Real, Portugal
- CECAV—Centre for Animal Sciences and Veterinary Studies, UTAD, Quinta de Prados, 5000-801 Vila Real, Portugal
- AL4AnimalS—Associate Laboratory for Animal and Veterinary Sciences, 1300-477 Lisboa, Portugal
| | - João F. Requicha
- Department of Veterinary Sciences, School of Agricultural and Veterinary Sciences (ECAV), UTAD, Quinta de Prados, 5000-801 Vila Real, Portugal
- CECAV—Centre for Animal Sciences and Veterinary Studies, UTAD, Quinta de Prados, 5000-801 Vila Real, Portugal
- AL4AnimalS—Associate Laboratory for Animal and Veterinary Sciences, 1300-477 Lisboa, Portugal
| | - Maria J. Saavedra
- CITAB—Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Universidade de Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5000-801 Vila Real, Portugal
- Inov4Agro—Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production, 5000-801 Vila Real, Portugal
- Department of Veterinary Sciences, School of Agricultural and Veterinary Sciences (ECAV), UTAD, Quinta de Prados, 5000-801 Vila Real, Portugal
| | - Jorge M. Azevedo
- CECAV—Centre for Animal Sciences and Veterinary Studies, UTAD, Quinta de Prados, 5000-801 Vila Real, Portugal
- AL4AnimalS—Associate Laboratory for Animal and Veterinary Sciences, 1300-477 Lisboa, Portugal
- Department of Animal Science, ECAV, UTAD, Quinta de Prados, 5000-801 Vila Real, Portugal
| | - Pedro P. Carvalho
- CIVG—Vasco da Gama Research Center, University School Vasco da Gama (EUVG), Av. José R. Sousa Fernandes, Campus Universitário, Lordemão, 3020-210 Coimbra, Portugal
- Vetherapy—Research and Development in Biotechnology, 3020-210 Coimbra, Portugal
| | - Isabel R. Dias
- CITAB—Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Universidade de Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5000-801 Vila Real, Portugal
- Inov4Agro—Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production, 5000-801 Vila Real, Portugal
- Department of Veterinary Sciences, School of Agricultural and Veterinary Sciences (ECAV), UTAD, Quinta de Prados, 5000-801 Vila Real, Portugal
- CECAV—Centre for Animal Sciences and Veterinary Studies, UTAD, Quinta de Prados, 5000-801 Vila Real, Portugal
- AL4AnimalS—Associate Laboratory for Animal and Veterinary Sciences, 1300-477 Lisboa, Portugal
- Correspondence:
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McGivern S, Boutouil H, Al-Kharusi G, Little S, Dunne NJ, Levingstone TJ. Translational Application of 3D Bioprinting for Cartilage Tissue Engineering. Bioengineering (Basel) 2021; 8:144. [PMID: 34677217 PMCID: PMC8533558 DOI: 10.3390/bioengineering8100144] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/07/2021] [Accepted: 10/10/2021] [Indexed: 12/16/2022] Open
Abstract
Cartilage is an avascular tissue with extremely limited self-regeneration capabilities. At present, there are no existing treatments that effectively stop the deterioration of cartilage or reverse its effects; current treatments merely relieve its symptoms and surgical intervention is required when the condition aggravates. Thus, cartilage damage remains an ongoing challenge in orthopaedics with an urgent need for improved treatment options. In recent years, major advances have been made in the development of three-dimensional (3D) bioprinted constructs for cartilage repair applications. 3D bioprinting is an evolutionary additive manufacturing technique that enables the precisely controlled deposition of a combination of biomaterials, cells, and bioactive molecules, collectively known as bioink, layer-by-layer to produce constructs that simulate the structure and function of native cartilage tissue. This review provides an insight into the current developments in 3D bioprinting for cartilage tissue engineering. The bioink and construct properties required for successful application in cartilage repair applications are highlighted. Furthermore, the potential for translation of 3D bioprinted constructs to the clinic is discussed. Overall, 3D bioprinting demonstrates great potential as a novel technique for the fabrication of tissue engineered constructs for cartilage regeneration, with distinct advantages over conventional techniques.
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Affiliation(s)
- Sophie McGivern
- Advanced Manufacturing Research Centre (I-Form), School of Mechanical and Manufacturing Engineering, Dublin City University, D09 NA55 Dublin, Ireland; (S.M.); (H.B.); (G.A.-K.); (N.J.D.)
| | - Halima Boutouil
- Advanced Manufacturing Research Centre (I-Form), School of Mechanical and Manufacturing Engineering, Dublin City University, D09 NA55 Dublin, Ireland; (S.M.); (H.B.); (G.A.-K.); (N.J.D.)
- Centre for Medical Engineering Research (MEDeng), Dublin City University, D09 NA55 Dublin, Ireland
| | - Ghayadah Al-Kharusi
- Advanced Manufacturing Research Centre (I-Form), School of Mechanical and Manufacturing Engineering, Dublin City University, D09 NA55 Dublin, Ireland; (S.M.); (H.B.); (G.A.-K.); (N.J.D.)
- Centre for Medical Engineering Research (MEDeng), Dublin City University, D09 NA55 Dublin, Ireland
| | - Suzanne Little
- Insight SFI Research Centre for Data Analytics, Dublin City University, D09 NA55 Dublin, Ireland;
| | - Nicholas J. Dunne
- Advanced Manufacturing Research Centre (I-Form), School of Mechanical and Manufacturing Engineering, Dublin City University, D09 NA55 Dublin, Ireland; (S.M.); (H.B.); (G.A.-K.); (N.J.D.)
- Centre for Medical Engineering Research (MEDeng), Dublin City University, D09 NA55 Dublin, Ireland
- Advanced Processing Technology Research Centre, Dublin City University, D09 NA55 Dublin, Ireland
- Biodesign Europe, Dublin City University, D09 NA55 Dublin, Ireland
- Trinity Centre for Biomedical Engineering (TCBE), Trinity Biomedical Sciences Institute, Trinity College Dublin, D02 PN40 Dublin, Ireland
- Advanced Materials and Bioengineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, D02 PN40 Dublin, Ireland
- School of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Tanya J. Levingstone
- Advanced Manufacturing Research Centre (I-Form), School of Mechanical and Manufacturing Engineering, Dublin City University, D09 NA55 Dublin, Ireland; (S.M.); (H.B.); (G.A.-K.); (N.J.D.)
- Centre for Medical Engineering Research (MEDeng), Dublin City University, D09 NA55 Dublin, Ireland
- Advanced Processing Technology Research Centre, Dublin City University, D09 NA55 Dublin, Ireland
- Biodesign Europe, Dublin City University, D09 NA55 Dublin, Ireland
- Trinity Centre for Biomedical Engineering (TCBE), Trinity Biomedical Sciences Institute, Trinity College Dublin, D02 PN40 Dublin, Ireland
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Intra-Articular Injection of (-)-Epigallocatechin 3-Gallate to Attenuate Articular Cartilage Degeneration by Enhancing Autophagy in a Post-Traumatic Osteoarthritis Rat Model. Antioxidants (Basel) 2020; 10:antiox10010008. [PMID: 33374730 PMCID: PMC7824012 DOI: 10.3390/antiox10010008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/05/2020] [Accepted: 12/14/2020] [Indexed: 12/13/2022] Open
Abstract
(-)-Epigallocatechin 3-gallate (EGCG) is the main active green tea catechin and has a wide variety of benefits for health. Post-traumatic osteoarthritis (PTOA) occurs as a consequence of joint injuries that commonly happen in the young population. In this study, we investigated the effects of EGCG on PTOA prevention by using the anterior cruciate ligament transection (ACLT)–OA model and further investigated the roles of autophagy in OA treatment. Our results showed that intra-articular injection of EGCG significantly improved the functional performances and decreased cartilage degradation. EGCG treatment attenuated the inflammation on synovial tissue and cartilage through less immunostained cyclooxygenase-2 and matrix metalloproteinase-13. We further noted EGCG may modulate the chondrocyte apoptosis by activation of the cytoprotective autophagy through reducing the expression of the mTOR and enhancing the expression of microtubule-associated protein light chain 3, beclin-1, and p62. In conclusion, intra-articular injection of EGCG after ACL injury inhibited the joint inflammation and cartilage degradation, thereby increasing joint function. EGCG treatment also reduced the chondrocyte apoptosis, possibly by activating autophagy. These findings suggested that EGCG may be a potential disease-modifying drug for preventing OA progression.
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Sobti AS, Baryeh KW, Woolf R, Chana R. Autologous matrix-induced chondrogenesis and bone marrow aspirate concentrate compared with microfracture for arthroscopic treatment of femoroacetabular impingement and chondral lesions of the hip: bridging the osteoarthritis gap and facilitating enhanced recovery. J Hip Preserv Surg 2020; 7:503-510. [PMID: 33948205 PMCID: PMC8081409 DOI: 10.1093/jhps/hnaa047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/05/2020] [Accepted: 08/15/2020] [Indexed: 12/12/2022] Open
Abstract
In an attempt to bridge the osteoarthritis (OA) gap, this study compared biological reconstruction with traditional microfracture (MF) techniques in patients with femoroacetabular impingement and focal cartilage defects. Cohorts of two groups were investigated; age, gender and Tonnis grade matched comparison for outcomes between MF and newer biological reconstruction techniques hip arthroscopy surgery using autologous matrix-induced chondrogenesis and bone marrow aspirate combination. Outcomes investigated were pre-op and post-op mean iHOT-12 scores up to 18 months after surgery with a Kaplan–Meier survivorship analysis. Of 111 patients, 46 patients underwent MF and 65 biological reconstruction hip arthroscopy including cam/pincer osteoplasty and labral repair surgery. Age range was 20–69, mean age 45 years for both groups, Tonnis grading was as follows: Grade 0: 26% versus 30%, Grade 1: 52% versus 47% and Grade 2: 22% versus 23% in MF and biological reconstruction groups, respectively. The mean post-operative iHOT-12 score differences between MF and biological reconstruction were significant at 1-year minimum follow-up (P = 0.01, SD 2.8). Biological reconstruction allowed for an enhanced recovery protocol. The MF group had a 67.4% survivorship for conversion to hip replacement at 18 months (32.6% failure rate for any reason) and biological reconstruction had 100% survivorship at 18 months post-operatively with no failures for any reason. This study provides further support to the evidence base for biological reconstructive techniques as superior to MF in combination with joint preservation arthroscopic surgery, even in the face of focal cartilage defects and offers both surgeons and patients a potential bridging of the OA gap.
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Affiliation(s)
- Anshul S Sobti
- FRCS (Tr & Orth), Rowley Bristow Unit, Ashford and St. Peter's Hospitals NHS Foundation Trust, Guildford Road, Lyne, Chertsey KT16 0PZ, UK
| | - Kwaku W Baryeh
- MRCSEd, South West London Elective Orthopaedic Centre, Dorking Road, Epsom KT18 7EG, UK
| | - Rex Woolf
- FRCA, Princess Margaret Hospital, Osborne Road, Windsor SL4 3SJ, UK
| | - Rishi Chana
- FRCS (Tr & Orth), Princess Margaret Hospital, Osborne Road, Windsor SL4 3SJ, UK
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Tangchitphisut P, Srikaew N, Phongkitkarun S, Jaovisidha S, Tawonsawatruk T. Using iron sucrose-labeled adipose-derived mesenchymal stem cells in 1.5 and 3 T MRI tracking: An in vitro study. Heliyon 2020; 6:e04582. [PMID: 32775748 PMCID: PMC7398940 DOI: 10.1016/j.heliyon.2020.e04582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 01/31/2020] [Accepted: 07/27/2020] [Indexed: 01/04/2023] Open
Abstract
Objectives The objective of this study was to investigate iron sucrose labeling in mesenchymal stem cell (MSCs) tracking. Background Adipose-derived mesenchymal stem cell-based therapy is a promising strategy for promoting musculoskeletal repair. Methods Iron sucrose-labeled adipose-derived mesenchymal stem cells (IS-labeled ASCs) were tracked using T2-and T2∗-weighted sequences by 1.5 and 3 T MRI in an in vitro model. ASCs were isolated from cosmetic liposuction specimens. ASCs from passages 4-6 were labeled with iron sucrose (Venofer®) which was added to the cell culture medium. Pre- and post-iron sucrose labeled ASCs were evaluated for cell surface immunophenotypes. Cell viability as well as chondrogenic, adipogenic and osteogenic differentiation of IS-labeled-ASCs were evaluated. The IS-labeled ASCs were titrated into microtubes at 1 × 103, 1 × 104, 1 × 105 and 1 × 106 cells/ml/microtube and their intensities were determined by 1.5 and 3T MRI using T2-and T2∗-weighted sequences. Results The expression markers of IS-labeled ASCs from flow cytometry were equivalent to control. The mean cell viability was 97.73 ± 2.06%. Cell differentiations of IS-labeled ASCs were confirmed in each lineage using specific staining solutions. T2∗-weighted sequences (T2∗) were able to detect iron sucrose labeled-ASCs at a minimum of 1 × 105 cells/ml/microtube using 1.5 and 3T MRI, but the detection sensitivity was lower with T2-weighted sequences (T2). Conclusions Iron sucrose incubation is a safe alternative method for ASCs labeling and tracking using MRI following treatment. Clinicians and researchers should be able to visualize the location of ASCs engraftment without secondary surgical investigation involving tissue sampling.
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Affiliation(s)
| | | | - Sith Phongkitkarun
- Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Thailand
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Howard TA, Murray IR, Amin AK, Simpson AH, Hall AC. Damage control articular surgery: Maintaining chondrocyte health and minimising iatrogenic injury. Injury 2020; 51 Suppl 2:S83-S89. [PMID: 31685207 DOI: 10.1016/j.injury.2019.10.072] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 10/22/2019] [Indexed: 02/02/2023]
Abstract
Articular cartilage has limited intrinsic regenerative potential. The maintenance of healthy articular cartilage is essential to prevent joint degeneration and the morbidity associated with arthritis. In this review, we outline the structure and function of healthy articular cartilage. We summarise some of the recent literature outlining the influence of surgical factors on chondrocyte health. These factors include mechanical injury from instrumentation and drilling, drying, and the influence of irrigation fluids, antimicrobial solutions and local anaesthetics. We demonstrate that there is scope for improving cartilage viability at the time of surgery if simple chondroprotective measures are routinely adopted.
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Affiliation(s)
- Thomas A Howard
- Department of Trauma and Orthopaedics, Royal Infirmary of Edinburgh, 49 Little France Crescent, EH16 4SA, UK
| | - Iain R Murray
- Department of Trauma and Orthopaedics, Royal Infirmary of Edinburgh, 49 Little France Crescent, EH16 4SA, UK; The University of Edinburgh, UK
| | - Anish K Amin
- Department of Trauma and Orthopaedics, Royal Infirmary of Edinburgh, 49 Little France Crescent, EH16 4SA, UK; The University of Edinburgh, UK
| | - A Hamish Simpson
- Department of Trauma and Orthopaedics, Royal Infirmary of Edinburgh, 49 Little France Crescent, EH16 4SA, UK; The University of Edinburgh, UK.
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Gao Y, Gao J, Li H, Du D, Jin D, Zheng M, Zhang C. Autologous costal chondral transplantation and costa-derived chondrocyte implantation: emerging surgical techniques. Ther Adv Musculoskelet Dis 2019; 11:1759720X19877131. [PMID: 31579403 PMCID: PMC6759717 DOI: 10.1177/1759720x19877131] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 08/29/2019] [Indexed: 01/08/2023] Open
Abstract
It is a great challenge to cure symptomatic lesions and considerable defects of hyaline cartilage due to its complex structure and poor self-repair capacity. If left untreated, unmatured degeneration will cause significant complications. Surgical intervention to repair cartilage may prevent progressive joint degeneration. A series of surgical techniques, including biological augmentation, microfracture and bone marrow stimulation, autologous chondrocyte implantation (ACI), and allogenic and autogenic chondral/osteochondral transplantation, have been used for various indications. However, the limited repairing capacity and the potential pitfalls of these techniques cannot be ignored. Increasing evidence has shown promising outcomes from ACI and cartilage transplantation. Nevertheless, the morbidity of autologous donor sites and limited resource of allogeneic bone have considerably restricted the wide application of these surgical techniques. Costal cartilage, which preserves permanent chondrocytes and the natural osteochondral junction, is an ideal candidate for the restoration of cartilage defects. Several in vitro and in vivo studies have shown good performance of costal cartilage transplantation. Although costal cartilage is a classic donor in plastic and cosmetic surgery, it is rarely used in skeletal cartilage restoration. In this review, we introduce the fundamental properties of costal cartilage and summarize costa-derived chondrocyte implantation and costal chondral/osteochondral transplantation. We will also discuss the pitfalls and pearls of costal cartilage transplantation. Costal chondral/osteochondral transplantation and costa-based chondrocytotherapy might be up-and-coming surgical techniques for recalcitrant cartilage lesions.
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Affiliation(s)
| | - Junjie Gao
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- Centre for Orthopaedic Translational Research, University of Western Australia, Nedlands, WA, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Hengyuan Li
- Department of Orthopaedics, Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China
- Centre for Orthopaedic Translational Research, Medical School, University of Western Australia, Nedlands, WA, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Dajiang Du
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Dongxu Jin
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Minghao Zheng
- Centre for Orthopaedic Translational Research, Medical School, University of Western Australia, Nedlands, WA, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Changqing Zhang
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China
- Institute of Microsurgery on Extremities, Shanghai 200233, China
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Chen MF, Chang CH, Chiang-Ni C, Hsieh PH, Shih HN, Ueng SWN, Chang Y. Rapid analysis of bacterial composition in prosthetic joint infection by 16S rRNA metagenomic sequencing. Bone Joint Res 2019; 8:367-377. [PMID: 31537994 PMCID: PMC6719533 DOI: 10.1302/2046-3758.88.bjr-2019-0003.r2] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Objectives Prosthetic joint infection (PJI) is the most common cause of arthroplasty failure. However, infection is often difficult to detect by conventional bacterial cultures, for which false-negative rates are 23% to 35%. In contrast, 16S rRNA metagenomics has been shown to quantitatively detect unculturable, unsuspected, and unviable pathogens. In this study, we investigated the use of 16S rRNA metagenomics for detection of bacterial pathogens in synovial fluid (SF) from patients with hip or knee PJI. Methods We analyzed the bacterial composition of 22 SF samples collected from 11 patients with PJIs (first- and second-stage surgery). The V3 and V4 region of bacteria was assessed by comparing the taxonomic distribution of the 16S rDNA amplicons with microbiome sequencing analysis. We also compared the results of bacterial detection from different methods including 16S metagenomics, traditional cultures, and targeted Sanger sequencing. Results Polymicrobial infections were not only detected, but also characterized at different timepoints corresponding to first- and second-stage exchange arthroplasty. Similar taxonomic distributions were obtained by matching sequence data against SILVA, Greengenes, and The National Center for Biotechnology Information (NCBI). All bacteria isolated from the traditional culture could be further identified by 16S metagenomics and targeted Sanger sequencing. Conclusion The data highlight 16S rRNA metagenomics as a suitable and promising method to detect and identify infecting bacteria, most of which may be uncultivable. Importantly, the method dramatically reduces turnaround time to two days rather than approximately one week for conventional cultures. Cite this article: M-F. Chen, C-H. Chang, C. Chiang-Ni, P-H. Hsieh, H-N. Shih, S. W. N. Ueng, Y. Chang. Rapid analysis of bacterial composition in prosthetic joint infection by 16S rRNA metagenomic sequencing. Bone Joint Res 2019;8:367–377. DOI: 10.1302/2046-3758.88.BJR-2019-0003.R2.
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Affiliation(s)
- Mei-Feng Chen
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chih-Hsiang Chang
- Bone and Joint Research Center, Chang Gung Memorial Hospital; Department of Orthopaedic Surgery, Chang Gung Memorial Hospital; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University. Taoyuan, Taiwan
| | - Chuan Chiang-Ni
- Department of Microbiology and Immunology, College of Medicine, Chang Gung University; Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital. Taoyuan, Taiwan
| | - Pang-Hsin Hsieh
- Bone and Joint Research Center, Chang Gung Memorial Hospital; Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hsin-Nung Shih
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Steve W N Ueng
- Bone and Joint Research Center, Chang Gung Memorial Hospital; Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yuhan Chang
- Bone and Joint Research Center, Chang Gung Memorial Hospital; Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Mayne E, Raut P, Memarzadeh A, Arora A, Khanduja V. Infographic: Measuring hip muscle strength in patients with femoroacetabular impingement and other hip pathologies. Bone Joint Res 2019; 8:288-289. [PMID: 31463036 PMCID: PMC6691368 DOI: 10.1302/2046-3758.87.bjr-2019-0113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- E Mayne
- James Cook University Hospital, Middlesbrough, UK
| | - P Raut
- James Cook University Hospital, Middlesbrough, UK
| | - A Memarzadeh
- Trauma and Orthopaedics, Addenbrooke's, Cambridge University Hospital, Cambridge, UK
| | - A Arora
- Trauma and Orthopaedics, Addenbrooke's, Cambridge University Hospital, Cambridge, UK
| | - V Khanduja
- Trauma and Orthopaedics, Addenbrooke's, Cambridge University Hospital, Cambridge, UK
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