Multilayered biomimetic scaffolds for cartilage repair of the talus. A systematic review of the literature

Kolar, Matic; Drobnič, Matej

doi:10.1016/j.fas.2022.10.007

Cited by 5 publications

(6 citation statements)

References 47 publications

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“…Furthermore, a recent clinical evaluation with two years of follow-up demonstrated that the treatment process of patients receiving the TruFit scaffold with the aim of repairing cartilage defects was not fairly effective. [81][82][83][84][85] TE approaches on the basis of "cell-scaffold constructs" are the most generally used techniques among all others. In this regard, matrix-induced autologous chondrocyte implantation (MACI) is a regular treatment method based upon the "cell-scaffold constructs" approach.…”

Section: Strategies For the Cartilage Treatmentmentioning

confidence: 99%

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Progress of Microfluidic Hydrogel‐Based Scaffolds and Organ‐on‐Chips for the Cartilage Tissue Engineering

et al. 2023

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Cartilage degeneration is among the fundamental reasons behind disability and pain across the globe. Numerous approaches have been employed to treat cartilage diseases. Nevertheless, none have shown acceptable outcomes in the long run. In this regard, the convergence of tissue engineering and microfabrication principles can allow developing more advanced microfluidic technologies, thus offering attractive alternatives to current treatments and traditional constructs used in tissue engineering applications. Herein, the current developments involving microfluidic hydrogel‐based scaffolds, promising structures for cartilage regeneration, ranging from hydrogels with microfluidic channels to hydrogels prepared by the microfluidic devices, that enable therapeutic delivery of cells, drugs, and growth factors, as well as cartilage‐related organ‐on‐chips are reviewed. Thereafter, cartilage anatomy and types of damages, and present treatment options are briefly overviewed. Various hydrogels are introduced, and the advantages of microfluidic hydrogel‐based scaffolds over traditional hydrogels are thoroughly discussed. Furthermore, available technologies for fabricating microfluidic hydrogel‐based scaffolds and microfluidic chips are presented. The preclinical and clinical applications of microfluidic hydrogel‐based scaffolds in cartilage regeneration and the development of cartilage‐related microfluidic chips over time are further explained. The current developments, recent key challenges, and attractive prospects that should be considered so as to develop microfluidic systems in cartilage repair are highlighted.

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Section: Strategies For the Cartilage Treatmentmentioning

confidence: 99%

“…Furthermore, a recent clinical evaluation with two years of follow‐up demonstrated that the treatment process of patients receiving the TruFit scaffold with the aim of repairing cartilage defects was not fairly effective. [ 81–85 ]…”

Section: Articular Cartilagementioning

confidence: 99%

Progress of Microfluidic Hydrogel‐Based Scaffolds and Organ‐on‐Chips for the Cartilage Tissue Engineering

et al. 2023

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“…13 Some of them have already demonstrated promising clinical results, both in stand-alone application and with biological augmentation. [14][15][16] In the present study, the absorbable gels: homologous (Beriplast, CSL Behring,Germany) and autologous (Vivostat, Alleroed, Denmark) fibrin glues or collagen gels (CartiFill, Seoul, Korea, and ChondroFiller, Meidrix Biomedicals, Esslingen, Germany), and multilayered biomimetic membrane: MaioRegen (Finceramica, Faenza, Italy) consisting of different ratios of equine collagen type I and hydroxyapatite (HA), with fBMA have been used to treat osteochondral lesions of talus (OLTs).…”

Section: Introductionmentioning

confidence: 99%

Biomaterials augmented with filtered bone marrow aspirate for the treatment of talar osteochondral lesions. A comparison of clinical and cellular parameters

Kolar,

Veber,

Girandon

et al. 2024

J Orthop Surg (Hong Kong)

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Background Biomaterials augmented with Bone Marrow Aspirate Concentrate (BMAC) are becoming increasingly utilized in the cartilage treatment. However, the potential role of cellular parameters in the intraoperatively applied BMAC have yet to be elucidated. Purpose (A) To evaluate clinical outcomes and safety of a combined single-step approach with scaffolds (fibrin glues, collagen gels, collagen-hydroxyapatite membrane) and filtered Bone Marrow Aspirate (fBMA) for the treatment of osteochondral lesions of the talus (OLTs). (B) To identify significant factors for postoperative improvements, considering cellular parameters as potential predictors. Methods All the patients operated on due to OLTs by the combination above were selected from the hospital registry database (35 pts, years 16–55, and minimally 1 year follow-up). Treatment outcomes were followed clinically with Patient-reported outcome measures (PROMs), and by pursuing serious adverse events (SAE) and graft failures (GF). Cellular parameters of the injected fBMA were determined. Pre- and postoperative PROMs values were compared to evaluate postoperative improvements. Multivariable regression models were applied to identify potential factors (demographics, medical history, joint and lesion characteristics, scaffold type, surgical and cellular parameters) that predict the treatment outcomes. Results At the mean follow-up of 32.2 (12.5) months, all Foot and Ankle Outcome Score (FAOS) and European Quality of Life in Five Dimensions Three-Level (EQ-5D-3 L) values improved significantly. 4 (11%) SAE (3 arthrofibrosis, one hardware removal), and 3 (9%) GF occurred. Female gender and concomitant procedures were the main negative predictors for postoperative outcomes. The number of fibroblast colony forming units (CFU-F) or their proportion among total nucleated cells (CFU-F/TNC) were positively correlated with the improvements of some PROMs. Conclusions Scaffolds augmented with fBMA proved as an adequate and safe approach for OLTs treatment. Cellular parameters seem to influence the treatment outcomes, thus further attention should be given to the intraoperatively applied products. Level of evidence Level IV.

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“…52 A CHAS has been mainly utilized in a stand-alone manner and demonstrated promising short-term to mid-term results, with superiority in osteochondral treatment over the control procedure of microfracture. 2,8,27,29 In the present study, the combined single-step approach using an fBMA-augmented CHAS for the treatment of KJSLs was evaluated. To the best of our knowledge, this is the largest case series on the treatment of KJSLs using a CHAS in the literature and the first one that considers cellular parameters of intraoperatively applied products as one of the potential predictors.…”

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confidence: 99%

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confidence: 99%

A Biomimetic Osteochondral Scaffold Augmented With Filtered Bone Marrow Aspirate for the Treatment of Joint Surface Lesions in the Knee

Kolar,

Veber,

Girandon

et al. 2024

Am J Sports Med

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Background: Multilayered osteochondral scaffolds are becoming increasingly utilized for the repair of knee joint surface lesions (KJSLs). However, the literature on predictive factors is rather limited. Purpose: To (1) evaluate the clinical outcomes and safety of a combined single-step approach using a biomimetic collagen-hydroxyapatite scaffold (CHAS) and filtered bone marrow aspirate (fBMA) for the treatment of KJSLs and (2) identify significant predictors of the treatment outcomes. Study Design: Case series; Level of evidence, 4. Methods: All patients who underwent surgery because of a KJSL (size ≥1.5 cm2; International Cartilage Regeneration & Joint Preservation Society grades 3-4) using the combination above were selected from a hospital registry database (100 patients; minimum 2-year follow-up). Patient characteristics, medical history, knee joint and lesion status, intraoperative details, and cellular parameters of the injected fBMA were collected. The arthroscopic evaluation of chondral and meniscal tissue quality in all knee compartments was performed using the Chondropenia Severity Score. Treatment outcomes were determined clinically using patient-reported outcome measures (Knee Injury and Osteoarthritis Outcome Score, EuroQol–5 Dimensions–3 Levels, EuroQol–Visual Analog Scale, and Tegner Activity Scale) and by assessing the occurrence of serious adverse events and graft failure. Multivariable regression analysis was performed to identify significant predictors of the treatment outcomes. Results: At a mean follow-up of 54.2 ± 19.4 months, 78 (87%) patients completed the questionnaires with significant improvements toward the baseline ( P < .00625): KOOS Pain subscale from 62 ± 17 to 79 ± 18, KOOS Total score from 57 ± 16 to 70 ± 20, EuroQol–Visual Analog Scale from 61 ± 21 to 76 ± 16, EuroQol–5 Dimensions–3 Levels from 0.57 ± 0.20 to 0.80 ± 0.21, and Tegner Activity Scale from 2.8 ± 1.5 to 3.9 ± 1.9. The graft failure rate was 4%. A longer duration of preoperative symptoms, previous surgery, larger lesions, older age, and female sex were the main negative predictors for the treatment outcomes. The Chondropenia Severity Score and the number of fibroblast colony-forming units in fBMA positively influenced some of the clinical results and safety. Conclusion: A CHAS augmented with fBMA proved to be an adequate and safe approach for the treatment of KJSLs up to midterm follow-up. Based on the subanalysis of predictive factors, the surgical intervention should be performed in a timely and precise manner to prevent lesion enlargement, deterioration of the general knee cartilage status, and recurrent surgical procedures, especially in older and female patients. When a CHAS is used, the quantity of MSCs seems to play a role in augmentation. Registration: NCT06078072 (ClinicalTrials.gov identifier).

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Multilayered biomimetic scaffolds for cartilage repair of the talus. A systematic review of the literature

Cited by 5 publications

References 47 publications

Progress of Microfluidic Hydrogel‐Based Scaffolds and Organ‐on‐Chips for the Cartilage Tissue Engineering

Progress of Microfluidic Hydrogel‐Based Scaffolds and Organ‐on‐Chips for the Cartilage Tissue Engineering

Biomaterials augmented with filtered bone marrow aspirate for the treatment of talar osteochondral lesions. A comparison of clinical and cellular parameters

A Biomimetic Osteochondral Scaffold Augmented With Filtered Bone Marrow Aspirate for the Treatment of Joint Surface Lesions in the Knee

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