The Effect of Intraarticular Insulin on Chondral Defect Repair

Cartilage ◽  
2020 ◽  
pp. 194760352093846
Author(s):  
Eren Yildiz ◽  
Ali Ersen ◽  
Emre Yener ◽  
Nil Comunoglu ◽  
Cengiz Sen
Keyword(s):  
Weight Bearing ◽  
Cartilage Regeneration ◽  
Negative Influence ◽  
Knee Joints ◽  
Cartilage Defects ◽  
Control Group ◽  
Negative Effects ◽  
Insulin Group ◽  
Chondral Defects ◽  
Healthy Cartilage

Objective The aim of this study is to evaluate the effects of intraarticular insulin on the treatment of chondral defects. Design Twenty-four mature New Zealand rabbits were randomly divided into 3 groups as control (Group 1), microfracture (Group 2), and microfracture and insulin (Group 3). Four-millimeter full-thickness cartilage defects were created to the weight-bearing surface on the medial femoral condyles of each rabbit. In the first group, any additional interventions were not performed. Microfracture was performed on defects in groups 2 and 3. Additionally, 10 IU of insulin glargine was administrated into the knee joints of the third group. Three months after surgery, the knee joints were harvested and cartilage quality was assessed according to Wakitani and ICRS (International Cartilage Repair Society) scores histopathologically. Insulin injections were performed into the knees of 2 additional rabbits without creating a cartilage defect to evaluate the potential adverse effects of insulin on healthy cartilage (Group 4). Results The total ICRS and Wakitani scores of the insulin group were found to be significantly lower than the microfracture group but similar to the control group. No negative effects of insulin on healthy cartilage were detected. Intraarticular insulin after surgery has led to a statistically significant decrease in systemic blood sugar levels whereas the decrease observed after administration to intact tissues was not statistically significant. Conclusions Insulin had a negative influence on the quality of cartilage regeneration and had no effect on healthy cartilage. Intraarticular insulin administration does not cause significant systemic effects in intact tissue.

MODIFICATION IN FOOT PRESSURE AND GAIT PATTERN AFTER ARTHROSCOPIC CARTILAGE REGENERATION FACILITATING PROCEDURES (ACRFP) IN PATIENTS WITH OSTEOARTHRITIS OF KNEE

2019 ◽  
Vol 19 (02) ◽  
pp. 1940026
Author(s):  
TSUNG-CHIAO WU ◽  
CHUAN-HSIN YEN ◽  
SHAW-RUEY LYU ◽  
SHUO-SUEI HUNG
Keyword(s):  
Knee Injury ◽  
Cartilage Regeneration ◽  
Gait Pattern ◽  
Knee Joints ◽  
Knee Adduction Moment ◽  
Control Group ◽  
Lateral Side ◽  
Foot Pressure ◽  
Chronic Knee Pain ◽  
Gait Parameters

Arthroscopic cartilage regeneration facilitating procedure (ACRFP) has been reported with satisfactory results, yet there is limited research on the biomechanics in these patients. The purpose of this study is to assess the change on the biomechanics after ACRFP, in terms of foot pressure and gait pattern. Patients with chronic knee pain due to osteoarthritis and received ACRFP were recruited, and the knee joints in each patient were divided into either study or control group according to radiographical or symptomatic severity. Assessments were done with Knee injury and Osteoarthritis Outcome Score (KOOS) and dynamic foot pressure at the time before surgery, three months and six months postoperatively. A total of 24 patients completed the study. Significant improvement was found of KOOS, at both three and six months postoperatively. No much change in the gait parameters was noted, but there was a significant decrease of foot pressure over lateral side of hindfoot at six months postoperatively. In conclusion, significant clinical improvements could be achieved with surgical results of ACRFP, and shifting of the foot pressure medially may be related to decrease in the knee adduction moment, which is more favorable for the knee joints.

Are Stem Cells Useful in the Regeneration and Repair of Cartilage Defects in the TMJ Condyle? An In Vivo Study

2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Guastaldi FPS ◽  
◽  
Hakim MA ◽  
Liapaki A ◽  
Lowe B ◽  
...  
Keyword(s):  
Stem Cells ◽  
Cartilage Defect ◽  
Cartilage Regeneration ◽  
Cartilage Defects ◽  
Control Group ◽  
Condylar Cartilage ◽  
Group Data ◽  
Group Control Group ◽  
Safranin O

Temporomandibular Joint (TMJ) disorders affect up to 10-40% of the population and if left untreated, may eventually lead to Osteoarthritis (OA) of the TMJ. In vivo TMJ repair and regeneration has received significant attention and represents a promising approach for the treatment of degenerative TMJ disorders. The aim of this study was to present a pre-clinical mouse model of TMJ articular cartilage defect and evaluate the utility of a potential tissue engineered TMJ therapy utilizing Mesenchymal Stem Cells (MSCs) derived from mice condyle, hydrogel, and biosilica. C57BL/6 mice (n=30) were equally divided into the following groups: sham group (S-group); control group, condylar cartilage defect only (CD-group); experimental group, condylar cartilage defect + direct administration of MSCs+hydrogel+biosilica (H-group). Mice were euthanized at 4 (n=15) and 8 (n=15) weeks and TMJ joint specimens were harvested for analysis. H&E and Safranin O stained sections showed intact articular surfaces on the condyle and glenoid fossa at both time points, maturation and distribution of chondrocytes along the condyle for the H-group compared to the CD-group. Data from this preliminary study shows that MSCs+hydrogel+biosilica may represent an experimental therapeutic compound for TMJ condylar cartilage regeneration.

Finite Element Analysis of Cartilage Stress of Rabbits in the Knee Joints and Establishment of a Model for Cartilage Defects in Different Weight-Bearing Sites

2020 ◽  
Vol 10 (6) ◽  
pp. 757-762
Author(s):  
Tan Zhen Wei ◽  
Wang Bin-ang ◽  
Chen Jialei ◽  
Duan Xin ◽  
Liu Ming ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Cartilage Defect ◽  
Weight Bearing ◽  
Posterior Part ◽  
Biomechanical Model ◽  
Knee Joints ◽  
Cartilage Defects ◽  
Minor Trauma ◽  
Element Analysis

New Zealand white rabbits have been widely used to establish cartilage defect models, but there has been less research on stress analysis of the knee joint, and even less in cartilage defect models at different weight-bearing sites. A biomechanical model of the upper zone was established using finite element analysis. An animal model of cartilage defect was established to replicate minor trauma in different weight-bearing parts by simple surgery. The results showed that the stress in the posterior region of condyle was heavier than any weight-bearing areas, the stress in the posterior part of condyle was intermediate, the stress in the trochlear region was the smallest. The cartilage can be exposed by prolonging the medial surgical incision and then cartilage defects can be formed. Finite element analysis is an effective technique to study the mechanical properties of animal cartilage. Prolonging the medial incision can expose cartilage at different weight-bearing sites and establish a cartilage defect model.

Effect of Woven Fabric Biodegradable Polyglycolic Acid on Joint Resurfacing with Fresh Chondrocytes in a Rabbit Model

2007 ◽  
Vol 330-332 ◽  
pp. 1197-1200
Author(s):  
Zhong Li Shi ◽  
Wei Qi Yan ◽  
Jie Feng ◽  
Bing Gang Guan ◽  
Yang Bo Liu ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Fibrous Tissue ◽  
Rabbit Model ◽  
Polyglycolic Acid ◽  
Woven Fabric ◽  
Histological Evaluation ◽  
Cell Group ◽  
Cartilage Defects ◽  
Control Group

To evaluate the effectiveness of the cell-material in situ on joint resurfacing, a woven fabric polyglycolic acid (PGA) treated with fresh chondrocytes was used for repairing cartilage defects. Full-thickness defects were created in the weight-bearing surfaces of the femoral intercondylar fossa in a rabbit model. The defect was filled with and without PGA under surgical condition. Before implantation, chondrocytes were co-cultured with PGA for one day. The animals were sacrificed at eight weeks after implantation and evaluated grossly and histological score. Morphological examination showed that for PGA/chondrocytes group, the repaired tissue appeared similar in color and texture to the surrounding articular surface. While for the untreated control, no cartilage-like tissue was observed at all defects, but connective fibrous tissue. Histological analysis revealed neochondrogenesis and clusters of cartilage matrix with specific safranin-O staining for the PGA/cell group. The Gross and histological evaluation indicated a significantly higher score for PGA/cell group than for PGA and control group. These results suggest that the woven fabric PGA may facilitate the formation of cartilage tissues by providing a biodegradable and good-handle vehicle for the delivery to and retention of organized cell matrix constructs in vivo site. It might therefore enhance neochondrogenesis because of the superior biodegradable and biocompatible of PGA scaffold sheet, while the more suitable biological environment might sustain cell growth and in situ cell function, suggesting a promising candidate for functional tissue engineering of clinical environment.

Transplantation of Aggregates of Autologous Synovial Mesenchymal Stem Cells for Treatment of Cartilage Defects in the Femoral Condyle and the Femoral Groove in Microminipigs

2019 ◽  
Vol 47 (10) ◽  
pp. 2338-2347 ◽  
Author(s):  
Shimpei Kondo ◽  
Yusuke Nakagawa ◽  
Mitsuru Mizuno ◽  
Kenta Katagiri ◽  
Kunikazu Tsuji ◽  
...  
Keyword(s):  
Femoral Condyle ◽  
Cartilage Regeneration ◽  
Medial Femoral Condyle ◽  
Cartilage Defects ◽  
Control Group ◽  
Osteochondral Defects ◽  
Medial Condyle ◽  
Femoral Groove ◽  
Articular Cartilage Regeneration

Background: Previous work has demonstrated that patients with cartilage defects of the knee benefit from arthroscopic transplantation of autologous synovial mesenchymal stem cells (MSCs) in terms of magnetic resonance imaging (MRI), qualitative histologic findings, and Lysholm score. However, the effectiveness was limited by the number of cells obtained, so large-sized defects (>500 mm2) were not investigated. The use of MSC aggregates may enable treatment of larger defects by increasing the number of MSCs adhering to the cartilage defect. Purpose: To investigate whether transplantation of aggregates of autologous synovial MSCs with 2-step surgery could promote articular cartilage regeneration in microminipig osteochondral defects. Study Design: Controlled laboratory study. Methods: Synovial MSCs derived from a microminipig were examined for in vitro colony-forming and multidifferentiation abilities. An aggregate of 250,000 synovial MSCs was formed with hanging drop culture, and 16 aggregates (for each defect) were implanted on both osteochondral defects (6 × 6 × 1.5 mm) created in the medial femoral condyle and femoral groove (MSC group). The defects in the contralateral knee were left empty (control group). The knee joints were evaluated at 4 and 12 weeks by macroscopic findings and histology. MRI T1rho mapping images were acquired at 12 weeks. For cell tracking, synovial MSCs were labeled with ferucarbotran before aggregate formation and were observed with MRI at 1 week. Results: Synovial MSCs showed in vitro colony-forming and multidifferentiation abilities. Regenerative cartilage formation was significantly better in the MSC group than in the control group, as indicated by International Cartilage Repair Society score (macro), modified Wakitani score (histology), and T1rho mapping (biochemical MRI) in the medial condyle at 12 weeks. Implanted cells, labeled with ferucarbotran, were observed in the osteochondral defects at 1 week with MRI. No significant difference was noted in the modified Wakitani score at 4 weeks in the medial condyle and at 4 and 12 weeks in the femoral groove. Conclusion: Transplantation of autologous synovial MSC aggregates promoted articular cartilage regeneration at the medial femoral condyle at 12 weeks in microminipigs. Clinical Relevance: Aggregates of autologous synovial MSCs could expand the indications for cartilage repair with synovial MSCs.

scholarly journals Safety and Efficacy of Kartigen® in Treating Cartilage Defects: A Randomized, Controlled, Phase I Trial

Polymers ◽  
2021 ◽  
Vol 13 (18) ◽  
pp. 3029
Author(s):  
Yen-Liang Liu ◽  
Chun-Che Yen ◽  
Tzu-Shang Thomas Liu ◽  
Chih-Hung Chang ◽  
Tiffany Ting-Fang Shih ◽  
...  
Keyword(s):  
Femoral Condyle ◽  
Weight Bearing ◽  
Autologous Bone Marrow ◽  
International Knee Documentation Committee ◽  
Cartilage Defects ◽  
Control Group ◽  
First Year ◽  
Recipient Site ◽  
Second Look ◽  
Second Year

Here, we aimed to investigate the safety and preliminary efficacy of Kartigen®, a matrix with autologous bone marrow mesenchymal stem cell-derived chondrocyte precursors embedded in atelocollagen. As a surgical graft, Kartigen® was implanted onto the cartilage defects at the weight-bearing site of the medial femoral condyle of the knee. Fifteen patients were enrolled and stratified into two groups, undergoing either Kartigen® implantation (n = 10) or microfracture (control group, n = 5). The primary endpoint was to evaluate the safety of Kartigen® by monitoring the occurrence of adverse events through physician queries, physical examinations, laboratory tests, and radiological analyses for 2 years. There were no infections, inflammations, adhesions, loose body, or tumor formations in the Kartigen®-implanted knees. The preliminary efficacy was assessed using the International Knee Documentation Committee (IKDC) score, visual analog scale, and second-look arthroscopy. The postoperative IKDC scores of the Kartigen® group significantly improved in the 16th week (IKDC = 62.1 ± 12.8, p = 0.025), kept increasing in the first year (IKDC = 78.2 ± 15.4, p < 0.005), and remained satisfactory in the second year (IKDC = 73.6 ± 13.8, p < 0.005), compared to the preoperative condition (IKDC = 47.1 ± 17.0), while the postoperative IKDC scores of the control group also achieved significant improvement in the 28th week (IKDC = 68.5 ± 6.1, p = 0.032) versus preoperative state (IKDC = 54.0 ± 9.1). However, the IKDC scores decreased in the first year (IKDC = 63.5 ± 11.6) as well as in the second year (IKDC = 52.6 ± 16.4). Thirteen patients underwent second-look arthroscopy and biopsy one year after the operation. The Kartigen® group exhibited integration between Kartigen® and host tissue with a smooth appearance at the recipient site, whereas the microfracture group showed fibrillated surfaces. The histological and immunohistochemical analyses of biopsy specimens demonstrated the columnar structure of articular cartilage and existence of collagen type II and glycosaminoglycan mimic hyaline cartilage. This study indicates that Kartigen® is safe and effective in treating cartilage defects.

scholarly journals Reparation of chondral defects in rabbits by autologous and allogenous chondrocytes seeded on collagen/hyaluronan scaffold or suspended in fibrin glue

2014 ◽  
Vol 64 (1) ◽  
pp. 61-72 ◽  
Author(s):  
Slavomír Horňák ◽  
Denisa Harvanová ◽  
Valent Ledecký ◽  
Marian Hluchý ◽  
Alexandra Valenčáková-Agyagosová ◽  
...  
Keyword(s):  
Fibrin Glue ◽  
Type Ii Collagen ◽  
Cartilage Tissue ◽  
Cartilage Defects ◽  
Control Group ◽  
Type I ◽  
Medial Condyle ◽  
Chondral Defects

Abstract The topic of the study was to verify in vivo survival of in vitro cultured autologous and allogenous chondrocytes suspended in a fibrin glue Beriplast® or seeded on Collagen type I-Hyaluronan (Col type I-HYA) scaffolds for the regeneration of articular cartilage defects in rabbits. The study was carried out on 15 domestic rabbits randomly assigned to five groups (n = 3 in each) with different treatments of artificially created chondral defects (ChD´s). These defects were made in a non-load-bearing area of medial condyle of the distal femur, and were treated as follows: 1st and 3rd group: the ChD´s were filled with autologous or allogenous chondrocytes seeded on Col type I-HYA scaffolds, respectively. The scaffolds were fixed to the ChD´s by fibrin glue Beriplast®; 2nd and 4th group: the ChD´s were filled with a suspension of autologous or allogenous chondrocytes in fibrin glue Beriplast®, respectively, and they were immediately covered by unseeded Col type I-HYA scaffolds; Control group: the ChD´s were left to heal spontaneously without any treatment. Macroscopical, histological and immunohistochemical analyses of the ChD´s were performed 12 months after the treatment. In all treated groups, the chondrocytes were capable to proliferate and produce the cartilage extracellular matrix, including proteoglycans and type II collagen, as compared to the control “untreated” group. On the other hand, the production of hyaline-like cartilage tissue confirmed that both therapeutic methods using autologous chondrocytes can be applied successfully for the treatment of chondral defects in rabbits.

scholarly journals Exosomes from Kartogenin-Pretreated Infrapatellar Fat Pad Mesenchymal Stem Cells Enhance Chondrocyte Anabolism and Articular Cartilage Regeneration

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Jiahua Shao ◽  
Jun Zhu ◽  
Yi Chen ◽  
Qiwei Fu ◽  
Lexiang Li ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Articular Cartilage ◽  
Cartilage Regeneration ◽  
Infrapatellar Fat Pad ◽  
Cartilage Defects ◽  
Control Group ◽  
Fat Pad ◽  
And Control

Objective. To evaluate the effect of Kartogenin-pretreated exosomes derived from infrapatellar fat pad mesenchymal stem cells on chondrocyte in vitro and articular cartilage regeneration in vivo. Methods. Infrapatellar fat pad mesenchymal stem cells (IPFP-MSCs) were isolated from rabbits to harvest exosomes. After identification of mesenchymal stem cells and exosomes, rabbit chondrocytes were divided into three groups for further treatment: the EXO group (chondrocytes treated with exosomes isolated from infrapatellar fat pad mesenchymal stem cells), KGN-EXO group (chondrocytes treated with exosomes isolated from infrapatellar fat pad mesenchymal stem cells pretreated with KGN), and control group. After processing and proliferation, phenotypic changes of chondrocytes were measured. In the in vivo study, 4 groups of rabbits with articular cartilage injury were treated with KGN-EXO, EXO, IPFP-MSCs, and control. Macroscopic evaluation and histological evaluation were made to figure out the different effects of the 4 groups on cartilage regeneration in vivo. Results. The proliferation rate of chondrocytes in the EXO or KGN-EXO group was significantly higher than that in the control group ( P < 0.05 ). The qRT-PCR results showed that the expression of Sox-9, Aggrecan, and Col II was the highest in the KGN-EXO group compared with the EXO group and the control group ( P < 0.05 ). The results of Western blot were consistent with the results of qRT-PCR. In vivo, the cartilage defects in the KGN-EXO group showed better gross appearance and improved histological score than those in IPFP-MSC groups, EXO groups, and control groups ( P < 0.05 ). At 12 weeks, the defect site in the KGN-EXO group was almost completely repaired with a flat and smooth surface, while a large amount of hyaline cartilage-like structures and no obvious cracks were observed. Conclusion. Our study demonstrates that the exosomes isolated from infrapatellar fat pad mesenchymal stem cells pretreated with KGN have potent ability to induce chondrogenic differentiation of stem cells, effectively promoting the proliferation and the expression of chondrogenic proteins and genes of chondrocytes. The KGN-EXO can also promote the repair of articular cartilage defects more effectively, which can be used as a potential therapeutic method in the future.

Cartilage Restoration: Microfracture and Osteochondral Autograft Transplantation

2018 ◽  
Vol 31 (03) ◽  
pp. 231-238 ◽  
Author(s):  
Michael Redondo ◽  
Adam Beer ◽  
Adam Yanke
Keyword(s):  
Articular Cartilage ◽  
Weight Bearing ◽  
Symptomatic Relief ◽  
Autologous Transplantation ◽  
Cartilage Defects ◽  
Osteochondral Autograft ◽  
Cartilage Lesions ◽  
Chondral Defects ◽  
Osteochondral Autograft Transplantation ◽  
Cartilage Restoration

AbstractThe treatment of patellofemoral cartilage defects presents several distinct challenges when compared with cartilage restoration techniques used for other compartments of the knee due to the unique anatomy and distribution of forces. The etiologies of patellofemoral articular cartilage lesions include acute traumatic instability injuries, such as dislocation and subluxation, osteochondritis dissecans, and chronic degenerative changes. Regardless of the etiology, untreated patellofemoral cartilage lesions can contribute to activity-limiting anterior knee pain. The goal of patellofemoral cartilage restoration procedures is to impart symptomatic relief and improve quality of life by repairing the articular cartilage surface and any comorbid malalignment or maltracking.Microfracture and osteochondral autograft transplantation (OAT) are two cartilage restoration procedures to consider when treating full-thickness patellofemoral chondral defects. Considered by some experts to be the gold standard therapy, microfracture is one of the most common procedures used for cartilage restoration. The technique involves the perforation of the subchondral bone plate for the release of marrow elements, filling the defect with a fibrocartilage clot repair. Though less commonly used, OAT allows defect replacement with native hyaline cartilage via autologous transplantation from a non-weight bearing area. The purpose of this article is to discuss the indication, technical considerations, and outcomes of microfracture and OAT when used for treating chondral lesions of the patellofemoral joint.

Cartilage tissue and therapeutic strategies for cartilage repair

2020 ◽  
Vol 20 ◽  
Author(s):  
Sahar Khajeh ◽  
Farzaneh Bozorg-Ghalati ◽  
Mina Zare ◽  
Ghodratollah Panahi ◽  
Vahid Razban
Keyword(s):  
Cartilage Damage ◽  
Trauma Surgery ◽  
Cartilage Regeneration ◽  
Biochemical Properties ◽  
Therapeutic Strategies ◽  
Cartilage Tissue ◽  
Cartilage Defects ◽  
Therapeutic Modalities ◽  
Chondral Defects ◽  
Cell Based Therapy

: High incidence of articular cartilage defects is still a major challenge in orthopedic and trauma surgery worldwide. It has also great socioeconomic effects as it is the major cause of disability in industrialized countries. These highlight the essential need for new treatments. Knowledge about the factors that have been implicated in the pathogenesis of cartilage diseases, including changes in the composition and structure of cartilaginous extracellular matrix (ECM), molecular factors and environmental signaling pathways could help the development of innovative therapeutic strategies. It is consensuses that the success of any technology aiming to repair chondral defects will be dependent upon its ability to produce tissues that most closely replicate the mechanical and biochemical properties of native cartilage. Increasing our knowledge about cartilage tissue and its molecular biomarkers could help us to find new and useful therapeutic approach in cartilage damage. This review tries to describe cartilage tissue biology in detail and discuss different available therapeutic modalities with their pros and cons. New cartilage regeneration strategies and therapies, with focusing on cell-based therapy and tissue engineering, and their underlying molecular and cellular bases will be pointed out as well.

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