Matrix-associated stem cell transplantation (MAST) in chondral defects of foot and ankle is effective

Richter, Martinus; Zech, Stefan

doi:10.1016/j.fas.2012.11.005

Cited by 38 publications

(20 citation statements)

References 54 publications

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“…Finally, Richter et al [ 35 ] investigated the outcomes offered by BMSCs onto a collagen matrix for chondral ankle lesions, confirming no complications and a promising clinical improvement at 24 months of follow-up.…”

Section: Resultsmentioning

confidence: 97%

“… The quality of cartilage further improved at MRI at 24 months Wong [ 24 ] 2013 Arthroscopy RCT IA injection Comb HTO + MFX and post-op injection Knee OA 28 BMSCs + HA 28 HA 24 months BMSCs i.a. injection produced superior clinical and MRI outcomes at 24 months Ricther [ 35 ] 2013 Foot & Ankle Case series Surgical delivery MAST Collagen membrane Ankle chondral defects 25 24 months No adverse events. Clinical scores improvement Positive findings at histology Orozco [ 22 ] 2013 Transplantation Case series IA injection Knee OA 12 12 months No safety issues.…”

Section: Resultsmentioning

confidence: 99%

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Stem cells in articular cartilage regeneration

et al. 2016

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Mesenchymal stem cells (MSCs) have emerged as a promising option to treat articular defects and early osteoarthritis (OA) stages. However, both their potential and limitations for a clinical use remain controversial. Thus, the aim of this systematic review was to examine MSCs treatment strategies in clinical settings, in order to summarize the current evidence of their efficacy for the treatment of cartilage lesions and OA.Among the 60 selected studies, 7 were randomized, 13 comparative, 31 case series, and 9 case reports; 26 studies reported the results after injective administration, whereas 33 used surgical implantation. One study compared the two different modalities. With regard to the cell source, 20 studies concerned BMSCs, 17 ADSCs, 16 BMC, 5 PBSCs, 1 SDSCs, and 1 compared BMC versus PBSCs. Overall, despite the increasing literature on this topic, the evidence is still limited, in particular for high-level studies. On the other hand, the available studies allow to draw some indications. First, no major adverse events related to the treatment or to the cell harvest have been reported. Second, a clinical benefit of using MSCs therapies has been reported in most of the studies, regardless of cell source, indication, or administration method. This effectiveness has been reflected by clinical improvements and also positive MRI and macroscopic findings, whereas histologic features gave more controversial results among different studies. Third, young age, lower BMI, smaller lesion size for focal lesions, and earlier stages of OA joints have been shown to correlate with better outcomes, even though the available data strength does not allow to define clear cutoff values. Finally, definite trends can be observed with regard to the delivery method: currently cultured cells are mostly being administered by i.a. injection, while one-step surgical implantation is preferred for cell concentrates. In conclusion, while promising results have been shown, the potential of these treatments should be confirmed by reliable clinical data through double-blind, controlled, prospective and multicenter studies with longer follow-up, and specific studies should be designed to identify the best cell sources, manipulation, and delivery techniques, as well as pathology and disease phase indications.

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Stem cells in articular cartilage regeneration

et al. 2016

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“…Regarding open foot and ankle chondral defect repairs, implantation of nonexpanded BMC-impregnated collagen matrix was reported by Richter and Zech 94 in 25 patients who were followed up with at 2 years with significant improvements in VAS foot and ankle scores.…”

Section: Methods Of Stem Cell Transplantationmentioning

confidence: 96%

Cell Therapy in Joint Disorders

et al. 2014

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Context:Articular cartilage possesses poor natural healing mechanisms, and a variety of non-cell-based and cell-based treatments aim to promote regeneration of hyaline cartilage.Data Sources:A review of the literature to December 2013 using PubMed with search criteria including the keywords stem cell, cell therapy, cell transplantation, cartilage, chondral, and chondrogenic.Study Selection:Forty-five articles were identified that employed local mesenchymal stem cell (MSC) therapy for joint disorders in humans. Nine comparative studies were identified, consisting of 3 randomized trials, 5 cohort studies, and 1 case-control study.Study Type:Clinical review.Level of Evidence:Level 4.Data Extraction:Studies were assessed for stem cell source, method of implantation, comparison groups, and concurrent surgical techniques.Results:Two studies comparing MSC treatment to autologous chondrocyte implantation found similar efficacy. Three studies reported clinical benefits with intra-articular MSC injection over non-MSC controls for cases undergoing debridement with or without marrow stimulation, although a randomized study found no significant clinical difference at 2-year follow-up but reported better 18-month magnetic resonance imaging and histologic scores in the MSC group. No human studies have compared intra-articular MSC therapy to non-MSC techniques for osteoarthritis in the absence of surgery.Conclusion:Mesenchymal stem cell–based therapies appear safe and effective for joint disorders in large animal preclinical models. Evidence for use in humans, particularly, comparison with more established treatments such as autologous chondrocyte implantation and microfracture, is limited.

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“…Richter et al 41 published the clinical assessment of a matrix-associated stem cell implantation strategy with a 2-year follow-up in chondral defects of the foot and ankle (figure 6). That interesting study evaluated 25 patients and showed good clinical results.…”

Section: Introductionmentioning

confidence: 99%

“…(A) A large defect (6 cm 2 ) at the entire talar dome after debridement; (B) the defect after microfracturing and (C) the matrix with cells in vivo. (Adapted from: Richter et al 41. ).…”

Section: Introductionmentioning

confidence: 99%