scholarly journals Early loss of subchondral bone following microfracture is counteracted by bone marrow aspirate in a translational model of osteochondral repair

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Liang Gao ◽  
Patrick Orth ◽  
Kathrin Müller-Brandt ◽  
Lars K. H. Goebel ◽  
Magali Cucchiarini ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Subchondral Bone ◽  
Bone Marrow Aspirate ◽  
Translational Model ◽  
Early Loss ◽  
Osteochondral Repair

scholarly journals Bone Marrow Aspirate Concentrate-Enhanced Marrow Stimulation of Chondral Defects

2017 ◽  
Vol 2017 ◽  
pp. 1-13 ◽  
Author(s):  
Henning Madry ◽  
Liang Gao ◽  
Hermann Eichler ◽  
Patrick Orth ◽  
Magali Cucchiarini
Keyword(s):  
Bone Marrow ◽  
Cartilage Repair ◽  
Subchondral Bone ◽  
Bone Marrow Aspirate ◽  
Critical Role ◽  
Three Dimensional ◽  
Marrow Stimulation ◽  
Chondral Defects ◽  
Osteochondral Repair ◽  
Additional Cell

Mesenchymal stem cells (MSCs) from bone marrow play a critical role in osteochondral repair. A bone marrow clot forms within the cartilage defect either as a result of marrow stimulation or during the course of the spontaneous repair of osteochondral defects. Mobilized pluripotent MSCs from the subchondral bone migrate into the defect filled with the clot, differentiate into chondrocytes and osteoblasts, and form a repair tissue over time. The additional application of a bone marrow aspirate (BMA) to the procedure of marrow stimulation is thought to enhance cartilage repair as it may provide both an additional cell population capable of chondrogenesis and a source of growth factors stimulating cartilage repair. Moreover, the BMA clot provides a three-dimensional environment, possibly further supporting chondrogenesis and protecting the subchondral bone from structural alterations. The purpose of this review is to bridge the gap in our understanding between the basic science knowledge on MSCs and BMA and the clinical and technical aspects of marrow stimulation-based cartilage repair by examining available data on the role and mechanisms of MSCs and BMA in osteochondral repair. Implications of findings from both translational and clinical studies using BMA concentrate-enhanced marrow stimulation are discussed.

Ultrapurified Alginate Gel Containing Bone Marrow Aspirate Concentrate Enhances Cartilage and Bone Regeneration on Osteochondral Defects in a Rabbit Model

2021 ◽  
pp. 036354652110141
Author(s):  
Liang Xu ◽  
Atsushi Urita ◽  
Tomohiro Onodera ◽  
Ryosuke Hishimura ◽  
Takayuki Nonoyama ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Bone Marrow ◽  
Cell Transplantation ◽  
Cartilage Repair ◽  
Subchondral Bone ◽  
Bone Repair ◽  
Bone Marrow Aspirate ◽  
Defect Group ◽  
The Other ◽  
Osteochondral Defects

Background: Ultrapurified alginate (UPAL) gel implantation has been demonstrated as effective in cartilage repair for osteochondral defects; however, cell transplantation within UPAL gels would be required to treat larger defects. Hypothesis: The combination of UPAL gel and bone marrow aspirate concentrate (BMAC) would enhance cartilage repair and subchondral bone repair for large osteochondral defects. Study Design: Controlled laboratory study. Methods: A total of 104 osteochondral defects (1 defect per knee) of 52 rabbits were randomly divided into 4 groups (26 defects per group): defects without any treatment (Defect group), defects treated using UPAL gel alone (UPAL group), defects treated using UPAL gel containing allogenic bone marrow mesenchymal stromal cells (UPAL-MSC group), and defects treated using UPAL gel containing BMAC (UPAL-BMAC group). At 4 and 16 weeks postoperatively, macroscopic and histologic evaluations and measurements of repaired subchondral bone volumes of reparative tissues were performed. Collagen orientation and mechanical properties of the reparative tissue were assessed at 16 weeks. Results: The defects in the UPAL-BMAC group were repaired with hyaline-like cartilage with well-organized collagen structures. The histologic scores at 4 weeks were significantly higher in the UPAL-BMAC group (16.9 ± 2.0) than in the Defect group (4.7 ± 1.9; P < .05), the UPAL group (10.0 ± 3.3; P < .05), and the UPAL-MSC group (12.2 ± 2.9; P < .05). At 16 weeks, the score in the UPAL-BMAC group (24.4 ± 1.7) was significantly higher than those in the Defect group (9.0 ± 3.7; P < .05), the UPAL group (14.2 ± 3.9; P < .05), and the UPAL-MSC group (16.3 ± 3.6; P < .05). At 4 and 16 weeks, the macroscopic evaluations were significantly superior in the UPAL-BMAC group compared with the other groups, and the values of repaired subchondral bone volumes in the UPAL-BMAC group were significantly higher than those in the Defect and UPAL groups. The mechanical properties of the reparative tissues were significantly better in the UPAL-BMAC group than in the other groups. Conclusion: The implantation of UPAL gel containing BMAC-enhanced hyaline-like cartilage repair and subchondral bone repair of osteochondral defects in a rabbit knee model. Clinical Relevance: These data support the potential clinical application of 1-step treatment for large osteochondral defects using biomaterial implantation with cell transplantation.

scholarly journals Role of Scaffolds, Subchondral, Intra-Articular Injections of Fresh Autologous Bone Marrow Concentrate Regenerative Cells in Treating Human Knee Cartilage Lesions: Different Approaches and Different Results

2021 ◽  
Vol 22 (8) ◽  
pp. 3844
Author(s):  
Jacques Hernigou ◽  
Pascale Vertongen ◽  
Joanne Rasschaert ◽  
Philippe Hernigou
Keyword(s):  
Bone Marrow ◽  
Subchondral Bone ◽  
Bone Marrow Aspirate ◽  
Autologous Bone Marrow ◽  
Long Term Results ◽  
Knee Cartilage ◽  
Human Knee ◽  
Cartilage Lesions ◽  
Autologous Bone

The value of bone marrow aspirate concentrates for treatment of human knee cartilage lesions is unclear. Most of the studies were performed with intra-articular injections. However, subchondral bone plays an important role in the progression of osteoarthritis. We investigated by a literature review whether joint, subchondral bone, or/and scaffolds implantation of fresh autologous bone marrow aspirate concentrated (BMAC) containing mesenchymal stem cells (MSCs) would improve osteoarthritis (OA). There is in vivo evidence that suggests that all these different approaches (intra-articular injections, subchondral implantation, scaffolds loaded with BMAC) can improve the patient. This review analyzes the evidence for each different approach to treat OA. We found that the use of intra-articular injections resulted in a significant relief of pain symptoms in the short term and was maintained in 12 months. However, the clinical trials indicate that the application of autologous bone marrow concentrates in combination with scaffolds or in injection in the subchondral bone was superior to intra-articular injection for long-term results. The tendency of MSCs to differentiate into fibrocartilage affecting the outcome was a common issue faced by all the studies when biopsies were performed, except for scaffolds implantation in which some hyaline cartilage was found. The review suggests also that both implantation of subchondral BMAC and scaffolds loaded with BMAC could reduce the need for further surgery.

scholarly journals Repair Potential of Matrix-Induced Bone Marrow Aspirate Concentrate and Matrix-Induced Autologous Chondrocyte Implantation for Talar Osteochondral Repair

Cartilage ◽  
2016 ◽  
Vol 8 (1) ◽  
pp. 50-60 ◽  
Author(s):  
Giovanna Desando ◽  
Isabella Bartolotti ◽  
Francesca Vannini ◽  
Carola Cavallo ◽  
Francesco Castagnini ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Autologous Chondrocyte Implantation ◽  
Bone Marrow Aspirate ◽  
Young Patients ◽  
Osteochondral Lesions ◽  
Aofas Score ◽  
Bone Marrow Aspirate Concentrate ◽  
Osteochondral Repair ◽  
Chondrocyte Implantation ◽  
Autologous Chondrocyte

Objective The low regenerative potential of cartilage contributed to the development of different cell therapies aimed to improve the clinical outcome in young patients with Osteochondral Lesions of the Talus (OLT). This study is designed to assess the regenerative potential of autologous matrix-induced Bone Marrow Aspirate Concentrate (mBMAC) and matrix-induced Autologous Chondrocyte Implantation (mACI) evaluating, on a small number of osteochondral biopsies, the expression of some catabolic, inflammatory, and pain mediators. Design Twenty-two patients with OLT were analyzed in this study; 7 were treated with mACI and 15 with mBMAC. Informed consent was obtained from all the patients. Clinical assessments were performed pre-operatively and at 12, 24, and 36 months after surgery using the American Orthopedic Foot and Ankle Society (AOFAS). Histology and immunohistochemistry were used to assess cartilage repair at 24 months. Data were analyzed using non-parametric Wilcoxon-Mann-Whitney and Spearman tests. Results A remarkable improvement in AOFAS score was noticed for both treatments up to 36 months; however, patients treated with mACI reported the best AOFAS score. Various degrees of tissue remodeling were observed by histological analysis for both cell strategies. However, mBMAC treatment showed a higher expression of some fibrous and hypertrophic markers compared to mACI group. A mild positivity for nerve growth factor, as pain mediator, was noticed for both treatments.M Conclusions Our findings demonstrated the best histological and clinical results following mACI treatment since different fibrotic and hypertrophic features were evident in the mBMAC group at 24-month follow-up.

scholarly journals MORPHOLOGICAL ASSESSMENT OF STRUCTURAL CHANGES IN KNEE JOIN IN MODELED OSTEOARTHROSIS AND APPLICATION OF AUTOLOGICAL BONE MARROW ASPIRATE

2019 ◽  
Vol 19 (4) ◽  
pp. 95-99
Author(s):  
P.V. Tkachuk ◽  
S.S. Strafun
Keyword(s):  
Bone Marrow ◽  
Knee Joint ◽  
Subchondral Bone ◽  
Structural Changes ◽  
Bone Marrow Aspirate ◽  
Social Issues ◽  
Autologous Bone Marrow ◽  
Joint Capsule ◽  
Joint Surface ◽  
Autologous Bone

Background. Treatment of knee join osteoarthritis is one of challenging medico-social issues. Sometimes the conservative treatment fails to produce therapeutic effect, therefore, the use of cellular technologies in the treatment for progressive degenerative changes of the knee joint has been proposed. The objective of this study was to investigate the effect of bone marrow aspirate on the structural changes in the knee joint in modelled osteoarthritis. Materials and methods. The experimental osteoarthritis was simulated in rabbits. Autologous bone marrow aspirate was injected into the knee cavity in 1 month after surgery, and then in 2, 5 months the structural changes of the capsule, meniscus, proximal epiphysis of the tibia were studied. Results. There were the following structural changes in the capsule of the knee joint: stratification of structural elements and reduction of the cell density of the capsule, cell necrosis of the inner surface of the capsule. The defect area of the epiphyseal cartilage was lacking in cartilage, and the peripheral cartilage thickness was decreased by 30, 4% (p<0,05); subchondral bone density made up an average 55,9% compared with the control. In the group with bone marrow aspirate, the density of fibroblasts in the joint capsule increased and the surface of the meniscus was partially preserved; the density of subchondral bone tissue was significantly higher by 79,5% (p<0.05) compared with the control. Structural changes in osteoarthritis include progressive dystrophic changes of the joint surface, subchondral bone, meniscus, and joint capsule. The use of autologous bone marrow aspirate can prevent damage to the subchondral bone, meniscus and joint capsule and promote reticular tissue formation and induction of angiogenesis. The morphological changes of bone marrow through progressive osteoarthritis and its renovation after local application of autological bone marrow aspirate concentrate are promising approaches for the further studies.

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