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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 immunohistochemical collagen type II and type I staining in condylar defects of different experimental groups. Collagen expression is indicated by brown staining. There is no collagen type II staining in subchondral bone, while bone tissue is positively stained for collagen type I, giving an internal positive control. 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, these examples do not represent a mean intensity of staining of the corresponding experimental group but give an impression of the quality of staining in general.Note: MACT I/III = matrix-associated autologous chondrocyte transplantation + Chondro-Gide scaffold; MF = microfracture; AMIC I/III = autologous membrane-induced chondrogenesis + Chondro-Gide scaffold.
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fig8-1947603509358721: Examples of immunohistochemical collagen type II and type I staining in condylar defects of different experimental groups. Collagen expression is indicated by brown staining. There is no collagen type II staining in subchondral bone, while bone tissue is positively stained for collagen type I, giving an internal positive control. 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, these examples do not represent a mean intensity of staining of the corresponding experimental group but give an impression of the quality of staining in general.Note: MACT I/III = matrix-associated autologous chondrocyte transplantation + Chondro-Gide scaffold; MF = microfracture; AMIC I/III = autologous membrane-induced chondrogenesis + Chondro-Gide scaffold.

Mentions: Collagen type II and I had been stained by immunohistochemistry (see examples in Fig. 8) and scored for no (0), moderate (1), or strong (2) staining in the repair tissue. To show relative levels of staining, the data from collagen type I was subtracted from the values of collagen type II staining, and the results are given in Figure 9. Looking at all defects, there was a significantly stronger staining of collagen type II than type I in condylar defects compared with defects in the trochlear region (shown by the positive values; P < 0.02). In addition, there was a trend showing that collagen type II staining was stronger than collagen type I staining in defects treated with I/III membranes. However, because of the limited number of defects, this trend slightly failed to be significant (P < 0.06).


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 immunohistochemical collagen type II and type I staining in condylar defects of different experimental groups. Collagen expression is indicated by brown staining. There is no collagen type II staining in subchondral bone, while bone tissue is positively stained for collagen type I, giving an internal positive control. 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, these examples do not represent a mean intensity of staining of the corresponding experimental group but give an impression of the quality of staining in general.Note: MACT I/III = matrix-associated autologous chondrocyte transplantation + Chondro-Gide scaffold; MF = microfracture; AMIC I/III = autologous membrane-induced chondrogenesis + Chondro-Gide scaffold.
© Copyright Policy
Related In: Results  -  Collection

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

fig8-1947603509358721: Examples of immunohistochemical collagen type II and type I staining in condylar defects of different experimental groups. Collagen expression is indicated by brown staining. There is no collagen type II staining in subchondral bone, while bone tissue is positively stained for collagen type I, giving an internal positive control. 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, these examples do not represent a mean intensity of staining of the corresponding experimental group but give an impression of the quality of staining in general.Note: MACT I/III = matrix-associated autologous chondrocyte transplantation + Chondro-Gide scaffold; MF = microfracture; AMIC I/III = autologous membrane-induced chondrogenesis + Chondro-Gide scaffold.
Mentions: Collagen type II and I had been stained by immunohistochemistry (see examples in Fig. 8) and scored for no (0), moderate (1), or strong (2) staining in the repair tissue. To show relative levels of staining, the data from collagen type I was subtracted from the values of collagen type II staining, and the results are given in Figure 9. Looking at all defects, there was a significantly stronger staining of collagen type II than type I in condylar defects compared with defects in the trochlear region (shown by the positive values; P < 0.02). In addition, there was a trend showing that collagen type II staining was stronger than collagen type I staining in defects treated with I/III membranes. However, because of the limited number of defects, this trend slightly failed to be significant (P < 0.06).

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