Focal chondral defect patella

Since the healing capacity of articular cartilage is limited, it is important to develop cell-based therapies for the repair of cartilage. Although synthetic or animal-derived scaffolds are frequently used for effective cell delivery long-term safety and efficiency of such scaffolds still remain unclear. We have been studying on a scaffold-free tissue engineered construct (TEC) bio-synthesized from synovium-derived mesenchymal stem cells (MSCs) [1]. As the TEC specimen is composed of cells with their native extracellular matrix, we believe that it is free from concern regarding long term immunological effects. our previous studies indicated that a porcine partial thickness chondral defect was successfully repaired with TEC but that the compressive property of the TEC-treated cartilage-like repaired tissue was different from normal cartilage in both immature and mature animals. Imura et al. found that the permeability of the immature porcine cartilage-like tissues repaired with TEC recovered to normal level for 6 months except the superficial layer [2]. Therefore, the present study was performed to determine the depth-dependent permeability of mature porcine cartilage-like tissue repaired with TEC. Moreover, we investigated the effect of difference of permeability on the compressive property of articular cartilage using a finite element analysis (FEM).

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Use of human induced pluripotent stem cells for cartilage regeneration in vitro and within chondral defect models of knee joint cartilage in vivo: a Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic literature review

Cytotherapy ◽

10.1016/j.jcyt.2021.03.008 ◽

2021 ◽

Author(s):

Achi Kamaraj ◽

Harry Kyriacou ◽

K.T. Matthew Seah ◽

Wasim S. Khan

Keyword(s):

Stem Cells ◽

Pluripotent Stem Cells ◽

Cartilage Regeneration ◽

Chondral Defect ◽

Joint Cartilage ◽

Regeneration In Vitro ◽

Induced Pluripotent ◽

Meta Analyses

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Arthroscopic Autologous Chondrocyte Bone Grafting of a Lateral Tibial Plateau Chondral Defect

Arthroscopy Techniques ◽

10.1016/j.eats.2020.10.078 ◽

2021 ◽

Author(s):

Steven F. DeFroda ◽

William Cregar ◽

Amar Vadhera ◽

Harsh Singh ◽

Allison Perry ◽

...

Keyword(s):

Bone Grafting ◽

Tibial Plateau ◽

Chondral Defect ◽

Lateral Tibial Plateau ◽

Autologous Chondrocyte

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Photopolymerizable Injectable Cartilage Mimetic Hydrogel for the Treatment of Focal Chondral Lesions: A Proof of Concept Study in a Rabbit Animal Model

The American Journal of Sports Medicine ◽

10.1177/0363546518808012 ◽

2018 ◽

Vol 47 (1) ◽

pp. 212-221 ◽

Cited By ~ 10

Author(s):

Cecilia Pascual-Garrido ◽

Elizabeth A. Aisenbrey ◽

Francisco Rodriguez-Fontan ◽

Karin A. Payne ◽

Stephanie J. Bryant ◽

...

Keyword(s):

Animal Model ◽

Chondrogenic Differentiation ◽

Osteochondral Lesions ◽

Chondral Defect ◽

Group A ◽

Group B ◽

Safranin O

Background: In this study, we investigate the in vitro and in vivo chondrogenic capacity of a novel photopolymerizable cartilage mimetic hydrogel, enhanced with extracellular matrix analogs, for cartilage regeneration. Purpose: To (1) determine whether mesenchymal stem cells (MSCs) embedded in a novel cartilage mimetic hydrogel support in vitro chondrogenesis, (2) demonstrate that the proposed hydrogel can be delivered in situ in a critical chondral defect in a rabbit model, and (3) determine whether the hydrogel with or without MSCs supports in vivo chondrogenesis in a critical chondral defect. Study Design: Controlled laboratory study. Methods: Rabbit bone marrow–derived MSCs were isolated, expanded, encapsulated in the hydrogel, and cultured in chondrogenic differentiation medium for 9 weeks. Compressive modulus was evaluated at day 1 and at weeks 3, 6, and 9. Chondrogenic differentiation was investigated via quantitative polymerase reaction, safranin-O staining, and immunofluorescence. In vivo, a 3 mm–wide × 2-mm-deep chondral defect was created bilaterally on the knee trochlea of 10 rabbits. Each animal had 1 defect randomly assigned to be treated with hydrogel with or without MSCs, and the contralateral knee was left untreated. Hence, each rabbit served as its own matched control. Three groups were established: group A, hydrogel (n = 5); group B, hydrogel with MSCs (n = 5); and group C, control (n = 10). Repair tissue was evaluated at 6 months after intervention. Results: In vitro, chondrogenesis and the degradable behavior of the hydrogel by MSCs were confirmed. In vivo, the hydrogel could be delivered intraoperatively in a sterile manner. Overall, the hydrogel group had the highest scores on the modified O’Driscoll scoring system (group A, 17.4 ± 4.7; group B, 13 ± 3; group C, 16.7 ± 2.9) ( P = .11) and showed higher safranin-O staining (group A, 49.4% ± 20%; group B, 25.8% ± 16.4%; group C, 36.9% ± 25.2%) ( P = .27), although significance was not detected for either parameter. Conclusion: This study provides the first evidence of the ability to photopolymerize this novel hydrogel in situ and assess its ability to provide chondrogenic cues for cartilage repair in a small animal model. In vitro chondrogenesis was evident when MSCs were encapsulated in the hydrogel. Clinical Relevance: Cartilage mimetic hydrogel may offer a tissue engineering approach for the treatment of osteochondral lesions.

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Treatment of a Patellar Chondral Defect Using Juvenile Articular Cartilage Allograft Implantation

Arthroscopy Techniques ◽

10.1016/j.eats.2013.06.003 ◽

2013 ◽

Vol 2 (4) ◽

pp. e351-e354 ◽

Cited By ~ 6

Author(s):

Justin W. Griffin ◽

C. Jan Gilmore ◽

Mark D. Miller

Keyword(s):

Articular Cartilage ◽

Chondral Defect

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Particulated Juvenile Articular Cartilage (PJAC) Allograft for Treatment of Lateral Femoral Condyle defect in High-Performance Athletes

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118s00055 ◽

2018 ◽

Vol 6 (6_suppl3) ◽

pp. 2325967118S0005 ◽

Cited By ~ 1

Author(s):

Gabriella Bucci ◽

Michael Begg ◽

Kevin Pillifant ◽

Steven B Singleton

Keyword(s):

Articular Cartilage ◽

Cartilage Defect ◽

High Performance ◽

Femoral Condyle ◽

Cartilage Lesion ◽

Lateral Femoral Condyle ◽

High Grade ◽

Chondral Defect ◽

Short Term ◽

High Level

Background: A relatively new technology for the treatment of high grade articular cartilage lesions is the implantation of particulated articular cartilage obtained from a juvenile allograft donor (PJAC).1-2 Previous studies have reported the ability of juvenile chondrocytes to migrate from cartilage explants after being secured in a cartilage defect.3 There is little in the literature to use as a reference with respect to the use of PJAC for high grade articular cartilage lesion of the lateral femoral condyle after a failure of treatment with a microfracture in the high level athlete. Objective: The aim of this report is to describe the technique of PJAC transplantation for the treatment of chondral lesions of the lateral femoral condyle and to report the short term outcomes in the high performance athlete. Methods: We present a case report of two patients who were treated in our clinic in December 2014. Case 1: 16 year old female Division 1 university soccer player, who one year prior to our index surgery underwent microfractures of a symptomatic lateral femoral condyle articular cartilage lesion without relief. Cae 2: 29 year old male professional tennis player (case 2) with a recurrent, symptomatic chondral defect on the lateral femoral condyle. The player had undergone multiple arthroscopic procedures on the same knee following an injury sustained while playing in the Australian Open, including a surgery 8 months prior to our index operation that had included lateral meniscal tear repair and microfractures. PJAC procedure consists of a minimal debridement and chondroplasty, performed arthroscopically. For these central lateral femoral condyle lesions, a mini-arthrotomy is created along the lateral parapatellar longitudinal axis over a length of about 3 cm. With the chondral defect localized and prepared, a thin fresh layer of fibrin glue is then applied. The PJAC graft is equally distributed in the defect with space in between the fragments so as not over-fill the defect. Then, a new fibrin glue layer is placed to cover the graft. The overall construct remains just below the level of the normal articular surface. The knee is cycled through the range of motion to ensure that the tissue construct is stable. We present images of the cartilage defect after debridement and the allograft implantation procedure. In addition we will submit an instructional video performed on a knee specimen. Results: Outcomes measured were: IKDC, Lysholm, and Tegner knee scores together with arc of motion of the joint. After 28 months follow up, patients had gained complete range of motion and significantly decreased pain. Improvement for each outcome measure used is reported. Conclusions: PJAC transplantation offers pain relief and improved short term outcomes in high level performance athletes. Both of our patients are back to practicing their sport with notable improvement in symptoms. No complications have been noted. Long-term data is not yet available. References: Am J Farr J, Tabet SK, Margerrison E, Cole BJ. Clinical, Radiographic, and Histological Outcomes After Cartilage Repair With Particulated Juvenile Articular Cartilage: A 2-Year Prospective Study. Sports Med. 2014 Jun;42(6):1417-25. Saltzman BM, Lin J, Lee S. Particulated Juvenile Articular Cartilage Allograft Transplantation for Osteochondral Talar Lesions. Cartilage. 2017 Jan;8(1):61-72. Arshi A, Wang D, Jones KJ. Combined Particulated Juvenile Cartilage Allograft Transplantation and Medial Patellofemoral Ligament Reconstruction for Symptomatic Chondral Defects in the Setting of Recurrent Patellar Instability. Arthrosc Tech. 2016 Oct 10;5(5)

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