Clinical, Radiographic, and Histological Outcomes After Cartilage Repair With Particulated Juvenile Articular Cartilage

Farr, Jack; Tabet, Samuel K.; Margerrison, Ed; Cole, Brian J.

doi:10.1177/0363546514528671

Cited by 178 publications

(140 citation statements)

References 12 publications

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“…However, given the regulatory hurdles for matrix-based technologies and the financial implications of this, the industry has developed alternatives. The manufacturer of DeNovo-Natural Tissue combined allograft particulated juvenile cartilage with fibrin adhesive to create a product that got regulatory approval as a minimally processed allograft in the United States [9,27]. As a cell source, DeNovo-Natural Tissue offers significant theoretical benefits with increased replicative and matrix synthetic ability compared with adult chondrocytes [1,22,38].…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, other companies are producing minimally processed allograft tissue matrices. The first case series on DeNovo-Natural Tissue recently was published and shows promising results compared with other available techniques [9,41]. Time will reveal whether allograft tissue matrices can fill the need for cartilage repair in the United States or whether they will become substandard treatments that will attain FDA approval as minimally processed allografts and not investigational devices, therefore being significantly less expensive and easier to get to market without the need for large randomized studies proving efficacy [27].…”

Section: Discussionmentioning

confidence: 99%

“…The implant procedure is referred to as autologous chondrocyte transplantation and, in the setting of juvenile allogeneic cartilage, is referred to as particulated juvenile articular cartilage. The currently available particulated juvenile articular cartilage in the United States is DeNovo-Natural Tissue (Zimmer, Warsaw, IN, USA) [9].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

What Is the Effect of Matrices on Cartilage Repair? A Systematic Review

Wylie

Hartley

Kapron

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Articular cartilage has minimal endogenous ability to undergo repair. Multiple chondral restoration strategies have been attempted with varied results. Questions/purposes The purpose of our review was to determine: (1) Does articular chondrocyte transplantation or matrix-assisted articular chondrocyte transplantation provide better patient-reported outcomes scores, MRI morphologic measurements, or histologic quality of repair tissue compared with microfracture in prospective comparative studies of articular cartilage repair; and (2) which available matrices for matrix-assisted articular chondrocyte transplantation show the best patient-reported outcomes scores, MRI morphologic measurements, or histologic quality of repair tissue? Methods We conducted a systematic review of PubMed, CINAHL, and MEDLINE from March 2004 to February 2014 using keywords determined to be important for articular cartilage repair, including ''cartilage'', ''chondral'', ''cell source'', ''chondrocyte'', ''matrix'', ''augment'', ''articular'', ''joint'', ''repair'', ''treatment'', ''regeneration'', and ''restoration'' to find articles related to cell-based articular cartilage repair of the knee. The articles were reviewed by two authors (JDW, MKH), our study exclusion criteria were applied, and articles were determined to be relevant (or not) to the research questions. The Methodological Index for Nonrandomized Studies (MIN-ORS) scale was used to judge the quality of nonrandomized manuscripts used in this review and the Jadad score was used to judge the quality of randomized trials. Seventeen articles were reviewed for the first research question and 83 articles were reviewed in the second research question from 301 articles identified in the original systematic search. The average MINORS score was 9.9 (62%) for noncomparative studies and 16

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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What Is the Effect of Matrices on Cartilage Repair? A Systematic Review

Wylie

Hartley

Kapron

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…In combination with a biocompatible and chondroinductive matrix, allogenic chondrocytes harvested from neonatal donors or from donor's knee joints within 24 hours of death may be used in a single-stage procedure. 84 Preliminary results demonstrated a safe and effective treatment for cartilage defects with a mean lesion size of 2.7 cm 2 . Clinical outcomes showed significant improvement over baseline and favorable histological repair tissue 2 years postoperatively.…”

Section: Potential Cell Types For Treatment Of Chondral Injuriesmentioning

confidence: 93%

Autologous chondrocyte implantation for cartilage repair: current perspectives

Zellner¹,

Krutsch²,

Pfeifer³

et al. 2015

ORR

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Over the last decade, regenerative treatment options have become the more routinely used techniques for treatment of cartilage defects, with predictable outcomes for their specific indications. For large chondral lesions in young patients, in particular, autologous chondrocyte implantation is the treatment of choice for restoration of joint health. This review focuses on indications, results, and outcome predictors of autologous chondrocyte implantation in comparison to other regenerative treatment procedures and discusses improvement options and future perspectives for autologous chondrocyte transplantation. As research activities are increasing in the field of regenerative joint therapy, recent developments may help to overcome remaining limitations step by step.

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“…Shortterm results have been promising, and compare favorably to more traditional cartilage repair techniques. 7,8 The purpose of this investigation was to comprehensively evaluate the magnetic resonance imaging (MRI) findings of the reconstructed cartilage in patients who had undergone transplantation of PJAC for symptomatic full thickness cartilage defects of the patella. Utilizing standard morphologic MRI and T2 mapping we sought to correlate patient and graft characteristics with lesion fill, maturation of healing tissue, and the status of the surrounding cartilage.…”

Section: Introductionmentioning

confidence: 99%

Cartilage Regeneration in Full-Thickness Patellar Chondral Defects Treated with Particulated Juvenile Articular Allograft Cartilage: An MRI Analysis

et al. 2017

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Background. Full-thickness cartilage lesions of the patella represent a common source of pain and dysfunction. Previously reported surgical treatment options include marrow stimulation, cell-based treatments, and osteochondral transfer. Minced juvenile allograft cartilage is a novel treatment option that allows for a single stage approach for these lesions. Hypothesis. Particulated juvenile allograft cartilage (PJAC) for the treatment of chondral defects of the patella would offer acceptable lesion fill rates, mature over time, and not be associated with any negative biologic effects on the surrounding tissue. Methods. A retrospective chart review of prospectively collected data was conducted to identify consecutive patients who were treated with PJAC for a full thickness symptomatic cartilage lesion. Qualitative (fast spin echo) and quantitative (T2 mapping) magnetic resonance imaging (MRI) was undertaken at the 6-, 12-, and 24-month postoperative mark. Numerous patient, lesion, and graft specific factors were assessed against MRI scores and percent defect fill of the graft. Graft maturation over time was also assessed. Results. Forty-five patients total were included in the study. Average age at the time of surgery was 26.5 years (range 13-45 years), average lesion size was 208 mm 2 (range 4-500 mm 2 ), and average donor age was 49.5 months (range 3-120 months). Sixty percent of the patients were female, while 93% of all patients underwent a concomitant procedure at the time of the index operation. Six-month MRI findings revealed that no patient-, graft-, or donor-specific factors correlated with MR scores, and 82% of the knees demonstrated good to excellent fill. Twelve-month MRI findings revealed that T2 relaxation times of deep graft demonstrated negative correlation with patient age (P = 0.049) and donor age (P = 0.006), the integration zone showed a negative correlation with donor age (P = 0.026). In all, 85% of patients at 12 months displayed good to moderate fill of the graft. At 24 months, patient age demonstrated negative correlation with average T2 relaxation times of the deep and superficial graft (P = 0.005; P = 0.0029) and positive correlation with the superficial zone of the adjacent cartilage (P = 0.001). Donor age showed negative correlation with grayscale score (P = 0.004) and T2 relaxation times at deep integration zone (P = 0.018). T2 relaxation times of deep and superficial graft and integration zone improved over time (P < 0.001) and between each time point.Conclusions. Particulated juvenile allograft tissue appears to be an acceptable reconstructive option for full-thickness cartilage lesions of the patella, offering satisfactory tissue defect fill at 6, 12, and 24 months after surgery. Imaging of the repaired cartilage demonstrates progressive graft maturation over time.

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Clinical, Radiographic, and Histological Outcomes After Cartilage Repair With Particulated Juvenile Articular Cartilage

Abstract: This study demonstrates a rapid, safe, and effective treatment for cartilage defects. For the patient population investigated, the clinical outcomes of the PJAC technique showed a significant improvement over baseline, with histologically favorable repair tissue 2 years postoperatively.

Cited by 178 publications

References 12 publications

What Is the Effect of Matrices on Cartilage Repair? A Systematic Review

What Is the Effect of Matrices on Cartilage Repair? A Systematic Review

Autologous chondrocyte implantation for cartilage repair: current perspectives

Cartilage Regeneration in Full-Thickness Patellar Chondral Defects Treated with Particulated Juvenile Articular Allograft Cartilage: An MRI Analysis

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