Autologous chondrocyte implantation for cartilage repair: current perspectives

Zellner, Johannes; Krutsch, Werner; Pfeifer, Christian; Koch, Matthias; Nerlich, Michael; Angele, Peter

doi:10.2147/orr.s65569

Cited by 9 publications

(11 citation statements)

References 94 publications

(119 reference statements)

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“…Additionally, chondrocytes tend to dedifferentiate during monolayer culture prior to implantation [ 8 ]. In order to overcome these drawbacks, the call for alternative cell sources such as mesenchymal stem cells (MSCs) and smart biomaterials [ 9 ] is on the rise. Both have been under investigation by several working groups, and while chondrogenic differentiation of MSCs was established already in the late 90 s [ 10 ], clinical applications are still not well established.…”

Section: Introductionmentioning

confidence: 99%

Higher Ratios of Hyaluronic Acid Enhance Chondrogenic Differentiation of Human MSCs in a Hyaluronic Acid–Gelatin Composite Scaffold

Pfeifer¹,

Berner²,

Koch³

et al. 2016

Materials

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Mesenchymal stem cells (MSCs) seeded on specific carrier materials are a promising source for the repair of traumatic cartilage injuries. The best supportive carrier material has not yet been determined. As natural components of cartilage’s extracellular matrix, hyaluronic acid and collagen are the focus of biomaterial research. In order to optimize chondrogenic support, we investigated three different scaffold compositions of a hyaluronic acid (HA)-gelatin based biomaterial. Methods: Human MSCs (hMSCs) were seeded under vacuum on composite scaffolds of three different HA-gelatin ratios and cultured in chondrogenic medium for 21 days. Cell-scaffold constructs were assessed at different time points for cell viability, gene expression patterns, production of cartilage-specific extracellular matrix (ECM) and for (immuno-)histological appearance. The intrinsic transforming growth factor beta (TGF-beta) uptake of empty scaffolds was evaluated by determination of the TGF-beta concentrations in the medium over time. Results: No significant differences were found for cell seeding densities and cell viability. hMSCs seeded on scaffolds with higher ratios of HA showed better cartilage-like differentiation in all evaluated parameters. TGF-beta uptake did not differ between empty scaffolds. Conclusion: Higher ratios of HA support the chondrogenic differentiation of hMSCs seeded on a HA-gelatin composite scaffold.

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Section: Introductionmentioning

confidence: 99%

Higher Ratios of Hyaluronic Acid Enhance Chondrogenic Differentiation of Human MSCs in a Hyaluronic Acid–Gelatin Composite Scaffold

Pfeifer¹,

Berner²,

Koch³

et al. 2016

Materials

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“…This was indicated by a significantly earlier progression to FWB (Figures 6 and 7a) and a significantly earlier start of rehab training. This can also be explained by the bone-tobone healing process, which is considered to be more resilient in OATS than in the case of MACT [5]. In addition, patients who have undergone OATS of the knee joint are more likely to return to full pre-injury activity levels sooner than patients who have had cartilage repair using MFX or MACT [21,31].…”

Section: Rehabilitation After Femorotibial Oatsmentioning

confidence: 99%

“…The choice of surgical treatment depends on the dimension and grade of the defect, the patient's preoperative activity level, and the cause of the defect (e.g., trauma, osteoarthritis), as well as numerous co-factors. In German-speaking countries, bone marrow stimulation techniques such as MFX and MACT are currently the most commonly performed surgical techniques to restore these defects [4,5]. [6] showed an improvement in all patient-reported outcomes after microfracturing of the knee joint after a mean follow-up of 5.7 years.…”

Section: Introductionmentioning

confidence: 99%

The Conformity of Rehabilitation Protocols Used for Different Cartilage Repairs of the Knee Joint—A Review on Rehabilitation Standards in German Speaking Countries

et al. 2021

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The present study analysed current rehabilitation protocols to investigate whether there is a standard for early rehabilitation after microfracturing (MFX), matrix-assisted cartilage transplantation (MACT), and osteochondral autograft transfer (OATS) of the knee joint in clinical routine, and if rehabilitation protocols differ in the repair technique used or the localization of the cartilage defect. The evaluation included rehabilitation criteria such as weight-bearing, range of motion, use of an orthosis, motion therapy, and rehabilitation training during the early rehabilitation phase after MFX, MACT, and OATS of the femorotibial and retropatellar joint space. We analysed 153 rehabilitation protocols after cartilage repair of the knee joint, including 137 protocols for after repair of the main weight-bearing (femorotibial) area and 16 for after retropatellar cartilage repair. Most of the protocols differed significantly according to the location of the repair and the procedure performed. Our findings indicate that full weight-bearing can be achieved significantly faster after MFX (5.6 weeks) and OATS (5.3 weeks) than after MACT of the main weight-bearing zone (6.6 weeks, p < 0.001). In addition, after retropatellar cartilage repair, patients are allowed full weight-bearing after 2.1 weeks compared to the main weight-bearing zone (5.3–6.6 weeks; p < 0.001). No standardized rehabilitation recommendations have been established. The present study shows that rehabilitation needs to be adjusted to the surgical technique and the location of the defect zone, and further investigation is warranted to establish standardized rehabilitation protocols after cartilage repair of the knee joint.

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“…In the ACI method, the chondrocytes from patients are taken, culture-expanded in vitro, and then implanted back into the knees of patients. This procedure is invasive and has a lesser success rate than total knee replacement surgeries [11].…”

Section: Current Treatment Options For Osteoarthritismentioning

confidence: 99%

The Role of Mesenchymal Stromal Cells in the Management of Osteoarthritis of the Knee

Thej¹,

Gupta²

2020

Update on Mesenchymal and Induced Pluripotent Stem Cells

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Osteoarthritis (OA) is one of the most common chronic, inflammatory, and degenerative diseases affecting the synovial joints, the hip, and the knee. OA is commonly managed clinically by treating pain with anti-inflammatory medicines using nonsteroidal anti-inflammatory drugs (NSAIDS) or analgesics. In severe OA patients, invasive knee replacement surgery is the last option. Treatment of OA using mesenchymal stromal cells (MSCs) has been widely explored due to their anti-inflammatory properties and chondrogenic differentiation potential. In this chapter, we comprehensively discuss in detail the in vitro OA potency development, OA preclinical studies, and clinical trials conducted using MSCs.

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Autologous chondrocyte implantation for cartilage repair: current perspectives

Cited by 9 publications

References 94 publications

Higher Ratios of Hyaluronic Acid Enhance Chondrogenic Differentiation of Human MSCs in a Hyaluronic Acid–Gelatin Composite Scaffold

Higher Ratios of Hyaluronic Acid Enhance Chondrogenic Differentiation of Human MSCs in a Hyaluronic Acid–Gelatin Composite Scaffold

The Conformity of Rehabilitation Protocols Used for Different Cartilage Repairs of the Knee Joint—A Review on Rehabilitation Standards in German Speaking Countries

The Role of Mesenchymal Stromal Cells in the Management of Osteoarthritis of the Knee

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