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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

Box and Whisker plot of the creep index at the condylus medialis (A) and at the trochlea (B). Values are depicted for the treatment groups (1-5), controls, and remote area cartilage. Scores are presented as medians; the ends of the boxes define the 25th and 75th percentiles.Note: MACT I/III = matrix-associated autologous chondrocyte transplantation + Chondro-Gide scaffold; MACT II = matrix-associated autologous chondrocyte transplantation + Chondrocell scaffold; MF = microfracture; AMIC I/III = autologous membrane-induced chondrogenesis + Chondro-Gide scaffold; AMIC II = autologous membrane induced chondrogenesis + Chondrocell scaffold; RAC = remote area cartilage.
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fig3-1947603509358721: Box and Whisker plot of the creep index at the condylus medialis (A) and at the trochlea (B). Values are depicted for the treatment groups (1-5), controls, and remote area cartilage. Scores are presented as medians; the ends of the boxes define the 25th and 75th percentiles.Note: MACT I/III = matrix-associated autologous chondrocyte transplantation + Chondro-Gide scaffold; MACT II = matrix-associated autologous chondrocyte transplantation + Chondrocell scaffold; MF = microfracture; AMIC I/III = autologous membrane-induced chondrogenesis + Chondro-Gide scaffold; AMIC II = autologous membrane induced chondrogenesis + Chondrocell scaffold; RAC = remote area cartilage.

Mentions: The 25-s creeping index was lower in remote area cartilage at the femoral condyle compared with the trochlea. At the treated defect sites, values were higher compared with remote area cartilage at both locations—the femoral condyle and the trochlea. However, comparing data from treated groups with data from control groups, no striking differences were measurable in general. After analyzing the data in detail, it must be assessed that repair tissues at the femoral condyle of the MF group were more viscous than in the other groups, including the use of a scaffold (Fig. 3 A). Results of the treatment groups at the trochlea did also not differ to a large extent (Fig. 3 B). A bias can be declared for the results of groups MACT I/III and AMIC I/III (Chondro-Gide matrix) showing a slightly higher deformity of repair tissue compared with groups MACT II and AMIC II (Chondrocell matrix). Both groups, using the AMIC technique, lead to softer repair tissue compared with groups using the MACT procedure.


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)

Box and Whisker plot of the creep index at the condylus medialis (A) and at the trochlea (B). Values are depicted for the treatment groups (1-5), controls, and remote area cartilage. Scores are presented as medians; the ends of the boxes define the 25th and 75th percentiles.Note: MACT I/III = matrix-associated autologous chondrocyte transplantation + Chondro-Gide scaffold; MACT II = matrix-associated autologous chondrocyte transplantation + Chondrocell scaffold; MF = microfracture; AMIC I/III = autologous membrane-induced chondrogenesis + Chondro-Gide scaffold; AMIC II = autologous membrane induced chondrogenesis + Chondrocell scaffold; RAC = remote area cartilage.
© Copyright Policy
Related In: Results  -  Collection

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

fig3-1947603509358721: Box and Whisker plot of the creep index at the condylus medialis (A) and at the trochlea (B). Values are depicted for the treatment groups (1-5), controls, and remote area cartilage. Scores are presented as medians; the ends of the boxes define the 25th and 75th percentiles.Note: MACT I/III = matrix-associated autologous chondrocyte transplantation + Chondro-Gide scaffold; MACT II = matrix-associated autologous chondrocyte transplantation + Chondrocell scaffold; MF = microfracture; AMIC I/III = autologous membrane-induced chondrogenesis + Chondro-Gide scaffold; AMIC II = autologous membrane induced chondrogenesis + Chondrocell scaffold; RAC = remote area cartilage.
Mentions: The 25-s creeping index was lower in remote area cartilage at the femoral condyle compared with the trochlea. At the treated defect sites, values were higher compared with remote area cartilage at both locations—the femoral condyle and the trochlea. However, comparing data from treated groups with data from control groups, no striking differences were measurable in general. After analyzing the data in detail, it must be assessed that repair tissues at the femoral condyle of the MF group were more viscous than in the other groups, including the use of a scaffold (Fig. 3 A). Results of the treatment groups at the trochlea did also not differ to a large extent (Fig. 3 B). A bias can be declared for the results of groups MACT I/III and AMIC I/III (Chondro-Gide matrix) showing a slightly higher deformity of repair tissue compared with groups MACT II and AMIC II (Chondrocell matrix). Both groups, using the AMIC technique, lead to softer repair tissue compared with groups using the MACT procedure.

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