Articular Cartilage Engineering With Autologous Chondrocyte Transplantation

Brittberg, Mats; Peterson, Lars; Sjögren‐Jansson, Eva; Tallheden, Tommi; Lindahl, Anders

doi:10.2106/00004623-200300003-00017

Cited by 347 publications

(245 citation statements)

References 28 publications

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“…[32][33][34] Non-weight-bearing cartilage is cultured after enzymatic degradation, and implanted into the chondral defect in a load-bearing region. The biochemical response of previously non-load-bearing chondrocytes, cultured and transposed into load-bearing regions, has yet to be clarified or correlated with the clinical response and is of interest given the results of our study.…”

Section: Discussionmentioning

confidence: 99%

Topographical variation in glycosaminoglycan content in human articular cartilage

Rogers

Murphy

Cannon

et al. 2006

The Journal of Bone and Joint Surgery. British volume

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The weight-bearing status of articular cartilage has been shown to affect its biochemical composition. We have investigated the topographical variation of sulphated glycosaminoglycan (GAG) relative to the DNA content of the chondrocyte in human distal femoral articular cartilage.Paired specimens of distal femoral articular cartilage, from weight-bearing and nonweight-bearing regions, were obtained from 13 patients undergoing above-knee amputation. After papain enzyme digestion, spectrophotometric GAG and fluorometric DNA assays assessed the biochemical composition of the samples. The results were analysed using a paired t-test.Although there were no significant differences in cell density between the regions, the weight-bearing areas showed a significantly higher concentration of GAG relative to DNA when compared with non-weight-bearing areas (p = 0.02).We conclude that chondrocytes are sensitive to their mechanical environment, and that local loading conditions influence the metabolism of the cells and hence the biochemical structure of the tissue.

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Section: Discussionmentioning

confidence: 99%

Topographical variation in glycosaminoglycan content in human articular cartilage

Rogers

Murphy

Cannon

et al. 2006

The Journal of Bone and Joint Surgery. British volume

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“…Autologous chondrocyte implantation has shown promising results clinically especially in second-and third-generation procedures when implantation is accompanied by a supporting biomaterial and/or arthroscopic techniques. 18,19 However, there are still limitations to be addressed such as isolating sufficient cell numbers from healthy tissue, To overcome the limitations of chondrocytes as a cell source, stem cells, specifically MSCs, are currently being investigated for use in cartilage regeneration. MSCs may be useful for this purpose as they are readily present within the bone marrow of adults in addition to being a precursor cell type to the chondrocytic lineage.…”

Section: Introductionmentioning

confidence: 99%

Cell-Derived Polymer/Extracellular Matrix Composite Scaffolds for Cartilage Regeneration, Part 1: Investigation of Cocultures and Seeding Densities for Improved Extracellular Matrix Deposition

Levorson

Mountziaris

et al. 2014

Tissue Engineering Part C: Methods

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This study investigated the coculture of chondrocytes and mesenchymal stem cells (MSCs) on electrospun fibrous polymer scaffolds to produce polymer/extracellular matrix (ECM) hybrid constructs with the objective of reducing the number of chondrocytes necessary to produce ample cartilage-like ECM within the scaffolds. To generate these hybrid constructs, electrospun poly(e-caprolactone) fibrous scaffolds were seeded at both high and low initial densities with five different ratios of chondrocytes to MSCs: 1:0, 1:1, 1:3, 1:5, and 0:1, and cultured for 7, 14, and 21 days. Glycosaminoglycan production and distribution within the three coculture groups was similar to quantities generated by chondrocyte-only controls. Conversely, as the concentration of chondrocytes was increased, the collagen content of the constructs also increased at each time point, with a 1:1 chondrocyte to MSC ratio approximating the collagen production of chondrocytes alone. Histological staining suggested that cocultured constructs mimicked the well-distributed ECM patterns of chondrocyte generated constructs, while improving greatly over the restricted distribution of matrix within MSC-only constructs. These results support the capacity of cocultures of chondrocytes and MSCs to generate cartilaginous matrix within a polymeric scaffold. Further, the inclusion of MSCs in these cocultures enables the reduction of chondrocytes needed to produce cell-generated ECM.

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“…However, this procedure is invasive and has certain limitations that is de-differentiation of the chondrocytes during the culture expansion with concomitant down-regulation of cartilage-specific markers and limited life span following transplantation. 34 ACI is a twostep procedure, one where autologous chondrocytes are harvested from cartilage, isolated, and cultured, and in second procedure the cultured cells are implanted into the defect. This procedure has been modified and tissue-engineered membranes are used as scaffolds for growing and expanding the chondrocytes, known as matrix guided autologous chondrocyte implantation (MACI).…”

Section: Autologous Chondrocyte Implantation (Aci)mentioning

confidence: 99%

Emerging Potential of Cell Based Therapies for Articular Cartilage Repair and Regeneration

Venkatesh¹

2017

ATROA

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Abbreviations: ACI, autologous chondrocyte implantation;MSCs, mesenchymal stem cells; PRP, platelet-rich plasma; BMC, autologous bone marrow concentrate; TKR, total knee replacement IntroductionOsteoarthritis is a form of arthritis described as a degenerative joint disease that results from the breakdown of articular cartilage and underlying subchondral bone.1,2 Cartilage is firm, rubbery, protein substance that serves as a "cushion" between the bones, providing a smooth, gliding surface for joint motion. As the cartilage breaks down, it causes pain, swelling, stiffness and problems moving the joint.3 Therefore, Osteoarthritis is a chronic disease and a major cause of disability, characterized by irreversible cartilage degeneration, bony changes of the joints, deterioration of tendons and ligaments, and inflammation of the synoviumas shown in Figure 1. 4 An initial degeneration, known as the 'pre-OA' state may be reversible spontaneously or through preventive measures, however, if not stopped, the disease progresses to later stages which results in loss of articular cartilage surface integrity, break down of bone and osteophyte formation.3,5 OA can affect any joint, but it most often occurs in the knee, hip, lower back and neck, small joints in the finger and base of the big toe ( Figure 2). 6,7Osteoarthritis of the knee is the most common chronic condition affecting all races, gender and ages, but known to be the most common in elderly and obese people. 8,9 The knee acts as a conduit for transferring body weight essential for normal human mobility and the menisci is known to maintain the normal function of the knee, distribute load, lubricate the joint and provide joint stability. Injury to the meniscus from ageing cartilage, repetitive activity or trauma results in pain, limits movement and can accelerate the occurrence and development of OA. In general, partial or complete meniscectomy causes OA of the knee. 8,10,11 While the prevalence of OA increases with age and causes significant decline in the quality of life of individuals above the age of 65, there is increasing evidence of OA in younger population as a result of prior injuries such as anterior cruciate ligament tear or meniscal tears. 8,12,13 Figure 1 Comparison schematic between healthy knee and arthritic knee.Osteoarthritis affects about 237 million of the population, of which an estimated 9 million people alone in United States suffer from symptomatic knee osteoarthritis and it is predicted that an additional 19 million people will be affected by arthritis by 2020. 14-17The incidence of chondral defects is frequent with sporting injuries, and in elderly patients specifically 10% of population over the age of 55 years have troublesome knee pain, and of those, 25% are severely disabled.18 Depending on disease severity, management ranges from conservative treatment to surgical intervention, including total knee replacement. 14,19 In recent years the number and cost of TKR has increased dramatically between 2001 and 2012 from 305,000 to 610,000 procedu...

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Articular Cartilage Engineering With Autologous Chondrocyte Transplantation

Cited by 347 publications

References 28 publications

Topographical variation in glycosaminoglycan content in human articular cartilage

Topographical variation in glycosaminoglycan content in human articular cartilage

Cell-Derived Polymer/Extracellular Matrix Composite Scaffolds for Cartilage Regeneration, Part 1: Investigation of Cocultures and Seeding Densities for Improved Extracellular Matrix Deposition

Emerging Potential of Cell Based Therapies for Articular Cartilage Repair and Regeneration

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