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Ahmed Al-Qarni, Matthew R Lewington, Ivan H Wong
It is well known that articular cartilage defects have little capability to heal. For grade III or IV cartilage defects, surgical intervention may be required for symptomatic patients. Microfracture is a commonly used surgical technique to address these injuries. However, microfracture has drawbacks, which include the risk of ossification of the newly formed tissue, as well as the imperfect and fragile nature of the fibrous cartilage. Given the challenges associated with microfracture, BST-CarGel (Piramal Healthcare, Laval, Quebec, Canada) has been developed to stabilize and support the nascent clot...
April 2016: Arthroscopy Techniques
Stéphane Méthot, Adele Changoor, Nicolas Tran-Khanh, Caroline D Hoemann, William D Stanish, Alberto Restrepo, Matthew S Shive, Michael D Buschmann
OBJECTIVE: The efficacy and safety of BST-CarGel, a chitosan-based medical device for cartilage repair, was compared with microfracture alone at 1 year during a multicenter randomized controlled trial (RCT) in the knee. The quality of repair tissue of osteochondral biopsies collected from a subset of patients was compared using blinded histological assessments. METHODS: The international RCT evaluated repair tissue quantity and quality by 3-dimensional quantitative magnetic resonance imaging as co-primary endpoints at 12 months...
January 2016: Cartilage
Jesús Vilá Y Rico, Antonio Dalmau, Francisco Javier Chaqués, Jordi Asunción
Bone marrow stimulation (BMS) techniques represent the first-line treatment for unstable osteochondral lesions of the talus or after conservative treatment failure. These techniques are intended to penetrate the subchondral bone to elicit bleeding and allow precursor cells and cytokines from bone marrow to populate the lesion. However, the fibrocartilaginous repair tissue arising after marrow stimulation confers inferior mechanical and biological properties compared with the original hyaline cartilage. The limitations of BMS can be overcome by the use of the soluble chitosan-based polymer BST-CarGel (Piramal Life Sciences, Laval, Quebec, Canada)...
December 2015: Arthroscopy Techniques
Caroline D Hoemann, Nicolas Tran-Khanh, Anik Chevrier, Gaoping Chen, Viorica Lascau-Coman, Colleen Mathieu, Adele Changoor, Alex Yaroshinsky, Robert G McCormack, William D Stanish, Michael D Buschmann
BACKGROUND: Current cartilage repair histological scoring systems are unable to explain the relationship between collagen type II deposition and overall repair quality. PURPOSE/HYPOTHESIS: The purpose of this study was to develop a novel zonal collagen type (ZCT) 5-point scoring system to measure chondroinduction in human clinical biopsy specimens collected after marrow stimulation. The hypothesis was that the ZCT scores would correlate with the International Cartilage Repair Society-II (ICRS-II) overall histological repair assessment score and glycosaminoglycan (GAG) content...
October 2015: American Journal of Sports Medicine
Matthew S Shive, William D Stanish, Robert McCormack, Francisco Forriol, Nicholas Mohtadi, Stéphane Pelet, Jacques Desnoyers, Stéphane Méthot, Kendra Vehik, Alberto Restrepo
OBJECTIVE: The efficacy and safety of BST-CarGel®, a chitosan scaffold for cartilage repair was compared with microfracture alone at 1 year during a multicenter randomized controlled trial in the knee. This report was undertaken to investigate 5-year structural and clinical outcomes. DESIGN: The international randomized controlled trial enrolled 80 patients, aged 18 to 55 years, with grade III or IV focal lesions on the femoral condyles. Patients were randomized to receive BST-CarGel® treatment or microfracture alone, and followed standardized 12-week rehabilitation...
April 2015: Cartilage
Marc Tey, Jesús Mas, Xavier Pelfort, Joan Carles Monllau
Microfracture, the current standard of care for the treatment of non-degenerative chondral lesions in the hip joint, is limited by the poor quality of the filling fibrocartilaginous tissue. BST-CarGel (Piramal Life Sciences, Laval, Quebec, Canada) is a chitosan-based biopolymer that, when mixed with fresh, autologous whole blood and placed over the previously microfractured area, stabilizes the blood clot and enhances marrow-triggered wound-healing repair processes. BST-CarGel has been previously applied in the knee, with statistically significant greater lesion filling and superior repair tissue quality compared with microfracture treatment alone...
February 2015: Arthroscopy Techniques
Matthias R Steinwachs, Bernhard Waibl, Marcus Mumme
Bone marrow stimulation techniques for the treatment of articular cartilage defects such as microfracture so far have solely reproduced mechanically inferior fibrous cartilage tissue, which might result in unsatisfactory clinical results at midterm follow-up. A recent study has shown an improvement in repair tissue quality by enhancing microfracture with a chitosan-based biomaterial (BST-CarGel; Piramal, Laval, Quebec, Canada). BST-CarGel so far has only been applied by arthrotomy, which might lead to increased scar tissue formation and thus compromise recovery time and clinical outcome...
June 2014: Arthroscopy Techniques
Julie Frappier, William Stanish, Mats Brittberg, Matthias Steinwachs, Lydia Crowe, David Castelo, Alberto Restrepo
OBJECTIVES: Knee cartilage damage is a common cause of referral for orthopedic surgery. Treatment aims to reduce pain and symptoms by repairing cartilage. Microfracture, the current standard of care, yields good short-term clinical outcomes; however, treatment might fail after 2-3 years. A Chitosan-Beta glycerolphosphate-based medical device (BST-CarGel) is used as an adjunct to microfracture and demonstrates improvements in quantity and quality of repaired tissue, potentially reducing the risk of treatment failure...
April 2014: Journal of Medical Economics
William D Stanish, Robert McCormack, Francisco Forriol, Nicholas Mohtadi, Stéphane Pelet, Jacques Desnoyers, Alberto Restrepo, Matthew S Shive
BACKGROUND: Microfracture, the standard of care, is recognized to be an incomplete solution for cartilage damage. BST-CarGel, a chitosan-based medical device, is mixed with autologous whole blood and is applied to a microfractured cartilage lesion in which it physically stabilizes the clot and guides and enhances marrow-derived repair. An international, multicenter, randomized controlled trial was conducted to evaluate BST-CarGel treatment compared with microfracture alone in the repair of cartilage lesions in the knee...
September 18, 2013: Journal of Bone and Joint Surgery. American Volume
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