Cartilage regeneration using a novel autologous growth factors-based matrix for full-thickness defects in sheep

Abstract

This novel treatment enhanced chondrogenesis and regenerated hyaline cartilage at 6 months with nearly normal macroscopic ICRS assessment. Histological analysis showed equivalent structure to mature cartilage tissue in the defect and a collagen expression pattern in the newly formed cartilage similar to that found in adjacent healthy articular cartilage. The present technique may have clinical application for chondral injuries in humans because this procedure is cheap (no need for allograft, or expensive instrumentation/biomaterials/techniques), easy and fast-performing through a small arthrotomy, and safe (no rejection possibility because the patients' own tissue, cells, and plasma are used).

A novel autologous-made matrix using hyaline cartilage chips and platelet-rich growth factors for the treatment of full-thickness cartilage or osteochondral defects: Preliminary results

“…The CN-Biomatrix preparation has slightly evolved with increasing experience. In the original preparation method used in the animal study, 8 only the PPP (fraction 1) was used to create the growth factor-based matrix. It was initially recommended that fibrin membranes should be elaborated using this fraction, 13 but we felt that this method led to a too rigid matrix that could not be easily adapted to the chondral defect and also reached the semisolid state quicker.…”

“…8 An histological and immunohistochemical analysis demonstrated that this technique was able to restore hyaline cartilage with adequate presence of type II collagen and minimum of type I collagen. 8 Despite the promising future of this technique given the high-quality cartilage tissue formation observed in sheep, this novel treatment option for articular cartilage injuries in humans has only been published as a case report. 6 The purpose of this study was to report the preliminary clinical, functional, and magnetic resonance imaging (MRI)-based outcomes of a novel autologous-made matrix consisting of hyaline cartilage chips combined with mixed plasma poor rich in platelets clot and PRGF in liquid stage for the treatment of full-thickness cartilage and osteochondral knee defects.…”

“…Moreover, the same group performed a study in sheep where the same technique was successfully applied. 8 An histological and immunohistochemical analysis demonstrated that this technique was able to restore hyaline cartilage with adequate presence of type II collagen and minimum of type I collagen. 8 Despite the promising future of this technique given the high-quality cartilage tissue formation observed in sheep, this novel treatment option for articular cartilage injuries in humans has only been published as a case report.…”

Biological Therapies in Orthopedics and Sports Medicine

“…They reported successful outcomes with good function and ability to return to high-level soccer. Moreover, the same group performed a study in sheep where the same technique was successfully applied [167]. A histological and immunohistochemical analysis demonstrated that this technique was able to restore hyaline cartilage with adequate presence of type II collagen and minimum of type I collagen.…”

“…This novel autologous-made matrix consisting of hyaline cartilage chips combined with mixed plasma poor-rich in platelets clot, and plasma rich in growth factors (PRGF) in liquid stage provided excellent clinical, functional, and MRI-based (cartilage repair quality and quantity) outcomes in young, active individuals with full-thickness cartilage or osteochondral defects. This technique seems an excellent alternative for cartilage injuries, as it can be performed in very active, young individuals as a single surgery, is cheap, has no intolerance or rejection potential, and has demonstrated histological and immunohistochemical characteristics very similar to healthy articular cartilage in animal studies [167,168] (Fig. 28.4).…”