scholarly journals Immunohistological Localization of BMP-2, BMP-7, and Their Receptors in Knee Joints with Focal Cartilage Lesions

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Hagen Schmal ◽  
Alexander T. Mehlhorn ◽  
Ingo H. Pilz ◽  
David Dovi-Akue ◽  
Christina Kirchhoff ◽  
...  
Keyword(s):  
Protein Expression ◽  
Autologous Chondrocyte Implantation ◽  
Defect Size ◽  
Knee Joints ◽  
Duration Of Symptoms ◽  
Cartilage Lesions ◽  
Defect Localization ◽  
Chondrocyte Implantation ◽  
Immunohistological Staining ◽  
Autologous Chondrocyte

Introduction. Although it is well known that BMP-2 and BMP-7 play significant roles in cartilage metabolism, data about intra-articular expression and localization of these proteins and their receptors in humans are rare.Methods. Biopsies of synovia and debrided cartilage were taken in patients undergoing autologous chondrocyte implantation. Expression of BMP-2, BMP-7, and their receptors BMPR-1A, BMPR-1B and BMPR-2 were semiquantitatively evaluated by immunohistological staining.Results. BMP-7 was equally highly expressed in all cartilage and synovial biopsies. Increased levels of BMPR-1A, but not of BMPR-1B, and BMPR-2, were found in all synovial and 47% of all cartilage samples (P=0.002). BMP-2 was positively scored in 47% of all cartilage and 40% of all synovial specimens. Defect size, KOSS, Henderson or Kellgren-Lawrence score did not statistically significant correlate with the expression of the analyzed proteins or Mankin and Pritzker scores. Duration of symptoms and localization of lesions were associated with KOSS (P<0.02), but there was no influence of these parameters on protein expression.Conclusions. BMP-2, BMP-7, and BMPR-1A were expressed in cartilage and synovia of knees with focal cartilage lesions. Although defect localization and duration of symptoms decisively influence KOSS, there was no associated alteration of protein expression observed.

Short-term radiological results after spheroid-based autologous chondrocyte implantation in the knee are independent of defect localisation

2021 ◽  
pp. 1-9
Author(s):  
David Grevenstein ◽  
Darius Schafigh ◽  
Stavros Oikonomidis ◽  
Peer Eysel ◽  
Christoph Brochhausen ◽  
...  
Keyword(s):  
Autologous Chondrocyte Implantation ◽  
Femoral Condyle ◽  
Defect Size ◽  
Radiological Outcome ◽  
Short Term ◽  
Radiological Results ◽  
Defect Localization ◽  
Chondrocyte Implantation ◽  
The Mean ◽  
Autologous Chondrocyte

BACKGROUND: Lesions of articular cartilage represent a crucial risk factor for the early development of osteoarthritis. Autologous chondrocyte implantation (ACI) is a well-established procedure in therapy of those lesions in the knee. The aim of the presented study is to detect differences in short-term radiological outcome depending on defect localization (femoral condyle vs. retropatellar) after spheroid-based ACI. OBJECTIVE: This study aimed to demonstrate that radiological outcome after spheroid-based ACI in the knee is independent of defect localization. METHODS: MRI-scans after retropatellar ACI and ACI of the medial/lateral femoral condyle, with a preoperative Outerbridge grade of III or IV were evaluated regarding MOCART 2.0. RESULTS: The mean defect-size was 5.0 ± 1.8 cm2, with a minimum size of 2 cm2 and a maximum size of 9 cm2. Scans were performed 7.7 months (± 3.1 months) postoperatively. The mean MOCART 2.0 score was 78.5 ± 15.6. No statistically significant influence neither of the localization (p= 0.159), the gender (p= 0.124) nor defect size (< 5 cm2 vs. ⩾ 5 cm2; p= 0.201) could be observed. CONCLUSIONS: The presented data demonstrate good to excellent radiological short-term results after spheroid-based ACI. Data indicates, that at least radiological results are independent of gender, defect-size and defect-localization.

Second-generation arthroscopic autologous chondrocyte implantation for the treatment of degenerative cartilage lesions

2011 ◽  
Vol 20 (9) ◽  
pp. 1704-1713 ◽  
Author(s):  
Giuseppe Filardo ◽  
Elizaveta Kon ◽  
Alessandro Di Martino ◽  
Silvio Patella ◽  
Giulio Altadonna ◽  
...  
Keyword(s):  
Autologous Chondrocyte Implantation ◽  
Second Generation ◽  
Cartilage Lesions ◽  
Chondrocyte Implantation ◽  
Degenerative Cartilage ◽  
Autologous Chondrocyte

Hip Cartilage Restoration: Available Evidence and Current Trends

2018 ◽  
Vol 02 (02) ◽  
pp. 081-087
Author(s):  
Tyler Collins
Keyword(s):  
Autologous Chondrocyte Implantation ◽  
Treatment Options ◽  
Cost Effective ◽  
Nonoperative Treatment ◽  
Current Evidence ◽  
Adequate Treatment ◽  
Cartilage Lesions ◽  
Chondrocyte Implantation ◽  
Osteochondral Grafting ◽  
Autologous Chondrocyte

AbstractTreatment of cartilage pathology is controversial. In the hip, it is even more so as identification and treatment of early cartilage disease are relatively new and little evidence exists. With the advent and more widespread use of hip arthroscopy, easier access to the hip joint is available, and adequate treatment is possible with less morbidity. Many treatment options exist for cartilage lesions including nonoperative treatment, debridement, microfracture, acetabuloplasty, cartilage fixation, cartilage scaffolds, autologous chondrocyte implantation, and osteochondral grafting. While far from definitive, the current evidence suggests that smaller cartilage lesions (< 4 cm2) have good results with most treatments while larger lesions fare better with treatments that produce hyaline-like cartilage. The most cost-effective arthroscopic treatments of smaller cartilage lesions include acetabuloplasty and microfracture, while larger lesions should be considered for autologous matrix-induced chondrogenesis or matrix-assisted autologous chondrocyte implantation. Larger cartilage lesions with bone disease are more adequately treated with open procedures such as osteochondral grafting or total hip arthroplasty.

Survival Analysis of Revision Autologous Chondrocyte Implantation for Failed ACI

2019 ◽  
Vol 47 (13) ◽  
pp. 3212-3220 ◽  
Author(s):  
Takahiro Ogura ◽  
Tim Bryant ◽  
Gergo Merkely ◽  
Brian A. Mosier ◽  
Tom Minas
Keyword(s):  
Survival Analysis ◽  
Clinical Outcomes ◽  
Cartilage Repair ◽  
Autologous Chondrocyte Implantation ◽  
Survival Rates ◽  
Successful Outcome ◽  
Data Set ◽  
Cartilage Lesions ◽  
Chondrocyte Implantation ◽  
Autologous Chondrocyte

Background: Autologous chondrocyte implantation (ACI) provides a successful outcome for treating articular cartilage lesions. However, there have been very few reports on the clinical outcomes of revision ACI for failed ACI. Purpose: To evaluate clinical outcomes in patients who underwent revision ACI of the knee for failure of an initial ACI and to determine the factors affecting the survival rate. Study Design: Case series; Level of evidence, 4. Methods: A review of a prospectively collected data set was performed from patients who underwent revision ACI of the knee for failure of an initial ACI between 1995 and 2014 by a single surgeon. The authors evaluated 53 patients (53 knees; mean age, 38 years) over a mean 11.2-year follow-up (range, 2-20). A total of 62 cartilage lesions were treated for failed graft lesions after an initial ACI, and 31 new cartilage lesions were treated at revision ACI, as there was progression of disease. Overall, 93 cartilage lesions (mean, 1.8 lesions per knee) with a total surface area of 7.4 cm2 (range, 2.5-18 cm2) per knee were treated at revision ACI. Survival analysis was performed with the Kaplan-Meier method, with ACI graft failure or conversion to a prosthetic arthroplasty as the endpoint. The modified Cincinnati Knee Rating Scale, Western Ontario and McMaster Universities Osteoarthritis Index, visual analog scale, and 36-Item Short Form Health Survey were used to evaluate clinical outcomes. Patients also self-reported knee function and satisfaction. Standard radiographs were evaluated with Kellgren-Lawrence grades. Results: Survival rates were 71% and 53% at 5 and 10 years, respectively. Survival subanalysis revealed a trend that patients without previous cartilage repair procedures before an initial ACI had better survival rates than those with such procedures (81% vs 62% at 5 years, 64% vs 42% at 10 years, P = .0958). Patients with retained grafts showed significant improvement in pain and function, with a high level of satisfaction. At a mean 5.1 years postoperatively, 18 of 27 successful knees were radiographically assessed with no significant osteoarthritis progression. Outcomes for 26 patients were considered failures (mean, 4.9 years postoperatively), in which 15 patients had prosthetic arthroplasty (mean, 4.6 years) and the other 11 patients had revision cartilage repair (mean, 5.4 years) and thus could maintain their native knees. Conclusion: Results of revision ACI for patients who failed ACI showed acceptable clinical outcomes. Revision ACI may be an option for young patients after failed initial ACI, particularly patients without previous cartilage repair procedures and those who desire to maintain their native knees.

scholarly journals High-Density Autologous Chondrocyte Implantation as Treatment for Ankle Osteochondral Defects

Cartilage ◽  
2019 ◽  
pp. 194760351983589 ◽  
Author(s):  
Juan Manuel López-Alcorocho ◽  
Isabel Guillén-Vicente ◽  
Elena Rodríguez-Iñigo ◽  
Ramón Navarro ◽  
Rosa Caballero-Santos ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Autologous Chondrocyte Implantation ◽  
Histological Study ◽  
High Density ◽  
Osteochondral Lesions ◽  
Type I ◽  
Cartilage Lesions ◽  
Chondrocyte Implantation ◽  
Autologous Chondrocyte

Purpose Two-year follow-up to assess efficacy and safety of high-density autologous chondrocyte implantation (HD-ACI) in patients with cartilage lesions in the ankle. Design Twenty-four consecutive patients with International Cartilage repair Society (ICRS) grade 3-4 cartilage lesions of the ankle were included. Five million chondrocytes per cm2 of lesion were implanted using a type I/III collagen membrane as a carrier and treatment effectiveness was assessed by evaluating pain with the visual analogue scale (VAS) and American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score at baseline, 12-month, and 24-month follow-up, together with dorsal and plantar flexion. Magnetic resonance observation for cartilage repair tissue (MOCART) score was used to evaluate cartilage healing. Histological study was possible in 5 cases. Results Patients’ median age was 31 years (range 18-55 years). Median VAS score was 8 (range 5-10) at baseline, 1.5 (range 0-8) at 12-month follow-up, and 2 (rang e0-5) at 24-month follow-up ( P < 0.001). Median AOFAS score was 39.5 (range 29-48) at baseline, 90 (range 38-100) at 12-month follow-up, and 90 (range 40-100) at 24-month follow-up ( P < 0.001). Complete dorsal flexion significantly increased at 12 months (16/24, 66.7%) and 24 months (17/24, 70.8%) with regard to baseline (13/24, 54.2%) ( P = 0.002). MOCART at 12- and 24-month follow-ups were 73.71 ± 15.99 and 72.33 ± 16.21. Histological study confirmed that neosynthetized tissue was cartilage with hyaline extracellular matrix and numerous viable chondrocytes. Conclusion HD-ACI is a safe and effective technique to treat osteochondral lesions in the talus, providing good clinical and histological results at short- and mid-term follow-ups.

scholarly journals Analysis of graft maturation after autologous chondrocyte implantation with T2 mapping

2017 ◽  
Vol 5 (4_suppl4) ◽  
pp. 2325967117S0015
Author(s):  
Thomas R. Niethammer ◽  
Ansgar Loitzsch ◽  
Matthias F. Pietschmann ◽  
Peter E. Müller ◽  
Annie Horng
Keyword(s):  
Relaxation Time ◽  
Autologous Chondrocyte Implantation ◽  
T2 Mapping ◽  
Cartilage Defects ◽  
T2 Relaxation Time ◽  
T2 Relaxation ◽  
Postoperative Course ◽  
Defect Localization ◽  
Chondrocyte Implantation ◽  
Autologous Chondrocyte

Aims and Objectives: It has been shown in numerous clinical studies that matrix-based autologous chondrocyte implantation (mb-ACI) leads to good clinical results in the medium-term course. But chondrogenic development of ACI grafts and the time of graft maturation are still unclear. The aim of this study was to investigate the graft maturation after mb-ACI with T2 mapping in the postoperative course of four years. Materials and Methods: In a total of 90 patients could be included after matrix-based autologous chondrocyte transplantation of the knee. All cartilage defects were treated with NOVOCART® 3D. The evaluation of the ACI grafts was conducted after 3, 6, 12, 24, 36 and 48 months by MRI. The T2 relaxation time values of the ACI graft and healthy native cartilage areas were determined to assess graft maturation using T2 mapping. MOCART score were used for morphological evaluation of ACI grafts. Results: The T2 relaxation time of ACI grafts showed a significant improvement during the postoperative course at all time points. The T2 relaxation improved from 48.0 ms after 3 months to 34.6 ms after four years. We found a significant influence of the patient’s age and the defect localization on the T2 relaxation time measuring. It could be detected an increasing integration of the ACI grafts into the healthy surrounding cartilage. No significant differences between the T2 relaxation time of ACI grafts and the surrounding healthy cartilage were found after 12 months postoperatively. Conclusion: Graft maturation after ACI in the knee joint needs at least 1 year, with ongoing adjustment of the T2 relaxation time values compared with native surrounding cartilage. Regarding the age and defect localization, significantly worse T2 relaxation times of the ACI grafts could be found with higher age and in cases with treated patellar defects.

The Role of Hypertension in Cartilage Restoration: Increased Failure Rate After Autologous Chondrocyte Implantation but Not After Osteochondral Allograft Transplantation

Cartilage ◽  
2020 ◽  
pp. 194760351990079 ◽  
Author(s):  
Gergo Merkely ◽  
Jakob Ackermann ◽  
Andreas H. Gomoll
Keyword(s):  
Graft Failure ◽  
Autologous Chondrocyte Implantation ◽  
Female Gender ◽  
Defect Size ◽  
Osteochondral Allograft ◽  
Multivariate Logistic Regression ◽  
Chondrocyte Implantation ◽  
Independent Risk Factors ◽  
Available Information ◽  
Autologous Chondrocyte

Objectives. The purpose of this study was to examine whether patients with diagnosed hypertension have an increased risk of graft failure following cartilage repair with either autologous chondrocyte implantation (ACI) or osteochondral allograft transplantation (OCA). We hypothesized that hypertension is related to higher ACI and OCA graft failure. Design. Patients who underwent ACI or OCA transplantation between February 2009 and December 2016 were included in this study. Inclusion criteria were (1) at least 2 years’ follow-up, (2) available information related to the living habits (smoking and medication status), and (3) available information related to the presence of hypertension, diabetes mellitus, or hyperlipidemia. To identify potential independent risk factors of graft failure, univariate screening was performed and factors with significance at a level of P < 0.1 were entered in multivariate logistic regression models. Results. A total of 368 patients (209 ACI and 159 OCA) were included into our study. In the ACI group, 61 patients’ (29.1%) graft failed. Univariate screening identified older age, female gender, defect size, higher prevalence of hypertension, and smoking as a predictor of graft failure. Following, multivariate logistic regression revealed female gender (odds ratio [OR] 1.02, P = 0.048), defect size (OR 1.07, P = 0.035), and hypertension (OR 3.73, P = 0.023) as significant independent risk factors predicting graft failure after ACI. In the OCA group, 29 patients’ (18.2%) graft failed and none of the included factors demonstrated to be a potential risk factor for graft failure. Conclusion. Hypertension, defect size, and female gender seem to predict ACI graft failure but not OCA failure.

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