What Is the Effect of Matrices on Cartilage Repair? A Systematic Review

Abstract

Background Articular cartilage has minimal endogenous ability to undergo repair. Multiple chondral restoration strategies have been attempted with varied results. Questions/purposes The purpose of our review was to determine: (1) Does articular chondrocyte transplantation or matrix-assisted articular chondrocyte transplantation provide better patient-reported outcomes scores, MRI morphologic measurements, or histologic quality of repair tissue compared with microfracture in prospective comparative studies of articular cartilage repair; and (2) which available matrices for matrix-assisted articular chondrocyte transplantation show the best patient-reported outcomes scores, MRI morphologic measurements, or histologic quality of repair tissue? Methods We conducted a systematic review of PubMed, CINAHL, and MEDLINE from March 2004 to February 2014 using keywords determined to be important for articular cartilage repair, including ''cartilage'', ''chondral'', ''cell source'', ''chondrocyte'', ''matrix'', ''augment'', ''articular'', ''joint'', ''repair'', ''treatment'', ''regeneration'', and ''restoration'' to find articles related to cell-based articular cartilage repair of the knee. The articles were reviewed by two authors (JDW, MKH), our study exclusion criteria were applied, and articles were determined to be relevant (or not) to the research questions. The Methodological Index for Nonrandomized Studies (MIN-ORS) scale was used to judge the quality of nonrandomized manuscripts used in this review and the Jadad score was used to judge the quality of randomized trials. Seventeen articles were reviewed for the first research question and 83 articles were reviewed in the second research question from 301 articles identified in the original systematic search. The average MINORS score was 9.9 (62%) for noncomparative studies and 16

Management of knee osteoarthritis. Current status and future trends

“…The even more challenging task is to regenerate the already damaged joint. Thus, research efforts are directed towards the development of tissue regenerative strategies, applying biomaterials and stem cells (Johnstone et al, ; Luyten and Vanlauwe, ; Veronesi et al, ; Wylie et al, ).…”

Geles y membranas

“…Estas técnicas de estimulación de condrogénesis autóloga mediante membranas (AMIC) o geles (ACIC), asociadas a perforaciones (micro-o nanofracturas), podrían denominarse de forma general "EMO aumentada" (10,29) . La matriz de base colágena tiene la doble función de andamiaje sobre el que "anidan" las células mesenquimales y, por otro, "contener" y estabilizar el hematoma en la lesión, logrando así un ambiente biológicamente propicio para la proliferación y diferenciación celular (2,4,16,19,24,28) .…”

“…En torno a esta tendencia cuyos resultados clínicos parecen prometedores, se ha desarrollado una industria que actualmente fabrica y promociona muchos y diferentes productos. A pesar de que pueden variar en su composición y características, aún no se han podido demostrar diferencias significativas en cuanto a resultados clínicos entre ellos (8,10,19) .…”

“…En 2015, Wylie et al (19) realizan una revisión sistemática planteándose el efecto de las matrices de colágeno en las técnicas reparadoras del cartílago. Seleccionan 17 artículos relevantes que cumplen los criterios de inclusión y en ellos identifican 11 técnicas diferentes basadas en matrices colágenas.…”

Tissue Engineering and Regenerative Medicine Technologies in the Treatment of Articular Cartilage Defects

“…2) [16][17][18][19]. Заметим, что свойства созданной с помощью клеточных технологий хрящевой ткани определя-ются многими параметрами, в том числе источни-ком клеток, типом скаффолда для прикрепления клеток, методом посева клеток, составом культу-ральной среды, доступом питательных веществ, факторами дифференцировки и механической сти-муляцией [20,21].…”