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.

scholarly journals Mesenchymal Stem Cell Extracellular Vesicles as Adjuvant to Bone Marrow Stimulation in Chondral Defect Repair in a Minipig Model

Cartilage ◽  
2021 ◽  
pp. 194760352110297
Author(s):  
Kris T. C. Hede ◽  
Bjørn B. Christensen ◽  
Morten L. Olesen ◽  
Jesper Skovhus Thomsen ◽  
Casper B. Foldager ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Mesenchymal Stem Cell ◽  
Extracellular Vesicles ◽  
Cartilage Repair ◽  
Subchondral Bone ◽  
Micro Computed Tomography ◽  
Bone Marrow Stimulation ◽  
Marrow Stimulation ◽  
Chondral Defects

Objective This study evaluated the effects of mesenchymal stem cell-extracellular vesicles (MSC-EVs) on chondrocyte proliferation in vitro and on cartilage repair in vivo following bone marrow stimulation (BMS) of focal chondral defects of the knee. Methods Six adult Göttingen minipigs received 2 chondral defects in each knee. The pigs were randomized to treatment with either BMS combined with MSC-EVs or BMS combined with phosphate-buffered saline (PBS). Intraarticular injections MSC-EVs or PBS were performed immediately after closure of the surgical incisions, and at 2 and 4 weeks postoperatively. Repair was evaluated after 6 months with gross examination, histology, histomorphometry, immunohistochemistry, and micro-computed tomography (µCT) analysis of the trabecular bone beneath the defect. Results Defects treated with MSC-EVs had more bone in the cartilage defect area than the PBS-treated defects (7.9% vs. 1.5%, P = 0.02). Less than 1% of the repair tissue in both groups was hyaline cartilage. International Cartilage and Joint Preservation Society II histological scoring showed that defects treated with MSC-EVs scored lower on “matrix staining” (20.8 vs. 50.0, P = 0.03), “cell morphology” (35.4 vs. 53.8, P = 0.04), and “overall assessment” (30.8 vs. 52.9, P = 0.03). Consistently, defects treated with MSC-EVs had lower collagen II and higher collagen I areal deposition. Defects treated with MSC-EVs had subchondral bone with significantly higher tissue mineral densities than PBS-treated defects (860 mg HA/cm3 vs. 838 mg HA/cm3, P = 0.02). Conclusion Intraarticular injections of MSC-EVs in conjunction with BMS led to osseous ingrowth that impaired optimal cartilage repair, while enhancing subchondral bone healing.

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 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 The Subchondral Bone Is Affected by Bone Marrow Stimulation: A Systematic Review of Preclinical Animal Studies

Cartilage ◽  
2017 ◽  
Vol 10 (1) ◽  
pp. 70-81 ◽  
Author(s):  
Dexter Seow ◽  
Youichi Yasui ◽  
Ian D. Hutchinson ◽  
Eoghan T. Hurley ◽  
Yoshiharu Shimozono ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Marrow ◽  
Articular Cartilage ◽  
Bone Density ◽  
Subchondral Bone ◽  
Animal Studies ◽  
Bone Marrow Stimulation ◽  
Marrow Stimulation ◽  
Chondral Defects ◽  
Meta Analyses

Objective Despite the mechanical and biological roles of subchondral bone (SCB) in articular cartilage health, there remains no consensus on the postoperative morphological status of SCB following bone marrow stimulation (BMS). The purpose of this systematic review was to clarify the morphology of SCB following BMS in preclinical, translational animal models. Design The MEDLINE and EMBASE databases were systematically reviewed using specific search terms on April 19, 2016 based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The morphology of the SCB was assessed using of microcomputed tomography (bone density) and histology (microscopic architecture). Results Seventeen animal studies with 520 chondral lesions were included. The morphology of SCB did not recover following BMS. Compared with untreated chondral defects, BMS resulted in superior morphology of superficial SCB and cartilage but inferior morphology (specifically bone density, P < 0.05) of the deep SCB. Overall, the use of biological adjuvants during BMS resulted in the superior postoperative morphology of SCB. Conclusions Alterations in the SCB following BMS were confirmed. Biologics adjuvants may improve the postoperative morphology of both SCB and articular cartilage. Refinements of BMS techniques should incorporate consideration of SCB damage and restoration. Investigations to optimize BMS techniques incorporating both minimally invasive approaches and biologically augmented platforms are further warranted.

scholarly journals 062 BONE-MARROW STIMULATION BY DRILLING VERSUS MICROFRACTURE LEADS TO BETTER CARTILAGE REPAIR IN RABBITS

2009 ◽  
Vol 17 ◽  
pp. S42-S43
Author(s):  
H. Chen ◽  
C.D. Hoemann ◽  
J. Sun ◽  
V. Lascau-Coman ◽  
W. Ouyang ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Cartilage Repair ◽  
Bone Marrow Stimulation ◽  
Marrow Stimulation

scholarly journals Effect of subchondral bone sclerosis in repair tissue after bone marrow stimulation for osteochondral talar lesions

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0052
Author(s):  
Ichiro Yoshimura ◽  
Tomonobu Hagio ◽  
Kazuki Kanazawa ◽  
Masahiro Suzuki ◽  
Takuaki Yamamoto
Keyword(s):  
Bone Marrow ◽  
Subchondral Bone ◽  
Cartilage Tissue ◽  
Osteochondral Lesions ◽  
Lesion Length ◽  
Bone Marrow Stimulation ◽  
Repair Tissue ◽  
Marrow Stimulation ◽  
Bone Sclerosis ◽  
The Relationship

Category: Arthroscopy Introduction/Purpose: The arthroscopic bone marrow stimulation (ABMS) technique is the first-line procedure for the treatment of osteochondral lesions of the talus (OLT). Recently, T2 mapping was used to evaluate repair cartilage tissue, but the prognostic factors for T2 values after ABMS have never been clarified. Some patients have OLT with sclerotic changes in the subchondral bone, and several articles have suggested that the subchondral bone condition affects the condition of the articular cartilage. Furthermore, subchondral bone sclerosis (SBC) was found to be associated with an inferior outcome after ABMS.The purpose of this study was to investigate the relationship between subchondral bone sclerotic changes and repair tissue T2 values on MRI after ABMS. Methods: Twenty ankles in 20 patients treated with ABMS for OLT were evaluated. The patients included 7 males and 13 females (age, 30.52±21.44 years, lesion length 10.4±3.0mm, lesion area 55.7±26.5mm2). Repair tissue was assessed using a 3T MRI unit, and T2 maps were calculated at the one-year post-ABMS follow up. The patients were divided into two groups; with SBC and without SBC on pre-ABMS CT images. We investigated the relationship between T2 values and SBC. Clinical results were measured using the Japanese Society for Surgery of the Foot (JSSF) Ankle-Hindfoot Scale. Results: No significant mean differences were found in T2 values or JSSF scores between the with SBC and without SBC groups post-ABMS (T2 values; 48.2±3.3ms vs. 50.1±2.9ms, P=0.7 / JSSF scale score; 89.4±5.8 points vs. 93.3±8.2 points, P=0.25). Lesion length was correlated with the T2 values of repair tissue (Length; r=0.3 P=0.01). Age and BMI were not significantly correlated with T2 values of the repair tissue. Conclusion: The presence of SBC prior to ABMS did not affect the T2 values of repair tissue after ABMS. However, we believe that lesion size affected the condition of the repair tissue.

scholarly journals A Novel Bone Marrow Stimulation Technique Augmented by Administration of Ultrapurified Alginate Gel Enhances Osteochondral Repair in a Rabbit Model

2015 ◽  
Vol 21 (12) ◽  
pp. 1263-1273 ◽  
Author(s):  
Rikiya Baba ◽  
Tomohiro Onodera ◽  
Daisuke Momma ◽  
Masatake Matsuoka ◽  
Kazutoshi Hontani ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Rabbit Model ◽  
Bone Marrow Stimulation ◽  
Alginate Gel ◽  
Marrow Stimulation ◽  
Osteochondral Repair ◽  
Stimulation Technique

scholarly journals Comparison of Bone Marrow Aspirate Concentrate and Allogenic Human Umbilical Cord Blood Derived Mesenchymal Stem Cell Implantation on Chondral Defect of Knee: Assessment of Clinical and Magnetic Resonance Imaging Outcomes at 2-Year Follow-Up

2020 ◽  
Vol 29 ◽  
pp. 096368972094358
Author(s):  
Dong Jin Ryu ◽  
Yoon Sang Jeon ◽  
Jun Sung Park ◽  
Gi Cheol Bae ◽  
Jeong-seok Kim ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Stem Cells ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Cartilage Repair ◽  
Bone Marrow Aspirate ◽  
Human Umbilical Cord Blood ◽  
Human Umbilical Cord ◽  
Resonance Imaging

Biological repair of cartilage lesions remains a significant clinical challenge. A wide variety of methods involving mesenchymal stem cells (MSCs) have been introduced. Because of the limitation of the results, most of the treatment methods have not yet been approved by the Food and Drug Administration (FDA). However, bone marrow aspirate concentrate (BMAC) and human umbilical cord blood derived mesenchymal stem cells (hUCB-MSCs) implantation were approved by Korea FDA. The aim of this study was to evaluate clinical and magnetic resonance imaging (MRI) outcomes after two different types of MSCs implantation in knee osteoarthritis. Fifty-two patients (52 knees) who underwent cartilage repair surgery using the BMAC (25 knees) and hUCB-MSCs (27 knees) were retrospectively evaluated for 2 years after surgery. Clinical outcomes were evaluated according to the score of visual analogue scale (VAS), the International Knee Documentation Committee (IKDC) subjective, and the Knee Injury and Osteoarthritis Outcome Score (KOOS). Cartilage repair was assessed according to the modified Magnetic Resonance Observation of Cartilage Repair Tissue (M-MOCART) score and the International Cartilage Repair Society (ICRS) cartilage repair scoring system. At 2-year follow-up, clinical outcomes including VAS, IKDC, and KOOS significantly improved ( P < 0.05) in both groups; however, there were no differences between two groups. There was no significant difference in M-MOCART [1-year ( P = 0.261), 2-year ( P = 0.351)] and ICRS repair score ( P = 0.655) between two groups. Both groups showed satisfactory clinical and MRI outcomes. Implantation of MSCs from BMAC or hUCB-MSCs is safe and effective for repairing cartilage lesion. However, large cases and a well-controlled prospective design with long-term follow-up studies are needed.

Concentrated Bone Marrow Aspirate in Cartilage Repair (SS-35)

2010 ◽  
Vol 26 (6) ◽  
pp. e17
Author(s):  
Alberto W. Gobbi ◽  
Lorenzo Boldrini ◽  
Brunella Grigolo ◽  
Laura Mazzuco
Keyword(s):  
Bone Marrow ◽  
Cartilage Repair ◽  
Bone Marrow Aspirate ◽  
Concentrated Bone Marrow
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