Matrix-induced autologous mesenchymal stem cell implantation versus matrix-induced autologous chondrocyte implantation in the treatment of chondral defects of the knee: a 2-year randomized study

Akgün, Işık; Ünlü, Mehmet Can; Erdal, Ozan Ali; Öğüt, Tahir; Ertürk, Murat; Ovalı, Ercüment; Kantarcı, Fatih; Çalışkan, Gürkan; Akgun, Yamac

doi:10.1007/s00402-014-2136-z

Cited by 129 publications

(137 citation statements)

References 47 publications

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“…Similar outcomes with improvement of OA clinical scores were published in additional case reports using BM-MSCs in platelet-rich fibrin glue or collagen [62,63]. Finally, a recent investigation comparing the implantation of matrix-induced autologous BM-MSCs versus chondrocytes in 14 patients described significantly better functional outcomes, better knee injury, and OA outcome score (KOOS) and visual analog scale score (VAS) with BM-MSCs than chondrocytes [64]. Indeed, although several studies indicate safety and efficacy of MSC-based tissue engineering approaches, no product is available for routine use.…”

Section: Mscs-based Tissue Engineering For Oa Treatmentsupporting

confidence: 68%

Therapeutic application of mesenchymal stem cells in osteoarthritis

Ruiz

Cosenza

Maumus

et al. 2015

Expert Opinion on Biological Therapy

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Section: Mscs-based Tissue Engineering For Oa Treatmentsupporting

confidence: 68%

Therapeutic application of mesenchymal stem cells in osteoarthritis

Ruiz

Cosenza

Maumus

et al. 2015

Expert Opinion on Biological Therapy

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“…of studies (total 28)ReferencesPhases of clinical studies Pilot/feasibility study incl. case report15 (54%)[104–108, 118, 119, 122, 124–129, 133] Phase 1 (safety assessment)8 (26%)[109–112, 116, 123, 130, 131] Phase 2 (efficacy assessment)8 (26%)[103, 113–115, 117, 120, 121, 132] Phase 3 (large scale efficacy assessment through a multi-centre RCT)0 (0%)– Phase 4 (post-market surveillance)0 (0%)– …”

Section: Resultsmentioning

confidence: 99%

The use of mesenchymal stem cells for cartilage repair and regeneration: a systematic review

et al. 2017

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BackgroundThe management of articular cartilage defects presents many clinical challenges due to its avascular, aneural and alymphatic nature. Bone marrow stimulation techniques, such as microfracture, are the most frequently used method in clinical practice however the resulting mixed fibrocartilage tissue which is inferior to native hyaline cartilage. Other methods have shown promise but are far from perfect. There is an unmet need and growing interest in regenerative medicine and tissue engineering to improve the outcome for patients requiring cartilage repair. Many published reviews on cartilage repair only list human clinical trials, underestimating the wealth of basic sciences and animal studies that are precursors to future research. We therefore set out to perform a systematic review of the literature to assess the translation of stem cell therapy to explore what research had been carried out at each of the stages of translation from bench-top (in vitro), animal (pre-clinical) and human studies (clinical) and assemble an evidence-based cascade for the responsible introduction of stem cell therapy for cartilage defects.Main body of abstractThis review was conducted in accordance to PRISMA guidelines using CINHAL, MEDLINE, EMBASE, Scopus and Web of Knowledge databases from 1st January 1900 to 30th June 2015. In total, there were 2880 studies identified of which 252 studies were included for analysis (100 articles for in vitro studies, 111 studies for animal studies; and 31 studies for human studies). There was a huge variance in cell source in pre-clinical studies both of terms of animal used, location of harvest (fat, marrow, blood or synovium) and allogeneicity. The use of scaffolds, growth factors, number of cell passages and number of cells used was hugely heterogeneous.Short conclusionsThis review offers a comprehensive assessment of the evidence behind the translation of basic science to the clinical practice of cartilage repair. It has revealed a lack of connectivity between the in vitro, pre-clinical and human data and a patchwork quilt of synergistic evidence. Drivers for progress in this space are largely driven by patient demand, surgeon inquisition and a regulatory framework that is learning at the same pace as new developments take place.

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“…Higher rates of clinical failure (poor patient-rated symptoms) were noted with lateral facet lesions, and the authors did not report distribution of lesions (medial facet, lateral facet, or multiple facets) by treatment group [17]. Finally, Akgun et al report a small randomized trial of MACI versus autologous mesenchymal stem cells (also seeded onto a collagen scaffold) with 2 years follow-up [18]. The stem cell group had greater symptom improvement at 6 months but similar improvement at final follow-up; no clinical failures were noted in either group [18].…”

Section: Scaffold Contentmentioning

confidence: 99%

“…Finally, Akgun et al report a small randomized trial of MACI versus autologous mesenchymal stem cells (also seeded onto a collagen scaffold) with 2 years follow-up [18]. The stem cell group had greater symptom improvement at 6 months but similar improvement at final follow-up; no clinical failures were noted in either group [18].…”

Section: Scaffold Contentmentioning

confidence: 99%

Autologous Chondrocyte Implantation: Scaffold-Based Solutions

Flanigan¹,

Everhart²,

Early³

2018

Cartilage Repair and Regeneration

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Autologous chondrocyte implantation is a surgical technique utilized for repair of articular cartilage defects. The originally described technique for autologous chondrocyte implantation involves applying a liquid suspension of the cultured chondrocytes to a cartilage defect and sealing the defect with a periosteum or collagen patch. Scaffolds for housing chondrocytes were introduced to allow for increased ease of delivery and application, to avoid leakage of chondrocytes out of the defect, and to allow for an implant that more closely mimics the non-uniform tissue architecture of healthy articular cartilage. In this chapter we describe the design, clinical outcomes, and commercial availability of various scaffolds reported in the clinical literature for autologous chondrocyte implantation.

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Matrix-induced autologous mesenchymal stem cell implantation versus matrix-induced autologous chondrocyte implantation in the treatment of chondral defects of the knee: a 2-year randomized study

Abstract: For the treatment of isolated full-thickness chondral lesion of the knee, m-AMI can be used effectively and may potentially accelerate recovery. A larger patient cohort and follow-up supported by histological analyses are necessary to determine long-term outcomes.

Cited by 129 publications

References 47 publications

Therapeutic application of mesenchymal stem cells in osteoarthritis

Therapeutic application of mesenchymal stem cells in osteoarthritis

The use of mesenchymal stem cells for cartilage repair and regeneration: a systematic review

Autologous Chondrocyte Implantation: Scaffold-Based Solutions

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