English
French
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).
Publication Date: 2009-12-16 PubMed ID: 19934439DOI: 10.1177/0363546509348478Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- 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
Researcher Affiliations
- Orthopaedic Research Center, Colorado State University, 300 West Drake, Fort Collins, CO 80523, USA.
MeSH Terms
- Animals
- Cartilage, Articular / injuries
- Cartilage, Articular / surgery
- Chondrocytes / transplantation
- Femur
- Horses
- Tissue Scaffolds
- Transplantation, Autologous
- Treatment Outcome
- Wound Healing
Citations
This article has been cited 42 times.- Ossendorff R, Walter SG, Schildberg FA, Spang J, Obudzinski S, Preiss S, Schneider S, Salzmann GM. Biologic principles of minced cartilage implantation: a narrative review.. Arch Orthop Trauma Surg 2023 Jun;143(6):3259-3269.
- Voga M, Majdic G. Articular Cartilage Regeneration in Veterinary Medicine.. Adv Exp Med Biol 2022;1401:23-55.
- O'Brien MC, Dzieza WK, Bruner ML, Farmer KW. Sufficient Cartilage for Most Talar Articular Defects Can Be Harvested From the Non-Loadbearing Talus: A Cadaveric Analysis.. Arthrosc Sports Med Rehabil 2021 Oct;3(5):e1315-e1320.
- De Angelis E, Saleri R, Martelli P, Elviri L, Bianchera A, Bergonzi C, Pirola M, Romeo R, Andrani M, Cavalli V, Conti V, Bettini R, Passeri B, Ravanetti F, Borghetti P. Cultured Horse Articular Chondrocytes in 3D-Printed Chitosan Scaffold With Hyaluronic Acid and Platelet Lysate.. Front Vet Sci 2021;8:671776.
- O'Brien MC, Dzieza WK, Bruner ML, Farmer KW. Assessment of Safe Cartilage Harvesting Quantity in the Shoulder: A Cadaveric Study.. Arthrosc Sports Med Rehabil 2021 Feb;3(1):e115-e120.
- Shah SS, Mithoefer K. Scientific Developments and Clinical Applications Utilizing Chondrons and Chondrocytes with Matrix for Cartilage Repair.. Cartilage 2021 Dec;13(1_suppl):1195S-1205S.
- Patel JM, Sennett ML, Martin AR, Saleh KS, Eby MR, Ashley BS, Miller LM, Dodge GR, Burdick JA, Carey JL, Mauck RL. Resorbable Pins to Enhance Scaffold Retention in a Porcine Chondral Defect Model.. Cartilage 2021 Dec;13(2_suppl):1676S-1687S.
- Salzmann GM, Ossendorff R, Gilat R, Cole BJ. Autologous Minced Cartilage Implantation for Treatment of Chondral and Osteochondral Lesions in the Knee Joint: An Overview.. Cartilage 2021 Dec;13(1_suppl):1124S-1136S.
- Christensen BB, Olesen ML, Hede KTC, Bergholt NL, Foldager CB, Lind M. Particulated Cartilage for Chondral and Osteochondral Repair: A Review.. Cartilage 2021 Dec;13(1_suppl):1047S-1057S.
- Fugazzola MC, van Weeren PR. Surgical osteochondral defect repair in the horse-a matter of form or function?. Equine Vet J 2020 Jul;52(4):489-499.
- Levinson C, Cavalli E, Sindi DM, Kessel B, Zenobi-Wong M, Preiss S, Salzmann G, Neidenbach P. Chondrocytes From Device-Minced Articular Cartilage Show Potent Outgrowth Into Fibrin and Collagen Hydrogels.. Orthop J Sports Med 2019 Sep;7(9):2325967119867618.
- Massen FK, Inauen CR, Harder LP, Runer A, Preiss S, Salzmann GM. One-Step Autologous Minced Cartilage Procedure for the Treatment of Knee Joint Chondral and Osteochondral Lesions: A Series of 27 Patients With 2-Year Follow-up.. Orthop J Sports Med 2019 Jun;7(6):2325967119853773.
- Stewart RC, Nelson BB, Kawcak CE, Freedman JD, Snyder BD, Goodrich LR, Grinstaff MW. Contrast-Enhanced Computed Tomography Scoring System for Distinguishing Early Osteoarthritis Disease States: A Feasibility Study.. J Orthop Res 2019 Oct;37(10):2138-2148.
- Lepage SIM, Robson N, Gilmore H, Davis O, Hooper A, St John S, Kamesan V, Gelis P, Carvajal D, Hurtig M, Koch TG. Beyond Cartilage Repair: The Role of the Osteochondral Unit in Joint Health and Disease.. Tissue Eng Part B Rev 2019 Apr;25(2):114-125.
- Lv X, He J, Zhang X, Luo X, He N, Sun Z, Xia H, Liu V, Zhang L, Lin X, Lin L, Yin H, Jiang D, Cao W, Wang R, Zhou G, Wang W. Comparative Efficacy of Autologous Stromal Vascular Fraction and Autologous Adipose-Derived Mesenchymal Stem Cells Combined With Hyaluronic Acid for the Treatment of Sheep Osteoarthritis.. Cell Transplant 2018 Jul;27(7):1111-1125.
- Hess DE, Werner BC, Deal DN. Use of Particulated Juvenile Articular Cartilage Allograft for Osteochondral Lesions of the Wrist.. Hand (N Y) 2017 Sep;12(5):NP62-NP67.
- York PJ, Wydra FB, Belton ME, Vidal AF. Joint Preservation Techniques in Orthopaedic Surgery.. Sports Health 2017 Nov Dec;9(6):545-554.
- Zlotnicki JP, Geeslin AG, Murray IR, Petrigliano FA, LaPrade RF, Mann BJ, Musahl V. Biologic Treatments for Sports Injuries II Think Tank-Current Concepts, Future Research, and Barriers to Advancement, Part 3: Articular Cartilage.. Orthop J Sports Med 2016 Apr;4(4):2325967116642433.
- Moran CJ, Ramesh A, Brama PA, O'Byrne JM, O'Brien FJ, Levingstone TJ. The benefits and limitations of animal models for translational research in cartilage repair.. J Exp Orthop 2016 Dec;3(1):1.
- Goodrich LR, Chen AC, Werpy NM, Williams AA, Kisiday JD, Su AW, Cory E, Morley PS, McIlwraith CW, Sah RL, Chu CR. Addition of Mesenchymal Stem Cells to Autologous Platelet-Enhanced Fibrin Scaffolds in Chondral Defects: Does It Enhance Repair?. J Bone Joint Surg Am 2016 Jan 6;98(1):23-34.
- Bonasia DE, Marmotti A, Rosso F, Collo G, Rossi R. Use of chondral fragments for one stage cartilage repair: A systematic review.. World J Orthop 2015 Dec 18;6(11):1006-11.
- Riboh JC, Cole BJ, Farr J. Particulated articular cartilage for symptomatic chondral defects of the knee.. Curr Rev Musculoskelet Med 2015 Dec;8(4):429-35.
- Christensen BB, Foldager CB, Jensen J, Lind M. Autologous Dual-Tissue Transplantation for Osteochondral Repair: Early Clinical and Radiological Results.. Cartilage 2015 Jul;6(3):166-73.
- Grande DA, Schwartz JA, Brandel E, Chahine NO, Sgaglione N. Articular Cartilage Repair: Where We Have Been, Where We Are Now, and Where We Are Headed.. Cartilage 2013 Oct;4(4):281-5.
- Malda J, McIlwraith CW. Current Trends in Cartilage Science: An Impression from the ICRS World Conference 2012.. Cartilage 2013 Oct;4(4):273-80.
- McIlwraith CW, Fortier LA, Frisbie DD, Nixon AJ. Equine Models of Articular Cartilage Repair.. Cartilage 2011 Oct;2(4):317-26.
- Hurtig MB, Buschmann MD, Fortier LA, Hoemann CD, Hunziker EB, Jurvelin JS, Mainil-Varlet P, McIlwraith CW, Sah RL, Whiteside RA. Preclinical Studies for Cartilage Repair: Recommendations from the International Cartilage Repair Society.. Cartilage 2011 Apr;2(2):137-52.
- Bonasia DE, Martin JA, Marmotti A, Kurriger GL, Lehman AD, Rossi R, Amendola A. The use of autologous adult, allogenic juvenile, and combined juvenile-adult cartilage fragments for the repair of chondral defects.. Knee Surg Sports Traumatol Arthrosc 2016 Dec;24(12):3988-3996.
- Yanke AB, Chubinskaya S. The state of cartilage regeneration: current and future technologies.. Curr Rev Musculoskelet Med 2015 Mar;8(1):1-8.
- Buckwalter JA, Bowman GN, Albright JP, Wolf BR, Bollier M. Clinical outcomes of patellar chondral lesions treated with juvenile particulated cartilage allografts.. Iowa Orthop J 2014;34:44-9.
- Miller RE, Grodzinsky AJ, Barrett MF, Hung HH, Frank EH, Werpy NM, McIlwraith CW, Frisbie DD. Effects of the combination of microfracture and self-assembling Peptide filling on the repair of a clinically relevant trochlear defect in an equine model.. J Bone Joint Surg Am 2014 Oct 1;96(19):1601-9.
- Martins EA, Michelacci YM, Baccarin RY, Cogliati B, Silva LC. Evaluation of chitosan-GP hydrogel biocompatibility in osteochondral defects: an experimental approach.. BMC Vet Res 2014 Aug 27;10:197.
- Wang N, Grad S, Stoddart MJ, Niemeyer P, Reising K, Schmal H, Su00fcdkamp NP, Alini M, Salzmann GM. Particulate cartilage under bioreactor-induced compression and shear.. Int Orthop 2014 May;38(5):1105-11.
- Kopesky PW, Byun S, Vanderploeg EJ, Kisiday JD, Frisbie DD, Grodzinsky AJ. Sustained delivery of bioactive TGF-u03b21 from self-assembling peptide hydrogels induces chondrogenesis of encapsulated bone marrow stromal cells.. J Biomed Mater Res A 2014 May;102(5):1275-85.
- McIlwraith CW, Frisbie DD, Kawcak CE. The horse as a model of naturally occurring osteoarthritis.. Bone Joint Res 2012 Nov;1(11):297-309.
- Gregory MH, Capito N, Kuroki K, Stoker AM, Cook JL, Sherman SL. A review of translational animal models for knee osteoarthritis.. Arthritis 2012;2012:764621.
- Filardo G, Madry H, Jelic M, Roffi A, Cucchiarini M, Kon E. Mesenchymal stem cells for the treatment of cartilage lesions: from preclinical findings to clinical application in orthopaedics.. Knee Surg Sports Traumatol Arthrosc 2013 Aug;21(8):1717-29.
- Marmotti A, Bonasia DE, Bruzzone M, Rossi R, Castoldi F, Collo G, Realmuto C, Tarella C, Peretti GM. Human cartilage fragments in a composite scaffold for single-stage cartilage repair: an in vitro study of the chondrocyte migration and the influence of TGF-u03b21 and G-CSF.. Knee Surg Sports Traumatol Arthrosc 2013 Aug;21(8):1819-33.
- Marmotti A, Bruzzone M, Bonasia DE, Castoldi F, Rossi R, Piras L, Maiello A, Realmuto C, Peretti GM. One-step osteochondral repair with cartilage fragments in a composite scaffold.. Knee Surg Sports Traumatol Arthrosc 2012 Dec;20(12):2590-601.
- Henson F, Getgood A. The use of scaffolds in musculoskeletal tissue engineering.. Open Orthop J 2011;5 Suppl 2:261-6.
- Bonasia DE, Martin JA, Marmotti A, Amendola RL, Buckwalter JA, Rossi R, Blonna D, Adkisson HD 4th, Amendola A. Cocultures of adult and juvenile chondrocytes compared with adult and juvenile chondral fragments: in vitro matrix production.. Am J Sports Med 2011 Nov;39(11):2355-61.
- Ulery BD, Nair LS, Laurencin CT. Biomedical Applications of Biodegradable Polymers.. J Polym Sci B Polym Phys 2011 Jun 15;49(12):832-864.
Secure Payments
Satisfaction Guarantee
We offer a 60-day guarantee to ensure you are completely satisfied.
Fast & Free Shipping
We provide fast and free shipping on all orders over $40.