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Autologous chondrocyte implantation for cartilage repair: monitoring its success by magnetic resonance imaging and histology.

Roberts S, McCall IW, Darby AJ, Menage J, Evans H, Harrison PE, Richardson JB - Arthritis Res. Ther. (2002)

Bottom Line: It was of varying morphology ranging from predominantly hyaline in 22% of biopsy specimens, mixed in 48%, through to predominantly fibrocartilage, in 30%, apparently improving with increasing time postgraft.MRI scans provide a useful assessment of properties of the whole graft area and adjacent tissue and is a noninvasive technique for long-term follow-up.It correlated with histology (P = 0.02) in patients treated with ACI alone.

View Article: PubMed Central - HTML - PubMed

Affiliation: Centre for Spinal Studies, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Trust, Oswestry, Shropshire, UK. s.roberts@keele.ac.uk

ABSTRACT
Autologous chondrocyte implantation is being used increasingly for the treatment of cartilage defects. In spite of this, there has been a paucity of objective, standardised assessment of the outcome and quality of repair tissue formed. We have investigated patients treated with autologous chondrocyte implantation (ACI), some in conjunction with mosaicplasty, and developed objective, semiquantitative scoring schemes to monitor the repair tissue using MRI and histology. Results indicate repair tissue to be on average 2.5 mm thick. It was of varying morphology ranging from predominantly hyaline in 22% of biopsy specimens, mixed in 48%, through to predominantly fibrocartilage, in 30%, apparently improving with increasing time postgraft. Repair tissue was well integrated with the host tissue in all aspects viewed. MRI scans provide a useful assessment of properties of the whole graft area and adjacent tissue and is a noninvasive technique for long-term follow-up. It correlated with histology (P = 0.02) in patients treated with ACI alone.

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Immunostaining for type X collagen after autologous chondrocyte implantation. Staining was typically seen around the cells in the deep zone (arrows) and calcified cartilage (sample 16).
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Figure 5: Immunostaining for type X collagen after autologous chondrocyte implantation. Staining was typically seen around the cells in the deep zone (arrows) and calcified cartilage (sample 16).

Mentions: Staining for type II collagen was positive in all specimens with hyaline morphology, although sometimes the uppermost layer (up to 300 μm) was negative. In most specimens with mixed or fibrocartilage morphology, 50% or more of the matrix was positive (Fig. 3; Table 5). There were few exceptions to this, with two fibrocartilage specimens being totally negative for type II collagen. Type I collagen immunostaining was seen in all samples but was more variable than for type II collagen. In the fibrocartilage-like samples, the staining was widespread throughout the matrix, whereas in those with hyaline morphology, its distribution was discrete and usually restricted to the very uppermost region, approximately 250 μm thick for the specimens from ACI-treated patients (Fig. 4). Staining for type X collagen occurred in 62% of samples, but when present it was only in small areas, usually in and around cells in the deep zone, close to the calcified cartilage or bone and the tidemark (Fig. 5). There was immunostaining for collagen types III and VI in all samples studied except for one, which was negative for type VI collagen. The distribution, however, differed markedly depending on the morphology of the matrix. In fibrocartilage, staining for collagen types III and VI was homogeneous throughout, whereas in hyaline cartilage it was clearly cell-associated, staining the cell and pericellular matrix but not the interterritorial matrix (Fig. 6).


Autologous chondrocyte implantation for cartilage repair: monitoring its success by magnetic resonance imaging and histology.

Roberts S, McCall IW, Darby AJ, Menage J, Evans H, Harrison PE, Richardson JB - Arthritis Res. Ther. (2002)

Immunostaining for type X collagen after autologous chondrocyte implantation. Staining was typically seen around the cells in the deep zone (arrows) and calcified cartilage (sample 16).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC154433&req=5

Figure 5: Immunostaining for type X collagen after autologous chondrocyte implantation. Staining was typically seen around the cells in the deep zone (arrows) and calcified cartilage (sample 16).
Mentions: Staining for type II collagen was positive in all specimens with hyaline morphology, although sometimes the uppermost layer (up to 300 μm) was negative. In most specimens with mixed or fibrocartilage morphology, 50% or more of the matrix was positive (Fig. 3; Table 5). There were few exceptions to this, with two fibrocartilage specimens being totally negative for type II collagen. Type I collagen immunostaining was seen in all samples but was more variable than for type II collagen. In the fibrocartilage-like samples, the staining was widespread throughout the matrix, whereas in those with hyaline morphology, its distribution was discrete and usually restricted to the very uppermost region, approximately 250 μm thick for the specimens from ACI-treated patients (Fig. 4). Staining for type X collagen occurred in 62% of samples, but when present it was only in small areas, usually in and around cells in the deep zone, close to the calcified cartilage or bone and the tidemark (Fig. 5). There was immunostaining for collagen types III and VI in all samples studied except for one, which was negative for type VI collagen. The distribution, however, differed markedly depending on the morphology of the matrix. In fibrocartilage, staining for collagen types III and VI was homogeneous throughout, whereas in hyaline cartilage it was clearly cell-associated, staining the cell and pericellular matrix but not the interterritorial matrix (Fig. 6).

Bottom Line: It was of varying morphology ranging from predominantly hyaline in 22% of biopsy specimens, mixed in 48%, through to predominantly fibrocartilage, in 30%, apparently improving with increasing time postgraft.MRI scans provide a useful assessment of properties of the whole graft area and adjacent tissue and is a noninvasive technique for long-term follow-up.It correlated with histology (P = 0.02) in patients treated with ACI alone.

View Article: PubMed Central - HTML - PubMed

Affiliation: Centre for Spinal Studies, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Trust, Oswestry, Shropshire, UK. s.roberts@keele.ac.uk

ABSTRACT
Autologous chondrocyte implantation is being used increasingly for the treatment of cartilage defects. In spite of this, there has been a paucity of objective, standardised assessment of the outcome and quality of repair tissue formed. We have investigated patients treated with autologous chondrocyte implantation (ACI), some in conjunction with mosaicplasty, and developed objective, semiquantitative scoring schemes to monitor the repair tissue using MRI and histology. Results indicate repair tissue to be on average 2.5 mm thick. It was of varying morphology ranging from predominantly hyaline in 22% of biopsy specimens, mixed in 48%, through to predominantly fibrocartilage, in 30%, apparently improving with increasing time postgraft. Repair tissue was well integrated with the host tissue in all aspects viewed. MRI scans provide a useful assessment of properties of the whole graft area and adjacent tissue and is a noninvasive technique for long-term follow-up. It correlated with histology (P = 0.02) in patients treated with ACI alone.

Show MeSH
Related in: MedlinePlus