Macroscopic cartilage repair scoring of defect fill, integration and total points correlate with corresponding items in histological scoring systems – a study in adult sheep

Goebel, Lars; Orth, Patrick; Cucchiarini, Magali; Pape, Dietrich; Madry, Henning

doi:10.1016/j.joca.2016.10.014

Cited by 13 publications

(18 citation statements)

References 35 publications

(25 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is important to determine standardized methods of assessing outcomes relevant to cartilage repair. Several studies reported improvements in the macroscopic appearance of cartilage; while macroscopic appearance scoring is predictive of histological scoring (Goebel et al, 2017), it is unclear how this correlates with functional improvements. The three studies that used collagenase to induce cartilage loss, often termed collagenase induced OA (CIOA) models, assessed the highly clinically relevant outcomes of pain behavior, with both reporting reduction from early stages.…”

Section: Discussionmentioning

confidence: 99%

The Treatment of Cartilage Damage Using Human Mesenchymal Stem Cell-Derived Extracellular Vesicles: A Systematic Review of in vivo Studies

Romain

Mak

et al. 2020

Front. Bioeng. Biotechnol.

View full text Add to dashboard Cite

Damage to joints through injury or disease can result in cartilage loss, which if left untreated can lead to inflammation and ultimately osteoarthritis. There is currently no cure for osteoarthritis and management focusses on symptom control. End-stage osteoarthritis can be debilitating and ultimately requires joint replacement in order to maintain function. Therefore, there is growing interest in innovative therapies for cartilage repair. In this systematic literature review, we sought to explore the in vivo evidence for the use of human Mesenchymal Stem Cell-derived Extracellular Vesicles (MSC-EVs) for treating cartilage damage. We conducted a systematic literature review in accordance with the PRISMA protocol on the evidence for the treatment of cartilage damage using human MSC-EVs. Studies examining in vivo models of cartilage damage were included. A risk of bias analysis of the studies was conducted using the SYRCLE tool. Ten case-control studies were identified in our review, including a total of 159 murine subjects. MSC-EVs were harvested from a variety of human tissues. Five studies induced osteoarthritis, including cartilage loss through surgical joint destabilization, two studies directly created osteochondral lesions and three studies used collagenase to cause cartilage loss. All studies in this review reported reduced cartilage loss following treatment with MSC-EVs, and without significant complications. We conclude that transplantation of MSC-derived EVs into damaged cartilage can effectively reduce cartilage loss in murine models of cartilage injury. Additional randomized studies in animal models that recapitulates human osteoarthritis will be necessary in order to establish findings that inform clinical safety in humans.

show abstract

Section: Discussionmentioning

confidence: 99%

The Treatment of Cartilage Damage Using Human Mesenchymal Stem Cell-Derived Extracellular Vesicles: A Systematic Review of in vivo Studies

Romain

Mak

et al. 2020

Front. Bioeng. Biotechnol.

View full text Add to dashboard Cite

show abstract

“…According to the initial report of this trial, the average and the size variation of the repair sites (2.4-2.6 cm 2 ; SD 1.2-1.0) were significantly smaller than in our material. 18 In an animal study, Goebel et al 20 analyzed macroscopically the performance of different repair tissue scoring systems, including the ICRS and the OAS scores. These investigators used material of standard-sized (4 × 8 mm) lesions in 38 medial femoral condyles of Merino sheep who were sacrificed 6 months postoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the reliability of both scores to evaluate repair tissue quality in larger cartilage lesions is unknown. Furthermore, previous validation studies have shown limitations in score performance, but the reasons for these deficiencies remain unclear . Because the ICRS and OAS scores are used to assess the outcome of cartilage repair in various types of cartilage lesions, it is important to understand how the lesion characteristics might affect the reliability of both scores and what reasons might explain the previously observed limitations in score performance.…”

mentioning

confidence: 99%

Assessment of Cartilage Repair Quality With the International Cartilage Repair Society Score and the Oswestry Arthroscopy Score

Paatela

Vasara

Nurmi

et al. 2019

Journal Orthopaedic Research

View full text Add to dashboard Cite

The International Cartilage Repair Society (ICRS) score and the Oswestry Arthroscopic Score (OAS) have been validated to evaluate repair tissue quality. However, the performance of these scores has not been studied in typical patients undergoing cartilage repair and who have lesions of varying sizes. In this study, we compared the performance of the ICRS and the OAS scores and analyzed the effect of lesion characteristics on the performance of these two scores. Cartilage repair quality was assessed in a total of 104 arthroscopic observations of cartilage repair sites of the knee in 62 patients after autologous chondrocyte implantation. Two observers scored the repair areas independently with the ICRS and the OAS scores. The performance of both scores was evaluated according to internal consistency and inter‐rater reliability and correlation between the scores. The frequency and proportion of disagreements were analyzed according to the repair site area and the given score. The correlation between the scores was good (r = 0.91, 95% confidence interval [CI]: 0.87–0.94). Both scores showed moderate internal consistency and inter‐rater reliability. Cronbach's α was 0.88 (95% CI: 0.80–0.92) for the ICRS score and 0.79 (95% CI: 0.70–0.86) for the OAS score. The intraclass correlation coefficient was 0.89 (95% CI: 0.84–0.92) for the ICRS and 0.81 (95% CI: 0.74–0.87) for the OAS scores. The frequency and proportion of disagreements were higher in larger repair sites. In arthroscopic use, both ICRS and OAS scores perform similarly, however, their reliability deteriorates as the lesion size increases. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:555–562, 2020

show abstract

“…Previous studies have shown excellent correlation and reliability between macroscopic and histological results when using the ICRS score. 16,47 Thus, we decided to use it to assess macroscopic regeneration. Correlation of macroscopic ICRS scoring to histological results has been validated only for assessment of cartilage repair with microfracture technique, 16 yet it is well known that microfracture does not lead to hyaline cartilage but rather leads to fibrous tissue.…”

Section: Discussionmentioning

confidence: 99%

“…16,47 Thus, we decided to use it to assess macroscopic regeneration. Correlation of macroscopic ICRS scoring to histological results has been validated only for assessment of cartilage repair with microfracture technique, 16 yet it is well known that microfracture does not lead to hyaline cartilage but rather leads to fibrous tissue. 13 Evaluation of cartilage repair with more sophisticated tissue engineering therapies may require further variables to be evaluated, such as those proposed by Goebel et al 16 In contrast with the ICRS score, Goebel's score evaluates 5 variables: defect fill and surface (also present in the ICRS score), color, presence of blood vessels, and degeneration of adjacent articular cartilage.…”

Section: Discussionmentioning

confidence: 99%

Photopolymerizable Injectable Cartilage Mimetic Hydrogel for the Treatment of Focal Chondral Lesions: A Proof of Concept Study in a Rabbit Animal Model

et al. 2018

View full text Add to dashboard Cite

Background: In this study, we investigate the in vitro and in vivo chondrogenic capacity of a novel photopolymerizable cartilage mimetic hydrogel, enhanced with extracellular matrix analogs, for cartilage regeneration. Purpose: To (1) determine whether mesenchymal stem cells (MSCs) embedded in a novel cartilage mimetic hydrogel support in vitro chondrogenesis, (2) demonstrate that the proposed hydrogel can be delivered in situ in a critical chondral defect in a rabbit model, and (3) determine whether the hydrogel with or without MSCs supports in vivo chondrogenesis in a critical chondral defect. Study Design: Controlled laboratory study. Methods: Rabbit bone marrow-derived MSCs were isolated, expanded, encapsulated in the hydrogel, and cultured in chondrogenic differentiation medium for 9 weeks. Compressive modulus was evaluated at day 1 and at weeks 3, 6, and 9. Chondrogenic differentiation was investigated via quantitative polymerase reaction, safranin-O staining, and immunofluorescence. In vivo, a 3 mm-wide 3 2-mm-deep chondral defect was created bilaterally on the knee trochlea of 10 rabbits. Each animal had 1 defect randomly assigned to be treated with hydrogel with or without MSCs, and the contralateral knee was left untreated. Hence, each rabbit served as its own matched control. Three groups were established: group A, hydrogel (n = 5); group B, hydrogel with MSCs (n = 5); and group C, control (n = 10). Repair tissue was evaluated at 6 months after intervention. Results: In vitro, chondrogenesis and the degradable behavior of the hydrogel by MSCs were confirmed. In vivo, the hydrogel could be delivered intraoperatively in a sterile manner. Overall, the hydrogel group had the highest scores on the modified O'Driscoll scoring system (group A, 17.4 6 4.7; group B, 13 6 3; group C, 16.7 6 2.9) (P = .11) and showed higher safranin-O staining (group A, 49.4% 6 20%; group B, 25.8% 6 16.4%; group C, 36.9% 6 25.2%) (P = .27), although significance was not detected for either parameter. Conclusion: This study provides the first evidence of the ability to photopolymerize this novel hydrogel in situ and assess its ability to provide chondrogenic cues for cartilage repair in a small animal model. In vitro chondrogenesis was evident when MSCs were encapsulated in the hydrogel. Clinical Relevance: Cartilage mimetic hydrogel may offer a tissue engineering approach for the treatment of osteochondral lesions.

show abstract

Macroscopic cartilage repair scoring of defect fill, integration and total points correlate with corresponding items in histological scoring systems – a study in adult sheep

Cited by 13 publications

References 35 publications

The Treatment of Cartilage Damage Using Human Mesenchymal Stem Cell-Derived Extracellular Vesicles: A Systematic Review of in vivo Studies

The Treatment of Cartilage Damage Using Human Mesenchymal Stem Cell-Derived Extracellular Vesicles: A Systematic Review of in vivo Studies

Assessment of Cartilage Repair Quality With the International Cartilage Repair Society Score and the Oswestry Arthroscopy Score

Photopolymerizable Injectable Cartilage Mimetic Hydrogel for the Treatment of Focal Chondral Lesions: A Proof of Concept Study in a Rabbit Animal Model

Contact Info

Product

Resources

About