Background: Autologous chondrocyte implantation (ACI) is often performed for large cartilage defects. Because this technique has several disadvantages, including the need for second-stage surgery, cartilage repair using minced cartilage has been suggested. However, this technique could be improved using 3-dimensional scaffolds.
Purpose: To examine the ability of chondrocyte migration and proliferation from minced cartilage in atelocollagen gel in vitro and evaluate the repairable potential of minced cartilage embedded in atelocollagen gel covered with a periosteal flap in a rabbit model.
Study Design: Controlled laboratory study.
Methods: Minced cartilage or isolated chondrocytes from rabbits were embedded in atelocollagen gel and cultured for 3 weeks. Chondrocyte proliferation and matrix production were evaluated in vitro. An osteochondral defect at the trochlear groove was created in 56 rabbits, which were divided into 4 groups. The defect was left empty (defect group), filled with allogenic minced cartilage (minced cartilage group), filled with isolated allogenic chondrocytes embedded in atelocollagen gel (ACI group), or filled with atelocollagen gel (atelocollagen with periosteal flap group). At 4, 12, and 24 weeks after surgery, repair of the defect was evaluated in these 4 groups.
Results: In vitro, the number of chondrocytes and abundant matrix on the surface of the gel significantly increased in the minced cartilage group compared with the ACI group ( < .05). In vivo, the minced cartilage and ACI groups showed good cartilage repair compared with the empty defect and atelocollagen/periosteal flap groups ( < .05); there was no significant difference in the Pineda score between the minced cartilage and ACI groups.
Conclusion: Minced cartilage in atelocollagen gel had good chondrocyte migration and proliferation abilities in vitro, and osteochondral defects were well repaired by implanting minced cartilage embedded in the atelocollagen gel in vivo. Implantation of minced cartilage embedded in atelocollagen gel showed good cartilage repair equivalent to ACI.
Clinical Relevance: Implantation of minced cartilage embedded in atelocollagen gel as a 1-step procedure has outcomes similar to those of ACI but is cheaper and more convenient than ACI.
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http://dx.doi.org/10.1177/0363546519854372 | DOI Listing |
Arch Orthop Trauma Surg
January 2025
University Medical Center Freiburg, Freiburg, Germany.
Introduction: Implantation of minced cartilage is a one-step-procedure that leads to satisfactory results in osteochondral defects.
Material And Methods: A retrospective review was performed on a consecutive cohort of patients that received minced cartilage with fibrin (MCF), minced cartilage with membrane and fibrin (MCMF) and minced cartilage with the "AutoCart"-procedure (MCAC) between January 2019 and December 2023. Radiological outcome parameters were evaluated via Magnet-Resonance-Tomography (MRI) within one year using Ankle-Osteoarthritis-Scoring-System (AOSS).
Arthrosc Tech
December 2024
Department of Orthopedics and Traumatology, Ankara Yıldırım Beyazıt University, Ankara Bilkent City Hospital, Ankara, Turkey.
Mosaicplasty is a relatively challenging procedure used in the management of focal osteochondral lesions of the joints. Donor-site morbidity is still the main concern after mosaicplasty because it entails the harvesting of an osteochondral autograft from an otherwise healthy region to be impacted later on the weight-bearing damaged site. We describe a possible alternative to conventional mosaicplasty with subchondral bone support harvested from the iliac crest as an osteoperiosteal autograft and covered with a minced cartilage layer.
View Article and Find Full Text PDFOrthop J Sports Med
December 2024
OrthoCentrum Hamburg, Hamburg, Germany.
Background: Symptomatic cartilage defects of the knee joint are frequently diagnosed and can be treated with different available surgical methods. Nevertheless, there is currently no gold standard treatment for all indications. Minced cartilage implantation is increasingly coming into focus as a refined surgical technique.
View Article and Find Full Text PDFJ Orthop Traumatol
November 2024
Department of Orthopaedic Surgery, National Taiwan University Hospital, 7 Chungsan South Road, Taipei City, 10002, Taiwan.
Background: Autologous minced cartilage is a method for cartilage defect repair, and our study focuses on a newly developed biphasic cylindrical osteochondral construct designed for use in human knees. We aimed to compare its clinical effectiveness and safety with microfracture, the commonly utilized reparative treatment for knee chondral or osteochondral defects.
Materials And Methods: Conducted as a prospective multicenter, randomized controlled, non-inferiority trial across nine hospitals, the study involved 92 patients with International Cartilage Repair Society (ICRS) grade 3 to 4 chondral or osteochondral lesions on femoral condyles.
Arthroscopy
November 2024
Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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