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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 of hematoxylin-eosin stained sections from defects in the condylar and Alcian blue–stained defects in the trochlear region. Arrows mark the borders of the defects; stars indicate more or less intact cartilage tissue surrounding the defect area. Because of the high variance in staining and structure of the tissue, these examples do not represent a mean histological outcome of the corresponding experimental group but give an impression of the quality of histological staining and structure in general.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.
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fig6-1947603509358721: Examples of hematoxylin-eosin stained sections from defects in the condylar and Alcian blue–stained defects in the trochlear region. Arrows mark the borders of the defects; stars indicate more or less intact cartilage tissue surrounding the defect area. Because of the high variance in staining and structure of the tissue, these examples do not represent a mean histological outcome of the corresponding experimental group but give an impression of the quality of histological staining and structure in general.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.

Mentions: In general, repair tissue analysis confirmed the macroscopic results, in which most of the controls showed empty defects with no or very limited repair tissue. Figure 6 shows for all treatment and control groups histological tissue sections after hematoxylin-eosin and Alcian blue staining. In some areas, a columnar and chondron-like distribution of cells with some clustering was found. In general, repair tissue was mostly neocartilage of partly hyline-like characteristics. There were no signs of abnormal calcification, infiltration of immunological cells, apoptosis of cells, or necrosis. Only partial defect filling in the control groups was observed in 30% of untreated defects in the trochlea and in 10% at the medial condyle defects, whereas treatment induced repair tissue formation in most of the defects. Interestingly, most of the spontaneous repair occurred in animals with less than 41 kg of body weight.


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 of hematoxylin-eosin stained sections from defects in the condylar and Alcian blue–stained defects in the trochlear region. Arrows mark the borders of the defects; stars indicate more or less intact cartilage tissue surrounding the defect area. Because of the high variance in staining and structure of the tissue, these examples do not represent a mean histological outcome of the corresponding experimental group but give an impression of the quality of histological staining and structure in general.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.
© Copyright Policy
Related In: Results  -  Collection

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

fig6-1947603509358721: Examples of hematoxylin-eosin stained sections from defects in the condylar and Alcian blue–stained defects in the trochlear region. Arrows mark the borders of the defects; stars indicate more or less intact cartilage tissue surrounding the defect area. Because of the high variance in staining and structure of the tissue, these examples do not represent a mean histological outcome of the corresponding experimental group but give an impression of the quality of histological staining and structure in general.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.
Mentions: In general, repair tissue analysis confirmed the macroscopic results, in which most of the controls showed empty defects with no or very limited repair tissue. Figure 6 shows for all treatment and control groups histological tissue sections after hematoxylin-eosin and Alcian blue staining. In some areas, a columnar and chondron-like distribution of cells with some clustering was found. In general, repair tissue was mostly neocartilage of partly hyline-like characteristics. There were no signs of abnormal calcification, infiltration of immunological cells, apoptosis of cells, or necrosis. Only partial defect filling in the control groups was observed in 30% of untreated defects in the trochlea and in 10% at the medial condyle defects, whereas treatment induced repair tissue formation in most of the defects. Interestingly, most of the spontaneous repair occurred in animals with less than 41 kg of body weight.

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