Matrix-Induced Autologous Chondrocyte Implantation (MACI^®): Biological and Histological Assessment

Abstract

Matrix-induced autologous chondrocyte implantation (MACI) has been a treatment of cartilage injury since 2000, but little is known of the histological paradigm of tissue regeneration after implantation. MACI is a stable cell-based delivery system that enables the regeneration of hyaline-like cartilage. From a cohort of 56 MACI patients, we examined the phenotype of chondrocytes seeded on type I/III collagen scaffold, and conducted progressive histologic assessment over a period of 6 months. Chondrocyte-seeded collagen scaffolds from patient implants were analyzed by electron microscopy, immunohistochemistry (type II collagen and S-100), and reverse transcription polymerase chain reaction (RT-PCR) (aggrecan and type II collagen). Coincidental cartilage biopsies were obtained at 48 hours, 21 days, 6 months, 8 months, 12 months, 18 months, and 24 months. Our data showed that chondrocytes on the collagen scaffold appeared spherical, well integrated into the matrix, and maintained the chondrocyte phenotype as evidenced by aggrecan, type II collagen, and S-100 expression. Progressive histologic evaluation of the biopsies showed the formation of cartilage-like tissue as early as 21 days, and 75% hyaline-like cartilage regeneration after 6 months. This preliminary study has suggested that MACI may offer an improved alternative to traditional treatments for cartilage injury by regenerating hyaline-like cartilage as early as 6 months after surgery.

Use of Collagen Scaffold and Autologous Bone Marrow Concentrate as a One-Step Cartilage Repair in the Knee: Histological Results of Second-Look Biopsies at 1 Year Follow-up

“…Only a few studies have investigated the histological appearance of ACI biopsies (12)(13)(14)(15)(16)(17)(18) and an even lower number have looked for clinical and histological outcomes of one-step procedures (10,19) in the treatment of articular cartilage lesions.…”

Neonatal Desensitization Supports Long-Term Survival and Functional Integration of Human Embryonic Stem Cell-Derived Mesenchymal Stem Cells in Rat Joint Cartilage Without Immunosuppression

“…Polymers or matrices are adopted during transplantation as a cell delivery vehicle. Collagen has been used as an efficient cell delivery vehicle in matrix-induced ACI for cartilage repair [44]. In this study, collagen I was used to fabricate the bilayer scaffold and transplanted into the knee cartilage together with hESCMSCs.…”

Gene expression profiles of human chondrocytes during passaged monolayer cultivation

“…[1][2][3][4][5]20 In this study, the gene expression profiles of normal and OA chondrocytes were compared. Surprisingly, little significant difference was observed between the two groups, suggesting that the in vitro biosynthetic profile of the chondrocyte is influenced more by the culture conditions, than the disease state of the donor cartilage.…”