Injectable autologous chondrocyte implantation in acetabular cartilage defects: 2-year minimum clinical and MRI results

Krueger, David R.; Baur, Alexander; Perka, Carsten; Schroeder, J.

doi:10.1007/s00402-021-04141-2

Cited by 8 publications

(3 citation statements)

References 55 publications

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“… 11 The clinical outcome was confirmed by a recent study, which showed complete defect filling in 87.5% of patients and a mean MOCART score of 82.2 in postoperatively performed MRIs at 2-year follow-up. 46 Putting the findings of the executed case series into perspective, it has to be mentioned that the MCI technique does not disrupt the subchondral plate, and thus, adverse effects of subchondral cyst formation that were observed for microfracture should not account for MCI. The clinical outcome demonstrated by the iHOT-12 was improved to a mean of 86.5%, thus comparable to the results of ACI and better than those reported for microfracture or AMIC.…”

Section: Discussionmentioning

confidence: 99%

Minced Cartilage Implantation in Acetabular Cartilage Defects: Case Series with 2-Year Results

et al. 2023

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Objective The objective was to evaluate clinical outcome and safety of arthroscopic, autologous minced cartilage implantation for acetabular cartilage lesions observed during hip arthroscopy to treat femoroacetabular impingement syndrome (FAIS). Design Eleven male patients, average age: 29.4 ± 5.4 years, average body mass index (BMI): 24.2 ± 2.2 kg/m2, scheduled for hip arthroscopy due to FAIS accompanied by an acetabular cartilage lesion were included in the case series. Cartilage tissue was harvested and minced from the loose cartilage flap at the chondrolabral lesion by arthroscopic shaver, augmented with autologous conditioned plasma, implanted into the defect, and fixated by autologous thrombin. Concomitant interventions were performed as indicated. The patients were evaluated preoperatively and at 24-month follow-up, using the International Hip Outcome Tool-12 (iHOT-12) and Visual Analog Scale (VAS) pain score and by magnetic resonance imaging (MRI) using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) grading scale at the 2-year follow-up. Results The defect size was on average 3.5 cm2 (1.5-4.5 cm2). From preoperatively to 2 years postoperatively, the iHOT-12 significantly improved from 50.2 ± 18 to 86.5 ± 19 ( P < 0.0001), and pain score decreased from 5.6 ± 1.8 to 1.0 ± 1.5 ( P < 0.0001) on the Visual Analog Scale pain score. Regarding functional outcome and pain, 10 of the 11 patients and all patients reached the minimal clinically important difference (MCID), respectively. The postoperative average MOCART score was 87.2 (± 9.2). No adverse events or reoperations were observed. Conclusions Arthroscopic, autologous minced cartilage implantation for treating full-thickness acetabular cartilage lesions in FAIS shows statistically and clinically significant improvement at short-term follow-up.

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Section: Discussionmentioning

confidence: 99%

Minced Cartilage Implantation in Acetabular Cartilage Defects: Case Series with 2-Year Results

et al. 2023

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“…Fontana et al 57 demonstrated superior outcomes with ACI over simple debridement in patients with an Outerbridge Classification >3 and a chondral defect >2 cm 2 . In a cohort of 36 patients, Krueger et al 58 demonstrated complete acetabular defect fill in 87.5% of patients based on MRI. Relative to microfracture, there is a lack of large-scale and long-term studies on the effectiveness of ACI.…”

Section: Operative Optionsmentioning

confidence: 99%

Treatment of Hip Cartilage Defects in Athletes

Alvero,

Wright-Chisem,

Vogel

et al. 2024

Sports Medicine and Arthroscopy Review

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Chondral defects in the athlete’s hip are a relatively common occurrence, often presenting with debilitating pain and activity limitation. Preoperative identification of cartilage defects is challenging and there are many different modalities for treatment. Nonsurgical interventions, including activity modification, physical therapy, and injections, play a vital role, especially in less severe cases and as adjuncts to surgical intervention. Treating surgeons must be familiar with the cartilage restoration procedures available, including debridement, microfracture, and various implantation and transplantation options. Safe and effective management of cartilage defects is imperative to an athlete’s return to sport. It is also imperative that surgeons are aware of all these various treatment options to determine what modality is best for their patients. This review serves to outline these options, cover the published literature, and provide general guidelines for surgeons when they encounter chondral defects in the office and the operating room.

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“…To date, different methods for articular cartilage regeneration have been introduced into clinical practice without a clear effect and without ensuring long-term beneficial outcomes. Such methods as autologous chondrocyte transplantation or microfractures show contradicting results, and permanent recovery is doubtful [2][3][4][5][6]. Currently, tissue engineering focuses on the development of a biomimetic construct with a capability to recreate the structure and morphology of cartilage.…”

Section: Introductionmentioning

confidence: 99%

Functionalized Electrospun Scaffold–Human-Muscle-Derived Stem Cell Construct Promotes In Vivo Neocartilage Formation

et al. 2022

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Polycaprolactone (PCL) is a non-cytotoxic, completely biodegradable biomaterial, ideal for cartilage tissue engineering. Despite drawbacks such as low hydrophilicity and lack of functional groups necessary for incorporating growth factors, it provides a proper environment for different cells, including stem cells. In our study, we aimed to improve properties of scaffolds for better cell adherence and cartilage regeneration. Thus, electrospun PCL–scaffolds were functionalized with ozone and loaded with TGF-β3. Together, human-muscle-derived stem cells (hMDSCs) were isolated and assessed for their phenotype and potential to differentiate into specific lineages. Then, hMDSCs were seeded on ozonated (O) and non-ozonated (“naïve” (NO)) scaffolds with or without protein and submitted for in vitro and in vivo experiments. In vitro studies showed that hMDSC and control cells (human chondrocyte) could be tracked for at least 14 days. We observed better proliferation of hMDSCs in O scaffolds compared to NO scaffolds from day 7 to day 28. Protein analysis revealed slightly higher expression of type II collagen (Coll2) on O scaffolds compared to NO on days 21 and 28. We detected more pronounced formation of glycosaminoglycans in the O scaffolds containing TGF-β3 and hMDSC compared to NO and scaffolds without TGF-β3 in in vivo animal experiments. Coll2-positive extracellular matrix was observed within O and NO scaffolds containing TGF-β3 and hMDSC for up to 8 weeks after implantation. These findings suggest that ozone-treated, TGF-β3-loaded scaffold with hMDSC is a promising tool in neocartilage formation.

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Injectable autologous chondrocyte implantation in acetabular cartilage defects: 2-year minimum clinical and MRI results

Cited by 8 publications

References 55 publications

Minced Cartilage Implantation in Acetabular Cartilage Defects: Case Series with 2-Year Results

Minced Cartilage Implantation in Acetabular Cartilage Defects: Case Series with 2-Year Results

Treatment of Hip Cartilage Defects in Athletes

Functionalized Electrospun Scaffold–Human-Muscle-Derived Stem Cell Construct Promotes In Vivo Neocartilage Formation

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