Arthroscopic multiple osteochondral transplantation to the chondral defect in the knee associated with anterior cruciate ligament disruption

Matsusue, Yoshitaka; Yamamuro, Takao; Hama, Hiromichi

doi:10.1016/s0749-8063(05)80428-1

Cited by 449 publications

(245 citation statements)

References 8 publications

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“…The current available treatments for cartilage defects include the application of a periosteal patch to cover the defect (O'Driscoll et al, 1986) and mosaicplasty, in which an osteochondral pillar is grafted from a non-weightbearing site (Matsusue et al, 1993). However, the use of periosteal patches has limitations due to problems with ossification and the limited area that can be treated.…”

Section: Introductionmentioning

confidence: 99%

Cultured articular chondrocytes sheets for partial thickness cartilage defects utilizing temperature-responsive culture dishes

Kaneshiro

Sato²,

Mitani³

et al. 2007

eCM

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The extracellular matrix (ECM) of articular cartilage has several functions that are unique to joints. Although a technique for transplanting cultured chondrocytes has already been introduced, it is difficult to collect intact ECM when using enzymes to harvest samples. Temperatureresponsive culture dishes have already been clinically applied in the fields of myocardial and corneal transplantation. Earlier studies have shown that a sheet of cultured cells with intact ECM and adhesive factors can be harvested using such culture dishes, which allow the surface properties of the dish to be reversibly altered by changing the temperature. Human chondrocytes were subjected to enzymatic digestion and then were seeded in temperatureresponsive culture dishes. A sheet of chondrocytes was harvested by only reducing the temperature after the cultured cells reached confluency. A real-time PCR analysis of the chondrocyte sheets confirmed that type II collagen, aggrecan, and fibronectin were present. These results suggested that, although chondrocytes undergo dedifferentiation in a monolayer culture, multilayer chondrocyte sheets grown in a similar environment to that of three-dimensional culture may be able to maintain a normal phenotype. A histological examination suggested that multilayer chondrocyte sheets could thus prevent the loss of proteoglycans because the area covered by the sheets was well stained by safranin-O. The present experiments suggested that temperature-responsive culture dishes are useful for obtaining cultured chondrocytes, which may then be clinically employed as a substitute for periosteal patches because such sheets can be applied without a scaffold.

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Section: Introductionmentioning

confidence: 99%

Cultured articular chondrocytes sheets for partial thickness cartilage defects utilizing temperature-responsive culture dishes

Kaneshiro

Sato²,

Mitani³

et al. 2007

eCM

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“…Common cartilage repair techniques comprise debridement, bone marrow stimulating techniques, osteochondral grafting, and autologous chondrocyte implantation. [1][2][3][4] Autologous chondrocyte implantation (ACI) has been shown to be clinically effective when implanting culture-expanded chondrocytes alone [5][6][7][8] or in combination with resorbable scaffolds made of collagen, hyaluronan, or polymers. [9][10][11] However, in clinical routine, bone marrow stimulating techniques like drilling, abrasion, or microfracture are frequently used, 1,12,13 are cost effective, and are firstline treatment options for focal cartilage defects.…”

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confidence: 99%

Formation of cartilage repair tissue in articular cartilage defects pretreated with microfracture and covered with cell‐free polymer‐based implants

Erggelet

Endres

Neumann

et al. 2009

Journal Orthopaedic Research

161

118

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The aim of our study was to evaluate the mid-term outcome of a cell-free polymer-based cartilage repair approach in a sheep cartilage defect model in comparison to microfracture treatment. Cell-free, freeze-dried implants (chondrotissue 1 ) made of a poly-glycolic acid (PGA) scaffold and hyaluronan were immersed in autologous serum and used for covering microfractured full-thickness articular cartilage defects of the sheep (n ¼ 4). Defects treated with microfracture only served as controls (n ¼ 4). Six months after implantation, cartilage implants and controls were analyzed by immunohistochemical staining of type II collagen, histological staining of proteoglycans, and histological scoring. Histological analysis showed the formation of a cartilaginous repair tissue rich in proteoglycans. Histological scoring documented significant improvement of repair tissue formation when the defects were covered with the cell-free implant, compared to controls treated with microfracture. Immunohistochemistry showed that the cell-free implant induced cartilaginous repair tissue and type II collagen. Controls treated with microfracture showed marginal formation of a mixed-type repair tissue consisting of cartilaginous tissue and fibro-cartilage. Covering of microfractured defects with the cell-free polymer-based cartilage implant is suggested to be a promising treatment option for cartilage defects and improves the regeneration of articular cartilage. ß

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“…When the fragment of JOCD was stable (ICRS OCD II and III), the fragment was fixed by osteochondral plugs. In case of total loss of cartilage (ICRS OCD IV), we performed the original mosaicplasty technique to resurface the chondral defect [20][21][22]. Rehabilitation protocol After surgery, the knee was immobilised for one week with a knee brace, and range of motion exercises were started from week two.…”

Section: Surgical Techniquesmentioning

confidence: 99%

Osteochondral autograft transplantation for juvenile osteochondritis dissecans of the knee: a series of twelve cases

Sasaki

Matsumoto

Matsushita

et al. 2012

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to evaluate the clinical outcomes of osteochondral autograft transplantation (OAT) for juvenile osteochondritis dissecans (JOCD) lesions of the knee, especially time to return to sports. Methods Twelve knee JOCD lesions with OCD grade 3 and 4 categorised by magnetic resonance imaging (MRI) were treated with OAT. Nine male and two female skeletally immature patients averaging 13.7 years old were included. The OCD lesions were assessed arthroscopically and then fixed in situ using multiple osteochondral plugs harvested under fluoroscopy from the distal femoral condyle without damaging the physis. International Cartilage Repair Society (ICRS) score and Lysholm score were assessed pre-and postoperatively.Results After a mean follow-up of 26.2±15.1 months, the International Knee Documentation Committee (IKDC) subjective score significantly improved (p<0.01). According to the IKDC score, objective assessment showed that ten of 12 (83 %) had excellent results (score: A) after OAT and significantly improved (p<0.01). Based on ICRS criteria, results were satisfactory in all patients. No patients experienced complications at the graft harvest site. All patients returned to their previous level of athletic activity at an average of 5.7 months after the surgery. Conclusions OAT for JOCD of the knee provided satisfactory results in all patients at a mean follow-up of 26.2 months.

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Arthroscopic multiple osteochondral transplantation to the chondral defect in the knee associated with anterior cruciate ligament disruption

Cited by 449 publications

References 8 publications

Cultured articular chondrocytes sheets for partial thickness cartilage defects utilizing temperature-responsive culture dishes

Cultured articular chondrocytes sheets for partial thickness cartilage defects utilizing temperature-responsive culture dishes

Formation of cartilage repair tissue in articular cartilage defects pretreated with microfracture and covered with cell‐free polymer‐based implants

Osteochondral autograft transplantation for juvenile osteochondritis dissecans of the knee: a series of twelve cases

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