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Cell-Laden and Cell-Free Matrix-Induced Chondrogenesis versus Microfracture for the Treatment of Articular Cartilage Defects: A Histological and Biomechanical Study in Sheep.

Gille J, Kunow J, Boisch L, Behrens P, Bos I, Hoffmann C, Köller W, Russlies M, Kurz B - Cartilage (2010)

Bottom Line: However, none of the index procedures surpassed the others from a biomechanical point of view or based on the histological scoring.Collagen type II expression was better in condylar defects compared to the trochlea, especially in those treated with collagen I/III membranes.However, it failed to improve the biomechanical and histological properties of regenerated articular cartilage compared to microfracture alone in an ovine model under the given circumstances.

View Article: PubMed Central - PubMed

Affiliation: Department of Trauma and Orthopaedic Surgery, University of Schleswig-Holstein, Campus Lübeck, Germany.

ABSTRACT

Objective: The aim of this study was to evaluate the regenerative potential of cell-laden and cell-free collagen matrices in comparison to microfracture treatment applied to full-thickness chondral defects in an ovine model.

Methods: Animals (n = 30) were randomized into 5 treatment groups, and 7-mm full-cartilage-thickness defects were set at the trochlea and medial condyle of both knee joints and treated as follows: 2 scaffolds in comparison (collagen I/III, Chondro-Gide(®); collagen II, Chondrocell(®)) for covering microfractured defects (autologous matrix-induced chondrogenesis), both scaffolds colonized in vitro with autologous chondrocytes (matrix-associated chondrocyte transplantation), or scaffold-free microfracture technique. One year after surgery, cartilage lesions were biomechanically (indentation test), histologically (O'Driscoll score), and immunohistochemically (collagen type I and II staining) evaluated.

Results: All treatment groups of the animal model induced more repair tissue and showed better histological scores and biomechanical properties compared to controls. The average thickness of the repair tissue was significantly greater when a scaffold was used, especially the collagen I/III membrane. However, none of the index procedures surpassed the others from a biomechanical point of view or based on the histological scoring. Collagen type II expression was better in condylar defects compared to the trochlea, especially in those treated with collagen I/III membranes.

Conclusion: Covering of defects with suitable matrices promotes repair tissue formation and is suggested to be a promising treatment option for cartilage defects. However, it failed to improve the biomechanical and histological properties of regenerated articular cartilage compared to microfracture alone in an ovine model under the given circumstances.

No MeSH data available.


Related in: MedlinePlus

Examples for gross findings at sacrifice, 1 y after defect setting and treatment. The defect sites are marked with an arrow. (a) Inhomogenous defect filling after microfracture at the medial femoral condyle and trochlear groove. (b) Incomplete defect filling after autologous matrix-induced chondrogenesis at the femoral condyle and trochlear groove.
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fig2-1947603509358721: Examples for gross findings at sacrifice, 1 y after defect setting and treatment. The defect sites are marked with an arrow. (a) Inhomogenous defect filling after microfracture at the medial femoral condyle and trochlear groove. (b) Incomplete defect filling after autologous matrix-induced chondrogenesis at the femoral condyle and trochlear groove.

Mentions: All animals tolerated surgery well, and their gaits were normal, without any severe limps. The joints appeared to be stable at physical examination. After sacrifice, the boundaries of the defects in all knees were clearly demarcated and macroscopically differentiable on sacrifice. A complete reconstruction of the articular cartilage was not evident. After MF repair, tissue appeared with an irregular texture and often depressed topology (Fig. 2 a). Almost no repair tissue was seen in control defects. Regenerated tissue of matrix-based treatment groups appeared white, smooth, glistening, and uniform in texture (Fig. 2 b). None of the specimens showed signs of degeneration, such as sclerosis or osteophyte. There were no significant differences in the macroscopic appearance of the synovial tissue analysis between treated and control joints.


Cell-Laden and Cell-Free Matrix-Induced Chondrogenesis versus Microfracture for the Treatment of Articular Cartilage Defects: A Histological and Biomechanical Study in Sheep.

Gille J, Kunow J, Boisch L, Behrens P, Bos I, Hoffmann C, Köller W, Russlies M, Kurz B - Cartilage (2010)

Examples for gross findings at sacrifice, 1 y after defect setting and treatment. The defect sites are marked with an arrow. (a) Inhomogenous defect filling after microfracture at the medial femoral condyle and trochlear groove. (b) Incomplete defect filling after autologous matrix-induced chondrogenesis at the femoral condyle and trochlear groove.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4440609&req=5

fig2-1947603509358721: Examples for gross findings at sacrifice, 1 y after defect setting and treatment. The defect sites are marked with an arrow. (a) Inhomogenous defect filling after microfracture at the medial femoral condyle and trochlear groove. (b) Incomplete defect filling after autologous matrix-induced chondrogenesis at the femoral condyle and trochlear groove.
Mentions: All animals tolerated surgery well, and their gaits were normal, without any severe limps. The joints appeared to be stable at physical examination. After sacrifice, the boundaries of the defects in all knees were clearly demarcated and macroscopically differentiable on sacrifice. A complete reconstruction of the articular cartilage was not evident. After MF repair, tissue appeared with an irregular texture and often depressed topology (Fig. 2 a). Almost no repair tissue was seen in control defects. Regenerated tissue of matrix-based treatment groups appeared white, smooth, glistening, and uniform in texture (Fig. 2 b). None of the specimens showed signs of degeneration, such as sclerosis or osteophyte. There were no significant differences in the macroscopic appearance of the synovial tissue analysis between treated and control joints.

Bottom Line: However, none of the index procedures surpassed the others from a biomechanical point of view or based on the histological scoring.Collagen type II expression was better in condylar defects compared to the trochlea, especially in those treated with collagen I/III membranes.However, it failed to improve the biomechanical and histological properties of regenerated articular cartilage compared to microfracture alone in an ovine model under the given circumstances.

View Article: PubMed Central - PubMed

Affiliation: Department of Trauma and Orthopaedic Surgery, University of Schleswig-Holstein, Campus Lübeck, Germany.

ABSTRACT

Objective: The aim of this study was to evaluate the regenerative potential of cell-laden and cell-free collagen matrices in comparison to microfracture treatment applied to full-thickness chondral defects in an ovine model.

Methods: Animals (n = 30) were randomized into 5 treatment groups, and 7-mm full-cartilage-thickness defects were set at the trochlea and medial condyle of both knee joints and treated as follows: 2 scaffolds in comparison (collagen I/III, Chondro-Gide(®); collagen II, Chondrocell(®)) for covering microfractured defects (autologous matrix-induced chondrogenesis), both scaffolds colonized in vitro with autologous chondrocytes (matrix-associated chondrocyte transplantation), or scaffold-free microfracture technique. One year after surgery, cartilage lesions were biomechanically (indentation test), histologically (O'Driscoll score), and immunohistochemically (collagen type I and II staining) evaluated.

Results: All treatment groups of the animal model induced more repair tissue and showed better histological scores and biomechanical properties compared to controls. The average thickness of the repair tissue was significantly greater when a scaffold was used, especially the collagen I/III membrane. However, none of the index procedures surpassed the others from a biomechanical point of view or based on the histological scoring. Collagen type II expression was better in condylar defects compared to the trochlea, especially in those treated with collagen I/III membranes.

Conclusion: Covering of defects with suitable matrices promotes repair tissue formation and is suggested to be a promising treatment option for cartilage defects. However, it failed to improve the biomechanical and histological properties of regenerated articular cartilage compared to microfracture alone in an ovine model under the given circumstances.

No MeSH data available.


Related in: MedlinePlus