scholarly journals Mosaicplasty versus Matrix-Assisted Autologous Chondrocyte Transplantation for Knee Cartilage Defects: A Long-Term Clinical and Imaging Evaluation

2020 ◽  
Vol 10 (13) ◽  
pp. 4615
Author(s):  
Stefano Zaffagnini ◽  
Angelo Boffa ◽  
Luca Andriolo ◽  
Davide Reale ◽  
Maurizio Busacca ◽  
...  
Keyword(s):  
Activity Level ◽  
Autologous Chondrocyte Transplantation ◽  
Cartilage Defects ◽  
Chondrocyte Transplantation ◽  
Knee Cartilage ◽  
Cartilage Lesions ◽  
Long Term Follow Up ◽  
Autologous Chondrocyte

Different surgical procedures have been proposed over the past few years to treat cartilage lesions. The aim of this study was to compare mosaicplasty and matrix-assisted autologous chondrocyte transplantation (MACT) at long-term follow-up. Forty-three patients were included: 20 mosaicplasty and 23 MACT. Patients were evaluated before and 12 years after surgery with the International Knee Documentation Committee (IKDC) subjective and objective scores for symptoms and function, and with the Tegner score for activity level. Magnetic Resonance Imaging (MRI) was used to evaluate repair tissue with the MOCART 2.0 score. Mosaicplasty and MACT showed good clinical and MRI results (IKDC subjective score 75.3 ± 21.8 and 81.8 ± 13.0, both p < 0.0005). Mosaicplasty presented a 10% reoperation rate and a 25% overall failure rate, while no failures were documented in MACT (p = 0.016). While size did not influence the results in the MACT group, mosaicplasty presented lower IKDC objective and Tegner scores in lesions bigger than 2 cm2 (p = 0.031 and p = 0.014, respectively). Mosaicplasty and MACT presented both satisfactory clinical and MRI results at long-term follow-up. However, for larger lesions, MACT presented better subjective and objective outcomes, as well as less failures, which should be considered when choosing the most suitable treatment for patients affected by knee cartilage lesions.

scholarly journals Applications of Chondrocyte-Based Cartilage Engineering: An Overview

2016 ◽  
Vol 2016 ◽  
pp. 1-17 ◽  
Author(s):  
Abdul-Rehman Phull ◽  
Seong-Hui Eo ◽  
Qamar Abbas ◽  
Madiha Ahmed ◽  
Song Ja Kim
Keyword(s):  
Biomedical Application ◽  
Therapeutic Option ◽  
Autologous Chondrocyte Transplantation ◽  
Cartilage Tissue ◽  
Chondrocyte Transplantation ◽  
Culture Methods ◽  
Pharmacological Significance ◽  
Long Term Follow Up ◽  
Autologous Chondrocyte

Chondrocytes are the exclusive cells residing in cartilage and maintain the functionality of cartilage tissue. Series of biocomponents such as different growth factors, cytokines, and transcriptional factors regulate the mesenchymal stem cells (MSCs) differentiation to chondrocytes. The number of chondrocytes and dedifferentiation are the key limitations in subsequent clinical application of the chondrocytes. Different culture methods are being developed to overcome such issues. Using tissue engineering and cell based approaches, chondrocytes offer prominent therapeutic option specifically in orthopedics for cartilage repair and to treat ailments such as tracheal defects, facial reconstruction, and urinary incontinence. Matrix-assisted autologous chondrocyte transplantation/implantation is an improved version of traditional autologous chondrocyte transplantation (ACT) method. An increasing number of studies show the clinical significance of this technique for the chondral lesions treatment. Literature survey was carried out to address clinical and functional findings by using various ACT procedures. The current study was conducted to study the pharmacological significance and biomedical application of chondrocytes. Furthermore, it is inferred from the present study that long term follow-up studies are required to evaluate the potential of these methods and specific positive outcomes.

scholarly journals Early Efficacy of Type I Collagen Based Matrix-Assisted Autologous Chondrocyte Transplantation to Treat Articular Cartilage Lesions

2021 ◽  
Author(s):  
Xiang Li ◽  
Jiatian Qian ◽  
Shiao Li ◽  
Peiliang Fu ◽  
Chengyan Chen
Keyword(s):  
Type I Collagen ◽  
Collagen Type ◽  
T2 Mapping ◽  
Autologous Chondrocyte Transplantation ◽  
Type I ◽  
Chondrocyte Transplantation ◽  
Cartilage Lesions ◽  
Autologous Chondrocyte

Abstract Purpose: To investigate the clinical, radiological, and histological results of type I collagen-based matrix-assisted autologous chondrocyte transplantation (MACT) in the treatment of chondral lesions of the knee.Methods: The study prospectively enrolled 20 patients with symptomatic knee chondral defects (mean size defect was 2.41±0.43 cm2, range 2.0 to 3.4 cm2) in the lateral femoral condyle and femoral groove who underwent type I collagen-based MACT between July 2017 and July 2019. KOOS was assessed preoperatively, with periodic clinical follow-up performed preoperatively and then every 3 months for up to 12 months postoperative period, and thereafter at 1-year intervals. During this follow-up, serial magnetic resonance imaging T2 mapping of repair cartilage was used to reflect the quantitative analysis quality of the regenerative cartilage. In one patient, second-look arthroscopy was performed at 12 months after implantation to assess the characteristics of cartilage regeneration.Results: Compared with preoperation, the score of the pain, symptoms, activities of daily living, sports and recreation, and quality of life showed statistically significant improvement with a significant difference at 3, 6, 12, and 24 months after operation(P<0.05). The difference in KOOS subscales scores between every two-time point was statistically significant (P<0.001). HE stains showed the newly formed cartilage was naive chondrocytes. Safranin O-fast green stain manifested in the regenerated tissue comprising predominantly fibroblast-like cells surrounded by glycosaminoglycans. Immunohistochemistry analysis showed that the expression of collagen type II was more clearly and evenly distributed than collagen type I.Conclusion: Type I collagen-based MACT was a clinically effective treatment for functional and pain level improvement, and this method presented histologic evidence of inducing hyaline‐like cartilage in cartilage lesions by biopsy in one case. The quantitative MRI T2-mapping test showed that there was a difference between the transplanted cartilage and the surrounding hyaline cartilage.

Matrix-Assisted Autologous Chondrocyte Transplantation for Cartilage Regeneration in Osteoarthritic Knees

2012 ◽  
Vol 41 (1) ◽  
pp. 95-100 ◽  
Author(s):  
Giuseppe Filardo ◽  
Francesca Vannini ◽  
Maurilio Marcacci ◽  
Luca Andriolo ◽  
Alberto Ferruzzi ◽  
...  
Keyword(s):  
Failure Rate ◽  
Young Patients ◽  
Activity Level ◽  
Autologous Chondrocyte Transplantation ◽  
Salvage Procedure ◽  
Chondrocyte Transplantation ◽  
The Mean ◽  
Eq Vas ◽  
Autologous Chondrocyte

Background: Young patients with osteoarthritic knees are a challenging population because of a combination of high functional demands and limited indication for joint replacement. Purpose: To analyze the potential of the cartilage regenerative approach by documenting the results and failures of matrix-assisted autologous chondrocyte transplantation (MACT) at midterm follow-up. Study Design: Case series; Level of evidence, 4. Methods: Forty-four patients affected by cartilage lesions in osteoarthritic knees underwent MACT as a salvage procedure. The mean age at surgery was 42 years (range, 20-58 years), and the average defect size was 4 cm2 (range, 1.5-9 cm2). Patients were prospectively evaluated with the subjective International Knee Documentation Committee (IKDC), EuroQol visual analog scale (EQ-VAS), and Tegner scores preoperatively; at 1, 2, and 5 years; and at a final assessment at 9 years’ mean follow-up. Adverse events and failures were also reported. Results: A statistically significant improvement was observed in all scores from the initial evaluation to the final follow-up. The mean ± standard deviation IKDC subjective score improved from 38.0 ± 15.8 to 67.0 ± 18.3 at 2 years ( P < .0005), with a subsequent decrease to 57.8 ± 20.6 at the final follow-up ( P = .012). The same trend was confirmed by the EQ-VAS score. The activity level revealed by the Tegner score improved at all follow-ups but without achieving the preinjury level. The analysis of the influencing factors showed the importance of the meniscus condition, revealing a significantly inferior outcome in knees with previous or combined partial meniscectomy procedures. During the study period, 12 patients had failed results, producing a cumulative failure rate of 27.3%. At the last evaluation, half of the patients considered their condition not better than before the treatment, and 39% would not repeat the treatment considering the results obtained. Conclusion: Despite a statistically significant improvement, the clinical outcome was poor. A higher improvement could be obtained in patients who had not undergone previous or combined meniscectomies, but this was limited over time. The failure rate was also high, regardless of the degree of osteoarthritis. Tissue-engineered cartilage implantation is questionable for this indication, and the limits of this scaffold-based procedure have to be considered if it is used as a salvage procedure for young patients affected by knee osteoarthritis.

High Rate of Failure After Matrix-Assisted Autologous Chondrocyte Transplantation in Osteoarthritic Knees at 15 Years of Follow-up

2019 ◽  
Vol 47 (9) ◽  
pp. 2116-2122 ◽  
Author(s):  
Luca Andriolo ◽  
Davide Reale ◽  
Alessandro Di Martino ◽  
Stefano Zaffagnini ◽  
Francesca Vannini ◽  
...  
Keyword(s):  
Young Patients ◽  
Osteochondral Lesions ◽  
Clinical Failure ◽  
Chondrocyte Transplantation ◽  
Long Term Follow Up ◽  
Ikdc Score ◽  
Eq Vas ◽  
Autologous Chondrocyte

Background: Chondral and osteochondral lesions in osteoarthritic knees of young patients remain challenging for orthopaedic surgeons, due to a combination of high functional demands and limited indications for joint replacement in this population. The possibility of extending the indication of cartilage regenerative procedures to these patients may allow the delay of metal resurfacing. Purpose: To analyze the potential of a cartilage regenerative approach to provide clinical benefits in young patients with osteoarthritic knees, documenting outcomes in terms of clinical improvement as well as failures, in particular regarding knee replacement, at long-term follow-up. Study Design: Case series; Level of evidence, 4. Methods: A total of 41 patients (mean ± SD age, 43 ± 9 years) who had cartilage lesions (4 ± 2 cm2) in osteoarthritic knees (Kellgren-Lawrence grade 2 or 3) underwent matrix-assisted autologous chondrocyte transplantation (MACT) as a salvage procedure. Patients were evaluated with International Knee Documentation Committee (IKDC), EuroQol visual analog scale (EQ-VAS), and Tegner scores before surgery; at 1, 2, 5, and 9 years after surgery; and at a final follow-up at a mean of 15 years after surgery (range, 14-18 years). Failures were also recorded. Results: An improvement was observed in all scores after surgery, but a progressive worsening over time was noted. The mean ± SD IKDC score improved from 38.6 ± 16.2 to a maximum of 66.0 ± 18.6 at 2 years ( P < .0005), with a subsequent deterioration until the final evaluation at 56.2 ± 21.7 ( P = .024). A similar trend was confirmed by EQ-VAS scores. Tegner scores improved at all follow-up points but did not reach the preinjury level. Patients who underwent combined surgery obtained significantly lower results. Only 13 patients (32%) had an IKDC score higher than 70. During the follow-up period, 21 patients underwent reoperation (18 with knee replacement) and 3 more patients experienced clinical failure, for a total surgical and clinical failure rate of 59% at 15 years. Conclusion: The use of cartilage regenerative surgical procedures, such as MACT, as salvage procedures for young, active patients affected by chondral and osteochondral lesions in osteoarthritic knees led to a limited improvement, with the majority of patients experiencing failure at long-term follow-up. Although a minor subpopulation experienced favorable and stable improvement, the use of MACT for such a challenging indication remains questionable until responding patients can be profiled.

Feasibility of arthroscopic autologous chondrocyte implantation in the hip using an injectable hydrogel

2017 ◽  
Vol 28 (4) ◽  
pp. 442-449 ◽  
Author(s):  
Steffen Thier ◽  
Florian Baumann ◽  
Christel Weiss ◽  
Stefan Fickert
Keyword(s):  
Autologous Chondrocyte Implantation ◽  
Activity Level ◽  
Cartilage Defects ◽  
Full Thickness ◽  
Short Term ◽  
Assessment Scores ◽  
Chondrocyte Implantation ◽  
Autologous Chondrocyte

Introduction: In the long term the treatment of articular cartilage defects of the hip has the most direct impact on the postoperative outcome and should diminish degenerative changes caused by different pathologies. The purpose of this prospective feasibility study is to describe technical aspects of arthroscopic, injectable autologous chondrocyte implantation in the hip and to report the short-term outcome. Methods: Full-thickness cartilage defects of 13 patients were treated arthroscopically with an injectable autologous chondrocyte transplantation product (Novocart Inject, Tetec) in a 2-step surgical procedure. Patient-related outcome was assessed with iHOT 33, EQ-5D and Non Arthritic Hip Score at baseline (day before transplantation), after 6 weeks and 3, 6 and 12 months. Results: 13 out of 13 patients (all men) with a mean age of 32.7 ± 6.9 years and an average defect size of 1.9 ± 1.0 cm2 were available for follow-up after a mean of 12 months (range 6-24 months). All defects were located on the acetabulum and 11 were associated with a labral lesion of 2.9 hours size. Femoroacetabular impingement (10 cam, 2 combined, 1 pincer) was the cause of all defects. An overall statistically significant improvement was observed for all assessment scores. Conclusions: In this study we present the feasibility and short-term data of an arthroscopic injectable autologous chondrocyte transplant as a treatment option for full-thickness cartilage defects of the hip. All patient-administered assessment scores demonstrated an increase in activity level, improvement in quality of life and reduction of pain after a 12-month follow-up. Further randomised controlled trails with long-term follow-up and additional morphological assessment are needed.

Diffusion-weighted imaging for the follow-up of patients after matrix-associated autologous chondrocyte transplantation

2010 ◽  
Vol 73 (3) ◽  
pp. 622-628 ◽  
Author(s):  
Klaus M. Friedrich ◽  
Tallal C. Mamisch ◽  
Christina Plank ◽  
Georg Langs ◽  
Stefan Marlovits ◽  
...  
Keyword(s):  
Diffusion Weighted Imaging ◽  
Autologous Chondrocyte Transplantation ◽  
Chondrocyte Transplantation ◽  
Diffusion Weighted ◽  
Autologous Chondrocyte
Sign in / Sign up

Export Citation Format

Share Document