Histologic Analysis of Tissue After Failed Cartilage Repair Procedures

Nehrer, Stefan; Spector, Myron; Minas, Tom

doi:10.1097/00003086-199908000-00020

Cited by 375 publications

(260 citation statements)

References 30 publications

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“…The success rates with these treatments vary greatly. While some of these approaches show promise, many lead to formation of fibrous tissue, apoptosis, and further cartilage degeneration (1)(2)(3)(4)(5)(6). To address the need for improved therapies to promote cartilage repair or regeneration, a number of novel tissue engineering approaches have been developed for the treatment of cartilage defects or osteoarthritis.…”

mentioning

confidence: 99%

Potent induction of chondrocytic differentiation of human adipose‐derived adult stem cells by bone morphogenetic protein 6

Estes

Guilak

2006

Arthritis & Rheumatism

269

212

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Objective. Recent studies have identified an abundant source of multipotent progenitor cells in subcutaneous human adipose tissue, termed human adiposederived adult stem cells (ADAS cells). In response to specific media formulations, including transforming growth factor ␤1 (TGF␤1), these cells exhibit significant ability to differentiate into a chondrocyte-like phenotype, expressing cartilage-specific genes and proteins such as aggrecan and type II collagen. However, the influence of other growth factors on the chondrogenic differentiation of ADAS cells is not fully understood. This study was undertaken to investigate the effects of TGF␤1, TGF␤3, insulin-like growth factor 1, bone morphogenetic protein 6 (BMP-6), and dexamethasone, in various combinations, on the chondrogenic potential of ADAS cells in alginate beads.Methods. The chondrogenic response of alginateencapsulated ADAS cells was measured by quantitative polymerase chain reaction, 3 H-proline and 35 S-sulfate incorporation, and immunolabeling for specific extracellular matrix components.Results. Significant differences in chondrogenesis were observed under the different culture conditions for all outcomes measured. Most notably, BMP-6 upregulated AGC1 and COL2A1 expression by an average of 205-fold and 38-fold, respectively, over day-0 controls, while down-regulating COL10A1 expression by ϳ2-fold.Conclusion. These findings suggest that BMP-6 is a potent inducer of chondrogenesis in ADAS cells, in contrast to mesenchymal stem cells, which exhibit increased expression of type X collagen and a hypertrophic phenotype in response to BMP-6. Combinations of growth factors containing BMP-6 may provide a novel means of regulating the differentiation of ADAS cells for applications in the tissue-engineered repair or regeneration of articular cartilage.

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mentioning

confidence: 99%

Potent induction of chondrocytic differentiation of human adipose‐derived adult stem cells by bone morphogenetic protein 6

Estes

Guilak

2006

Arthritis & Rheumatism

269

212

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“…As reported for other biomaterials used as scaffolds for cell transplantation, the fibrin-hyaluronan matrix did not produce any undue biological, immunological, or allergic response during the followup period. We observed no graft hypertrophy or delamination, which are often associated with failure of the periosteal patch technique [25].…”

Section: Discussionmentioning

confidence: 52%

“…Adverse effects such as hypertrophy of the graft or delamination which are often associated with failure of the periosteal patch technique were not recorded [25]. MRI findings demonstrated an adequate repair with a 75% to 100% defect-fill in all patients.…”

Section: Discussionmentioning

confidence: 92%

Results of Chondrocyte Implantation with a Fibrin-Hyaluronan Matrix: A Preliminary Study

Nehrer

Chiari

Domayer

et al. 2008

Clin Orthop Relat Res

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Fibrin, a homologous polymer, is the natural scaffold of wound healing and therefore a candidate as a carrier for cell transplantation. We explored a novel matrix-based implant cartilage repair composed of both fibrin and hyaluronan in a defined ratio that takes advantage of the biological and mechanical properties of these two elements. The matrix was seeded with autologous chondrocytes expanded in the presence of a proprietary growth factor variant designed to preserve their chondrogenic potential. We prospectively followed eight patients with symptomatic-chronic cartilage defects treated with this carrier. Patients had arthroscopy to harvest autologous chondrocytes then grown in autologous serum. Chondrocytes were cultured in the presence of the FGF variant and then seeded on the fibrin-hyaluronan matrix. About 4 weeks following biopsy, the patients underwent implantation of the constructs by miniarthrotomy. Three of the eight patients had transient effusion. Clinical performance was measured by Lysholm and IKDC scores, MRI, and the need for secondary surgery. The clinical outcome of a 1-year followup demonstrated increase of clinical scores.

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“…Mechanically, regenerated fibrous cartilage is inferior to hyaline cartilage [21,22]. Subchondral bone that has cross talk with articular cartilage [23,24] may not restore after the subchondral bone plate is damaged by BMS in animal osteochondral models [25,26].…”

Section: Reparative Proceduresmentioning

confidence: 99%

Osteochondral lesions of the talus in the athlete: up to date review

Shimozono

Yasui

Ross

et al. 2017

Curr Rev Musculoskelet Med

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Purpose of review Osteochondral lesions of the talus (OLT) are common injuries in athletes. The purpose of this study is to comprehensively review the clinical results and return to sport capacity in athletes following treatment for OLT. Recent findings Reparative procedures, such as bone marrow stimulation, and replacement procedures, such as autologous osteochondral transplantation, provide good clinical outcomes in short-and mid-term follow-up in the athlete. Recently, biological augmentation and scaffold-based therapies have been shown to improve clinical and radiological outcomes in OLT in both the general population and athletes. Summary Most studies are of a low level of evidence. Studies analyzing the return to sport capability in athletes are further lacking. High-level evidence and well-designed clinical trials are required to establish the most effective treatment protocol.

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Histologic Analysis of Tissue After Failed Cartilage Repair Procedures

Cited by 375 publications

References 30 publications

Potent induction of chondrocytic differentiation of human adipose‐derived adult stem cells by bone morphogenetic protein 6

Potent induction of chondrocytic differentiation of human adipose‐derived adult stem cells by bone morphogenetic protein 6

Results of Chondrocyte Implantation with a Fibrin-Hyaluronan Matrix: A Preliminary Study

Osteochondral lesions of the talus in the athlete: up to date review

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