Fabrication of Tissue-Engineered Cartilage Using Decellularized Scaffolds and Chondrocytes

Biomedical Application of Decellularized Scaffolds

Tissue loss and end-stage organ failure are serious health problems across the world. Natural and synthetic polymer scaffold material based artificial organs play an important role in the field of tissue engineering and organ regeneration, but they are not from the body and may cause side effects such as rejection. In recent years, the biomimetic decellularized scaffold based materials have drawn great attention in the tissue engineering field for their good biocompatibility, easy modification, and excellent organism adaptability. Therefore, in this review, we comprehensively summarize the application of decellularized scaffolds in tissue engineering and biomedicine in recent years. The preparation methods, modification strategies, construction of artificial tissues, and application in biomedical applications are discussed. We hope that this review will provide a useful reference for research on decellularized scaffolds and promote their application tissue engineering.

Mid- to Long-Term Clinical Outcomes of Cartilage Restoration of Knee Joint with Allogenic Next-Generation Matrix-Induced Autologous Chondrocyte Implantation (MACI)

OBJECTIVE

Cartilage defect is a common pathology still lacking a unified treating option. The purpose of this retrospective study is to evaluate the safety, efficacy, and clinical and radiological outcome of cartilage restoration of knee joint with allogenic next-generation Matrix-Induced Autologous Chondrocyte Implantation (MACI) for the first time, as well as the correlation between postoperative clinical and radiological outcomes and preoperative patient history and demographics.

METHODS

From July 2014 to August 2020, 15 patients who went through cartilage restoration with allogenic next-generation MACI were included in this study. Patient demographics and PROM including the International Knee Documentation Committee (IKDC) subjective knee score, Lysholm score, Tegner Activity Scale (TAS), and Knee Injury and Osteoarthritis Outcome Score (KOOS) were obtained preoperatively, at 3, 6, 12 months postoperatively and the last follow-up using an online questionnaire platform. MOCART 2.0 score was calculated at the last follow-up. Analysis of variance (ANOVA) was used to compare PROM pre- and post-operation, with two-tailed p < 0.05 defined as statistical significant. Pearson correlation coefficient was used to evaluate correlation between the PROM and MOCART 2.0 score at the last follow-up with patients demorgraphics.

RESULTS

All patients were followed for an average of 66.47 ± 24.15 months (range, 21-93). All patients were satisfied with the outcome of the surgery and no complication was reported at the end of the study. No significant improvement was observed until 1 year after the implantation, except for IKDC score at 6 months. All PROM showed significant improvement 1 year post-op except for Lysholm score and TAS, which also increased significantly at the time of the last follow-up. Pearson correlation coefficient showed that the size of the defect, before or after debridement, was significantly negatively correlated with final KOOS-Pain (before debridement: r = -0.57, p < 0.05; after debridement: r = -0.54, p < 0.05) and KOOS-Symptoms score (before debridement: r = -0.66, p < 0.05; after debridement: r = -0.67, p < 0.05). The MOCART 2.0 score was found significantly and negatively correlated with BMI (r = -0.60, p < 0.05), and significantly and positively correlated with Lysholm score (r = 0.70, p < 0.05).

CONCLUSION

The next generation MACI with autologous chondrocyte and allogenic chondrocyte ECM scaffold could be used to treat focal articular cartilage defect in the knee joint safely and efficiently with lasting promising outcomes for more than 5 years. The size of the defects should be considered the most negatively correlated parameters influencing the postoperative clinical outcomes.