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Autologous chondrocyte implantation

M Aurich, D Albrecht, P Angele, C Becher, S Fickert, J Fritz, P E Müller, P Niemeyer, M Pietschmann, G Spahn, M Walther
Background: Osteochondral lesions (OCL) of the ankle are a common cause of ankle pain. Although the precise pathophysiology has not been fully elucidated, it can be assumed that a variety of factors are responsible, mainly including traumatic events such as ankle sprains. Advances in arthroscopy and imaging techniques, in particular magnetic resonance imaging (MRI), have improved the possibilities for the diagnosis of OCLs of the ankle. Moreover, these technologies aim at developing new classification systems and modern treatment strategies...
October 21, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Graeme P Whyte, Alberto Gobbi, Boguslaw Sadlik
Cartilage lesions of the knee are a frequent finding; however, treatment options that are capable of restoring hyaline-like tissue are not routinely used. Cell-based technology such as autologous chondrocyte implantation may in some cases provide durable cartilage repair, but availability of this procedure is often restricted due to cost constraints. There have been promising outcomes reported with the use of scaffolds seeded with activated bone marrow aspirate concentrate in cases of chondral injury. There are clear advantages to cell-based cartilage repair techniques that are performed as a single-stage procedure, particularly when the repair technology can be used in a minimally invasive manner...
August 2016: Arthroscopy Techniques
Margot Den Hondt, Bart M Vanaudenaerde, Erik K Verbeken, Jan J Vranckx
BACKGROUND: Successful trachea transplantation comprises the use of biocompatible constructs with little immune-reactivity, submucosal revascularization and creation of an epithelial covering. Allogenic chondrocytes might be protected from an overt immune-response due to physical isolation. Our aim was to evaluate in-vivo biocompatibility of allotracheae, stripped of their highly-immunogenic inner lining. Secondly, we established whether these constructs might serve as suitable scaffolds for autologous epithelial grafting...
October 4, 2016: Acta Chirurgica Belgica
Justus Gille, Peter Behrens, Arndt Peter Schulz, Ralf Oheim, Benjamin Kienast
INTRODUCTION: A prospective clinical investigation was carried out in order to clarify whether Matrix-associated autologous chondrocyte implantation (MACI) results in clinical improvement at long-term follow-up. HYPOTHESIS: MACI will result in clinical improvement at long-term follow-up. STUDY DESIGN: Case series; level of evidence, 4. METHODS: Thirty-eight patients were treated with MACI. These patients were evaluated for up to a mean of 16 years (range 15-17 years) after the intervention...
October 2016: Cartilage
Ayoosh Pareek, James L Carey, Patrick J Reardon, Lars Peterson, Michael J Stuart, Aaron J Krych
OBJECTIVE: Autologous chondrocyte implantation (ACI) has not been proven to be durable over the long-term. The purpose of this systematic review was (1) to evaluate activity level and knee function, (2) to evaluate reoperation and failure rates, and (3) to analyze risk factors for reoperation and failure of ACI at minimum long-term follow-up. DESIGN: A comprehensive review was performed for studies with long-term outcomes after ACI for cartilage defect repair. Studies reported outcome scores such as Tegner score, Lysholm score, and International Knee Documentation Society (IKDC) score along with rates of failure and reoperation...
October 2016: Cartilage
Cecilia Pascual-Garrido, Erika Daley, Nikhil N Verma, Brian J Cole
PURPOSE: To compare the results of focal metallic resurfacing with biologic procedures in patients more than 35 years of age with isolated, full thickness defects of the femoral condyle. METHODS: A total of 61 patients met the selection criteria resulting in 30 patients treated with biological procedures, including debridement, microfracture, osteochondral autograft transplantation, osteochondral allograft, and autologous chondrocyte implantation (BIO group), and 32 patients treated with focal metallic resurfacing (CAP group)...
September 20, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Tomoyuki Oda, Tadahiro Sakai, Hideki Hiraiwa, Takashi Hamada, Yohei Ono, Motoshige Nakashima, Shinya Ishizuka, Tetsuya Matsukawa, Satoshi Yamashita, Saho Tsuchiya, Naoki Ishiguro
The natural healing capacity of damaged articular cartilage is poor, rendering joint surface injuries a prime target for regenerative medicine. While autologous chondrocyte or mesenchymal stem cell (MSC) implantation can be applied to repair cartilage defects in young patients, no appropriate long-lasting treatment alternative is available for elderly patients with osteoarthritis (OA). Multipotent progenitor cells are reported to present in adult human articular cartilage, with a preponderance in OA cartilage...
October 21, 2016: Biochemical and Biophysical Research Communications
Marcus Mumme, Amir Steinitz, Katja M Nuss, Karina Klein, Sandra Feliciano, Peter Kronen, Marcel Jakob, Brigitte von Rechenberg, Ivan Martin, Andrea Barbero, Karoliina Pelttari
Nasal chondrocytes (NC) were previously demonstrated to remain viable and to participate in the repair of articular cartilage defects in goats. Here, we investigated critical features of tissue-engineered grafts generated by NC in this large animal model, namely cell retention at the implantation site, architecture and integration with adjacent tissues, and effects on subchondral bone changes. In this study, isolated autologous goat NC (gNC) and goat articular chondrocytes (gAC, as control) were expanded, green fluorescent protein-labelled and seeded on a type I/III collagen membrane...
October 11, 2016: Tissue Engineering. Part A
Abdul-Rehman Phull, Seong-Hui Eo, Qamar Abbas, Madiha Ahmed, Song Ja Kim
Chondrocytes are the exclusive cells residing in cartilage and maintain the functionality of cartilage tissue. Series of biocomponents such as different growth factors, cytokines, and transcriptional factors regulate the mesenchymal stem cells (MSCs) differentiation to chondrocytes. The number of chondrocytes and dedifferentiation are the key limitations in subsequent clinical application of the chondrocytes. Different culture methods are being developed to overcome such issues. Using tissue engineering and cell based approaches, chondrocytes offer prominent therapeutic option specifically in orthopedics for cartilage repair and to treat ailments such as tracheal defects, facial reconstruction, and urinary incontinence...
2016: BioMed Research International
Leela C Biant, Michiel Simons, Trudi Gillespie, Michael J McNicholas
BACKGROUND: Autologous chondrocyte implantation (ACI) is an effective method of repair of articular cartilage defects. It is a 2-stage operation, with the second stage most commonly performed via mini-arthrotomy. Arthroscopic ACI is gaining popularity, as it is less invasive and may accelerate early rehabilitation. However, handling and manipulation of the implant have been shown to cause chondrocyte cell death. PURPOSE: To assess the number and viability of cells delivered via an open versus arthroscopic approach in ACI surgery...
September 9, 2016: American Journal of Sports Medicine
Bert R Mandelbaum
Articular cartilage lesions, whether acute or chronic, are among the most common and difficult-to-treat conditions of the knee in the adolescent and athletic population. The results from a study in this issue as well as some in the previous literature suggest that autologous chondrocyte implantation yields long-term improvement in function and symptoms and may be a viable treatment for young to adult athletes or patients with high physical demands and a long active lifespan. No intervention in the young symptomatic patient will yield inferior results because it appears that no treatment over time has deleterious effects...
September 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Adem Topkara, Adem Özkan, Ramazan Hakan Özcan, Mustafa Öksüz, Metin Akbulut
BACKGROUND: Diced cartilage grafts are important in rhinoplasty for raising the dorsum and eliminating dorsal irregularities. The most common problems with the use of diced cartilage are wrapping and cartilage resorption. OBJECTIVES: To histopathologically investigate and compare the viability of diced cartilage grafts wrapped with concentrated growth factor, fascia and fenestrated fascia, or blood glue. METHODS: Cartilage grafts were harvested from the ears of 10 New Zealand White rabbits and diced into 0...
September 2, 2016: Aesthetic Surgery Journal
Jay R Ebert, Michael Fallon, David J Wood, Gregory C Janes
BACKGROUND: While midterm outcomes after matrix-induced autologous chondrocyte implantation (MACI) are encouraging, the procedure permits an arthroscopic approach that may reduce the morbidity of arthrotomy and permit accelerated rehabilitation. HYPOTHESIS: A significant improvement in clinical and radiological outcomes after arthroscopic MACI will exist through to 5 years after surgery. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: We prospectively evaluated the first 31 patients (15 male, 16 female) who underwent MACI via arthroscopic surgery to address symptomatic tibiofemoral chondral lesions...
September 1, 2016: American Journal of Sports Medicine
Y Melgarejo-Ramírez, R Sánchez-Sánchez, J García-López, A M Brena-Molina, C Gutiérrez-Gómez, C Ibarra, C Velasquillo
The external ear is composed of elastic cartilage. Microtia is a congenital malformation of the external ear that involves a small reduction in size or a complete absence. The aim of tissue engineering is to regenerate tissues and organs clinically implantable based on the utilization of cells and biomaterials. Remnants from microtia represent a source of cells for auricular reconstruction using tissue engineering. To examine the macromolecular architecture of microtia cartilage and behavior of chondrocytes, in order to enrich the knowledge of this type of cartilage as a cell reservoir...
September 2016: Cell and Tissue Banking
Gregory L Cvetanovich, Jonathan C Riboh, Annemarie K Tilton, Brian J Cole
BACKGROUND: Existing studies of autologous chondrocyte implantation (ACI) in adolescent patients have primarily reported outcomes that have not been validated for cartilage repair and have failed to include measures of general health or health-related quality of life. PURPOSE: This study assesses validated knee-specific functional outcomes and health-related quality of life after ACI in adolescent patients. STUDY DESIGN: Case series; Level of evidence, 4...
August 26, 2016: American Journal of Sports Medicine
Aaron J Krych, Ayoosh Pareek, Alexander H King, Nick R Johnson, Michael J Stuart, Riley J Williams
PURPOSE: Optimal surgical treatment of chondral defects in an athletic population remains highly controversial and has yet to be determined. The purpose of this review was to (1) report data on return to sport and (2) compare activity and functional outcome measures following various cartilage restoration techniques. METHODS: A comprehensive review was performed for studies with return-to-sport outcomes after microfracture (MFX), osteochondral autograft transfer (OAT), osteochondral allograft transplantation (OCA), and autologous chondrocyte implantation (ACI)...
August 18, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Gunnar Knutsen, Jon Olav Drogset, Lars Engebretsen, Torbjørn Grøntvedt, Tom C Ludvigsen, Sverre Løken, Eirik Solheim, Torbjørn Strand, Oddmund Johansen
BACKGROUND: The management of cartilage and osteochondral lesions in the knee remains problematic and controversial. Our group reported the 2-year and 5-year results of a randomized controlled trial comparing autologous chondrocyte implantation (ACI) and microfracture in patients with focal femoral cartilage injuries. The objective of the present study was to report the long-term results. METHODS: Eighty patients with a single symptomatic chronic cartilage defect on the femoral condyle without general osteoarthritis were included in the study at the time of the index operation (January 1999 to February 2000)...
August 17, 2016: Journal of Bone and Joint Surgery. American Volume
G M Salzmann, G A Baumann, S Preiss
Articular cartilage defects at the knee joint are being identified and treated with increasing frequency. Chondrocytes may have strongest potential to generate high-quality repair tissue within the defective region, in particular when large diameter defects are present. Autologous chondrocyte implantation is not available in every country. We present a case where we spontaneously covered an acute cartilage defect, which was significantly larger than expected and loose during initial arthroscopic inspection after reading preoperative MRI, by mincing the separated fragment and directly implanting the autologous cartilage chips into the defective region...
2016: Case Reports in Orthopedics
Natasja L Joergensen, Casper B Foldager, Dang Q S Le, Martin Lind, Helle Lysdahl
Cells constantly sense and receive chemical and physical signals from neighboring cells, interstitial fluid, and extracellular matrix, which they integrate and translate into intracellular responses. Thus, the nature of the surface on which cells are cultured in vitro plays an important role for cell adhesion, proliferation, and differentiation. Autologous chondrocyte implantation is considered the treatment of choice for larger cartilage defects in the knee. To obtain a sufficient number of chondrocytes for implantation multiple passaging is often needed, which raises concerns about the changes in the chondrogenic phenotype...
August 4, 2016: Journal of Biomedical Materials Research. Part A
Asode Ananthram Shetty, Seok Jung Kim, Vishvas Shetty, Jae Deog Jang, Sung Woo Huh, Dong Hwan Lee
The defects of articular cartilage in the knee joint are a common degenerative disease and currently there are several established techniques to treat this problem, each with their own advantages and shortcomings. Autologous chondrocyte implantation is the current gold standard but the technique is expensive, time-consuming and most versions require two stage procedures and an arthrotomy. Autologous collagen induced chondrogenesis (ACIC) is a single-stage arthroscopic procedure and we developed. This method uses microfracture technique with atelocollagen mixed with fibrin gel to treat articular cartilage defects...
July 2016: Journal of Clinical Orthopaedics and Trauma
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