Collagen-covered versus matrix-induced autologous chondrocyte implantation for osteochondral defects of the knee: a comparison of tourniquet times

Bartlett, Will; Krishnan, Shibu P.; Skinner, John; Carrington, Richard; Briggs, Tim; Bentley, G.

doi:10.1007/s00590-006-0096-x

Cited by 24 publications

(18 citation statements)

References 8 publications

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“…[5][6][7][8] These techniques show the advantage of a decreased operation time, limited surgical trauma, and lack of complications associated with the use of periosteum in first-generation ACI (e.g., graft overgrowth) and have employed materials such as collagen membranes (type I/III collagen membrane). [9][10][11] One commercial MACI product (type I collagen-based CaReS) has been extensively applied in Europe (and "offlabel" in the United States) and is currently used with some clinical success. 12 CaReS, a 3-dimensional hydrogel, is first seeded with in vitro-enriched autologous chondrocytes and then introduced into the debrided cartilage defect.…”

Section: Introductionmentioning

confidence: 99%

In Vitro Analysis of Cartilage Regeneration Using a Collagen Type I Hydrogel (CaReS) in the Bovine Cartilage Punch Model

et al. 2018

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Objective Limitations of matrix-assisted autologous chondrocyte implantation to regenerate functional hyaline cartilage demand a better understanding of the underlying cellular/molecular processes. Thus, the regenerative capacity of a clinically approved hydrogel collagen type I implant was tested in a standardized bovine cartilage punch model. Methods Cartilage rings (outer diameter 6 mm; inner defect diameter 2 mm) were prepared from the bovine trochlear groove. Collagen implants (± bovine chondrocytes) were placed inside the cartilage rings and cultured up to 12 weeks. Cartilage-implant constructs were analyzed by histology (hematoxylin/eosin; safranin O), immunohistology (aggrecan, collagens 1 and 2), and for protein content, RNA expression, and implant push-out force. Results Cartilage-implant constructs revealed vital morphology, preserved matrix integrity throughout culture, progressive, but slight proteoglycan loss from the "host" cartilage or its surface and decreasing proteoglycan release into the culture supernatant. In contrast, collagen 2 and 1 content of cartilage and cartilage-implant interface was approximately constant over time. Cell-free and cell-loaded implants showed (1) cell migration onto/into the implant, (2) progressive deposition of aggrecan and constant levels of collagens 1 and 2, (3) progressively increased mRNA levels for aggrecan and collagen 2, and (4) significantly augmented push-out forces over time. Cell-loaded implants displayed a significantly earlier and more long-lasting deposition of aggrecan, as well as tendentially higher push-out forces. Conclusion Preserved tissue integrity and progressively increasing cartilage differentiation and push-out forces for up to 12 weeks of cultivation suggest initial cartilage regeneration and lateral bonding of the implant in this in vitro model for cartilage replacement materials.

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Section: Introductionmentioning

confidence: 99%

In Vitro Analysis of Cartilage Regeneration Using a Collagen Type I Hydrogel (CaReS) in the Bovine Cartilage Punch Model

et al. 2018

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“…(20) For select lesions this technique can be modified to be performed arthroscopically with the use of an inflatable silastic catheter as described by Cortese et al(36) This in turn had led to reduced surgical times and reduced the overall surgical morbidity. (12)…”

Section: Maci Surgical Implantationmentioning

confidence: 99%

“…The periosteal harvest required for the original ACI technique is technically cumbersome and increases operative time and morbidity. (12) Complications associated with the arthrotomy and use of the periosteal patch due to graft hypertrophy have been reported. (13–15) Due to the technical difficulty and associated complications, the second generation of ACI was developed using a collagen scaffold instead of a periosteal patch.…”

Section: Introductionmentioning

confidence: 99%

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New and Emerging Techniques in Cartilage Repair: Matrix-Induced Autologous Chondrocyte Implantation

Dunkin

Lattermann

2013

Operative Techniques in Sports Medicine

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The management of full thickness articular cartilage defects is a challenging problem for orthopaedic surgeons. It has limited potential for healing and can be a significant source of pain and loss of function. Multiple cartilage repair strategies have been attempted. Matrix-induced Autologous Chondrocyte Implantation (MACI) has been shown to produce hyaline-like cartilage into chondral defects. The goal of this review is to provide the current principles and technique of the MACI procedure along with reported clinical outcomes with its use.

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“… 1 - 10 The durability of ACI has also been observed in some studies for up to 18 to 20 years. 11 , 12 As the technology has evolved, clinical improvements and generation of hyaline-like repair tissue have been observed with collagen-covered ACI (CACI), in which a type I/III collagen membrane is used instead of a periosteum, 13 - 19 and MACI (matrix-induced autologous chondrocyte implant; Genzyme Biosurgery, Cambridge, MA) in which autologous chondrocytes are cultured in a type I/III collagen membrane prior to implantation. 17 , 20 - 22 …”

Section: Introductionmentioning

confidence: 99%

Arthroscopic Delivery of Matrix-Induced Autologous Chondrocyte Implant

et al. 2012

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Objective:To identify consensus recommendations for the arthroscopic delivery of the matrix-induced autologous chondrocyte implant.Design:An invited panel was assembled on November 20 and 21, 2009 as an international advisory board in Zurich, Switzerland, to discuss and identify best practices for the arthroscopic delivery of matrix-induced autologous chondrocyte implantation.Results:Arthroscopic matrix-induced autologous chondrocyte implantation is suitable for patients 18 to 55 years of age who have symptomatic, contained chondral lesions of the knee with normal or corrected alignment and stability. This technical note describes consensus recommendations of the international advisory board for the technique of arthroscopic delivery of the matrix-induced autologous chondrocyte implant.Conclusions:Matrix-induced autologous chondrocyte implantation can be further improved by arthroscopic delivery that does not require special instrumentation. In principle, arthroscopic versus open procedures of delivery of the matrix-induced autologous chondrocyte implant are less invasive and may potentially result in less postoperative pain, less surgical site morbidity, and faster surgical recovery. Long-term studies are needed to confirm these assumptions as well as the efficacy and safety of this arthroscopic approach.

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Collagen-covered versus matrix-induced autologous chondrocyte implantation for osteochondral defects of the knee: a comparison of tourniquet times

Cited by 24 publications

References 8 publications

In Vitro Analysis of Cartilage Regeneration Using a Collagen Type I Hydrogel (CaReS) in the Bovine Cartilage Punch Model

In Vitro Analysis of Cartilage Regeneration Using a Collagen Type I Hydrogel (CaReS) in the Bovine Cartilage Punch Model

New and Emerging Techniques in Cartilage Repair: Matrix-Induced Autologous Chondrocyte Implantation

Arthroscopic Delivery of Matrix-Induced Autologous Chondrocyte Implant

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