Early Efficacy of Type I Collagen Based Matrix-Assisted Autologous Chondrocyte Transplantation to Treat Articular Cartilage Lesions

Abstract

Purpose: To investigate the clinical, radiological, and histological results of type I collagen-based matrix-assisted autologous chondrocyte transplantation (MACT) in the treatment of chondral lesions of the knee.Methods: The study prospectively enrolled 20 patients with symptomatic knee chondral defects (mean size defect was 2.41±0.43 cm2, range 2.0 to 3.4 cm2) in the lateral femoral condyle and femoral groove who underwent type I collagen-based MACT between July 2017 and July 2019. KOOS was assessed preoperatively, with periodic clinical follow-up performed preoperatively and then every 3 months for up to 12 months postoperative period, and thereafter at 1-year intervals. During this follow-up, serial magnetic resonance imaging T2 mapping of repair cartilage was used to reflect the quantitative analysis quality of the regenerative cartilage. In one patient, second-look arthroscopy was performed at 12 months after implantation to assess the characteristics of cartilage regeneration.Results: Compared with preoperation, the score of the pain, symptoms, activities of daily living, sports and recreation, and quality of life showed statistically significant improvement with a significant difference at 3, 6, 12, and 24 months after operation(P<0.05). The difference in KOOS subscales scores between every two-time point was statistically significant (P<0.001). HE stains showed the newly formed cartilage was naive chondrocytes. Safranin O-fast green stain manifested in the regenerated tissue comprising predominantly fibroblast-like cells surrounded by glycosaminoglycans. Immunohistochemistry analysis showed that the expression of collagen type II was more clearly and evenly distributed than collagen type I.Conclusion: Type I collagen-based MACT was a clinically effective treatment for functional and pain level improvement, and this method presented histologic evidence of inducing hyaline‐like cartilage in cartilage lesions by biopsy in one case. The quantitative MRI T2-mapping test showed that there was a difference between the transplanted cartilage and the surrounding hyaline cartilage.