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The American journal of sports medicine2009; 37 Suppl 1; 71S-80S; doi: 10.1177/0363546509348478

In vivo evaluation of autologous cartilage fragment-loaded scaffolds implanted into equine articular defects and compared with autologous chondrocyte implantation.

Abstract: Current autologous chondrocyte implantation (ACI) techniques require 2 surgical procedures: 1 for cell harvest and 1 for reimplantation of cultured cells. A 1-step procedure is more desirable. Objective: A 1-step surgical procedure using autologous cartilage fragments on a polydioxanone scaffold, or CAIS (cartilage autograft implantation system), in a clinically relevant defect (15-mm diameter) within equine femoral trochlea was compared with a 2-step ACI technique as well as with empty defects and defects with polydioxanone foam scaffolds alone. Methods: Controlled laboratory study. Methods: Ten skeletally mature horses were used. Articular cartilage from the lateral trochlea of the femur was harvested arthroscopically (n = 5), and chondrocytes were cultured on small intestinal submucosa to produce ACI constructs. The CAIS procedure had cartilage harvested during defect creation to prepare minced cartilage on polydioxanone-reinforced foam. The ACI and CAIS constructs were placed in defects using polydioxanone/polyglycolic acid staples. Defects were examined arthroscopically at 4, 8, and 12 months and with gross, histological, and immunohistochemical examination at 12 months. Results: Arthroscopic, histologic, and immunohistochemistry results show superiority of both implantation techniques (ACI and CAIS) compared with empty defects and defects with polydioxanone foam alone, with CAIS having the highest score. Conclusions: This is the first demonstration of long-term healing with strenuous exercise using ACI and CAIS in a critically sized defect. Conclusions: Given these results with the CAIS procedure, testing in human patients is the next logical step (a phase 1 human clinical study has proceeded from this work).
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Publication Date: 2009-12-16 PubMed ID: 19934439DOI: 10.1177/0363546509348478Google Scholar: Lookup
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  • Journal Article
  • Research Support
  • Non-U.S. Gov't

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The study explored an in vivo one-step alternative to the two-step Autologous Chondrocyte Implantation (ACI) procedures currently used in repairing articular defects. It found that the novel technique, Cartilage Autograft Implantation System (CAIS), where cartilage fragments are placed upon a polydioxanone scaffold, produced superior outcomes when compared to the two-step ACI and other controls.

Research Methodology

  • Research involved the use of a controlled laboratory study involving ten skeletally mature horses.
  • The study applied four types of treatment procedures on defects within equine femoral trochlea. This included the new one-step procedure CAIS, a two-step process known as Autologous Chondrocyte Implantation (ACI), unattended (empty) defects and defects filled with only polymer scaffolds.
  • For the ACI procedure, articular cartilage was harvested arthroscopically from the lateral trochlea of the femur of the horses, and chondrocytes were cultured on small intestinal submucosa to create ACI constructs.
  • In the case of CAIS, cartilage was harvested during defect creation to produce minced cartilage, which was then put on polydioxanone-reinforced foam.
  • The resulting implants from both ACI and CAIS procedures were attached to the defects using polydioxanone/polyglycolic acid staples.
  • Subsequent evaluations of the treated areas were performed arthroscopically at 4, 8, and 12 months, and then examined grossly, histologically, and through immunohistochemical analysis at the 12-month marker.

Research Findings

  • The outcomes of both the ACI and CAIS procedures surpassed those of the control groups (empty defects and defects with polydioxanone foam alone).
  • Among the tested solutions, the newly introduced CAIS procedure had the highest score, indicative of the best recovery and treatment outcome.
  • A significant finding was that both ACI and CAIS techniques demonstrated long-term healing with strenuous exercise in the treated horses, even when addressing critically sized defects.

Conclusions

  • The results provide the first evidence of the potential effectiveness of the one-step CAIS treatment procedure in cartilage repair. The procedure not only reduces the complexity of the treatment but also outperforms the conventional two-step ACI process.
  • Given the encouraging results from the equine model, the study advocates for CAIS procedure testing in humans as the next phase in research. Progress towards a human clinical trial has already commenced following this work.

Cite This Article

APA
Frisbie DD, Lu Y, Kawcak CE, DiCarlo EF, Binette F, McIlwraith CW. (2009). In vivo evaluation of autologous cartilage fragment-loaded scaffolds implanted into equine articular defects and compared with autologous chondrocyte implantation. Am J Sports Med, 37 Suppl 1, 71S-80S. https://doi.org/10.1177/0363546509348478

Publication

The American journal of sports medicine
ISSN: 1552-3365
NlmUniqueID: 7609541
Country: United States
Language: English
Volume: 37 Suppl 1
Pages: 71S-80S

Researcher Affiliations

Frisbie, David D
  • Orthopaedic Research Center, Colorado State University, 300 West Drake, Fort Collins, CO 80523, USA.
Lu, Y
    Kawcak, Christopher E
      DiCarlo, E F
        Binette, F
          McIlwraith, C Wayne

            MeSH Terms

            • Animals
            • Cartilage, Articular / injuries
            • Cartilage, Articular / surgery
            • Chondrocytes / transplantation
            • Femur
            • Horses
            • Tissue Scaffolds
            • Transplantation, Autologous
            • Treatment Outcome
            • Wound Healing

            Citations

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