A chondrocyte infiltrated collagen type I/III membrane (MACI® implant) improves cartilage healing in the equine patellofemoral joint model.
Abstract: Autologous chondrocyte implantation (ACI) has improved outcome in long-term studies of joint repair in man. However, ACI requires sutured periosteal flaps to secure the cells, which precludes minimally-invasive implantation, and introduces complications with arthrofibrosis and graft hypertrophy. This study evaluated ACI on a collagen type I/III scaffold (matrix-induced autologous chondrocyte implantation; MACI(®)) in critical sized defects in the equine model. Methods: Chondrocytes were isolated from horses, expanded and seeded onto a collagen I/III membrane (ACI-Maix™) and implanted into one of two 15-mm defects in the femoral trochlear ridge of six horses. Control defects remained empty as ungrafted debrided defects. The animals were examined daily, scored by second look arthroscopy at 12 weeks, and necropsy examination 6 months after implantation. Reaction to the implant was determined by lameness, and synovial fluid constituents and synovial membrane histology. Cartilage healing was assessed by arthroscopic scores, gross assessment, repair tissue histology and immunohistochemistry, cartilage glycosaminoglycan (GAG) and DNA assay, and mechanical testing. Results: MACI(®) implanted defects had improved arthroscopic second-look, gross healing, and composite histologic scores, compared to spontaneously healing empty defects. Cartilage GAG and DNA content in the defects repaired by MACI implant were significantly improved compared to controls. Mechanical properties were improved but remained inferior to normal cartilage. There was minimal evidence of reaction to the implant in the synovial fluid, synovial membrane, subchondral bone, or cartilage. Conclusions: The MACI(®) implant appeared to improve cartilage healing in a critical sized defect in the equine model evaluated over 6 months.
Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
Publication Date: 2015-01-07 PubMed ID: 25575968DOI: 10.1016/j.joca.2014.12.021Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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The research study evaluates the effectiveness of a specific collagen scaffold (MACI® implant) in improving the healing process of cartilage defects in horses. The results show better healing outcomes and minimum reactions or complications to the implanted scaffold.
Objective and Background
- The main objective of this research was to study the effectiveness of Autologous Chondrocyte Implantation (ACI) on a collagen type I/III scaffold (also known as matrix-induced autologous chondrocyte implantation; MACI® implant) in healing cartilage defects in the equine model (horses).
- Traditionally, ACI has been used in treating joint repair in humans and has shown significant positive results. However, the conventional ACI requires suturing of periosteal flaps, hampering minimally invasive implantation and potentially leading to complications like arthrofibrosis and graft hypertrophy. Thus, the introduction of a more efficient and less complicated method, like the MACI® implant, is considered.
Methods
- Chondrocytes (cartilage cells) were isolated from horses, expanded, and then seeded onto a collagen I/III membrane (ACI-Maix™).
- The membrane was then implanted into defects in the femoral trochlear ridge of six horses. The control defects were left ungrafted and empty, to allow natural healing.
- Horses were examined daily, scored by second look arthroscopy at 12 weeks, and necropsy examination after 6 months following implantation.
- The implantation’s effect was evaluated through tracking lameness of the horse, analyzing synovial fluid and its constituents, and histology of the synovial membrane.
- Cartilage healing was determined through a series of arthroscopic scores, gross assessment, repair tissue histology, immunohistochemistry, and mechanical testing.
Results
- Defects treated with the MACI® implant demonstrated improved arthroscopic second-look, gross healing, and composite histologic scores, as compared to defects that underwent natural healing.
- The DNA content and glycosaminoglycan (GAG, a type of molecule found in cartilage) in the cartilage defects repaired by the MACI implant showed significant improvement over the control group.
- Though mechanical properties were enhanced, they were still lower than those of normal cartilage.
- The research also reports minimal evidence of reaction to the implant in the synovial fluid, synovial membrane, subchondral bone, or cartilage, suggesting minimum complications and higher safety.
Conclusion
- The MACI® implant seems to be a better alternative method of healing cartilage in a critical-sized defect in the equine model, with the evaluation period spanning over six months.
Cite This Article
APA
Nixon AJ, Rickey E, Butler TJ, Scimeca MS, Moran N, Matthews GL.
(2015).
A chondrocyte infiltrated collagen type I/III membrane (MACI® implant) improves cartilage healing in the equine patellofemoral joint model.
Osteoarthritis Cartilage, 23(4), 648-660.
https://doi.org/10.1016/j.joca.2014.12.021 Publication
Researcher Affiliations
- Comparative Orthopedics Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA. Electronic address: AJN1@cornell.edu.
- Comparative Orthopedics Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
- Genzyme-Sanofi, 500 Kendall St, Cambridge, MA, USA.
- Comparative Orthopedics Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
- Genzyme-Sanofi, 500 Kendall St, Cambridge, MA, USA.
- Genzyme-Sanofi, 500 Kendall St, Cambridge, MA, USA.
MeSH Terms
- Animals
- Arthroscopy
- Biomechanical Phenomena / physiology
- Biopsy
- Cartilage, Articular / drug effects
- Cartilage, Articular / physiology
- Cell Survival
- Cell Transplantation / methods
- Cells, Cultured
- Chondrocytes / pathology
- Chondrocytes / transplantation
- Collagen Type I / administration & dosage
- Collagen Type I / pharmacology
- Collagen Type III / administration & dosage
- Collagen Type III / pharmacology
- Disease Models, Animal
- Glycosaminoglycans / physiology
- Horses
- Humans
- In Vitro Techniques
- Patellofemoral Joint / injuries
- Patellofemoral Joint / physiopathology
- Treatment Outcome
- Wound Healing / drug effects
- Wound Healing / physiology
Citations
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