Matrix-induced autologous chondrocyte implantation for the treatment of chondral defects of the knees in Chinese patients

Abstract

Articular cartilage injury is the most common type of damage seen in clinical orthopedic practice. The matrix-induced autologous chondrocyte implant (MACI) was developed to repair articular cartilage with an advance on the autologous chondrocyte implant procedure. This study aimed to evaluate whether MACI is a safe and efficacious cartilage repair treatment for patients with knee cartilage lesions. The primary outcomes were the Knee Injury and Osteoarthritis Outcome Score (KOOS) domains and magnetic resonance imaging (MRI) results, compared between baseline and postoperative months 3, 6, 12, and 24. A total of 15 patients (20 knees), with an average age of 33.9 years, had a mean defect size of 4.01 cm2. By 6-month follow-up, KOOS results demonstrated significant improvements in symptoms and knee-related quality of life. MRI showed significant improvements in four individual graft scoring parameters at 24 months postoperatively. At 24 months, 90% of MACI grafts had filled completely and 10% had good-to-excellent filling of the chondral defect. Most (95%) of the MACI grafts were isointense and 5% were slightly hyperintense. Histologic evaluation at 15 and 24 months showed predominantly hyaline cartilage in newly generated tissue. There were no postoperative complications in any patients and no adverse events related to the MACI operation. This 2-year study has confirmed that MACI is safe and effective with the advantages of a simple technique and significant clinical improvements. Further functional and mechanistic studies with longer follow-up are needed to validate the efficacy and safety of MACI in patients with articular cartilage injuries.

Ovine Mesenchymal Stem Cell Chondrogenesis on a Novel 3D-Printed Hybrid Scaffold In Vitro

“…For larger defects, autologous chondrocyte implantation (ACI) and matrixinduced chondrocyte implantation (MACI) use a two-step process with harvested chondrocytes from the patient. In particular, ACI involves implantation under a periosteal flap, while MACI uses a matrix without a flap [13][14][15][16][17][18]. Autologous matrix-induced chondrogenesis (AMIC) is a one-step alternative treatment combining subchondral microfracture (which releases MSC) with a collagen I/III matrix for covering the blood clot and its MSC [19].…”

Repopulation of decellularised articular cartilage by laser-based matrix engraving

“…Early graft failures often result from insufficient rehabilitation or traumatic events after implantation [1,12] while later deterioration may take place after several years, even if clinical parameters had indicated a good performance in the early phase [4,6,7]. The rare biopsies available from transplanted areas, harvested in the course of clinically indicated reoperations or as experimental endoscopic biopsies, reveal incompletely masked hyaline cartilage with random collagen alignment [13][14][15] and the formation of fibrocartilage in a majority of defects [16,17]. This repair tissue differs from native hyaline cartilage, which features completely masked collagen fibres by incorporation of glycosaminoglycans (GAG) and a complex collagen architecture with generally vertical alignment in deeper regions, with fibrils bending towards the upper regions and being horizontally aligned at the surface [18,19].…”