Matrix-Induced Autologous Chondrocyte Implantation (MACI) Using a Cell-Seeded Collagen Membrane Improves Cartilage Healing in the Equine Model.
Abstract: Autologous chondrocyte implantation (ACI) using a collagen scaffold (matrix-induced ACI; MACI) is a next-generation approach to traditional ACI that provides the benefit of autologous cells and guided tissue regeneration using a biocompatible collagen scaffold. The MACI implant also has inherent advantages including surgical implantation via arthroscopy or miniarthrotomy, the elimination of periosteal harvest, and the use of tissue adhesive in lieu of sutures. This study evaluated the efficacy of the MACI implant in an equine full-thickness cartilage defect model at 1 year. Methods: Autologous chondrocytes were seeded onto a collagen type-I/III membrane and implanted into one of two 15-mm defects in the femoral trochlear ridge of 24 horses. Control defects either were implanted with cell-free collagen type-I/III membrane (12 horses) or were left ungrafted as empty defects (12 horses). An additional 3 horses had both 15-mm defects remain empty as nonimplanted joints. The repair was scored by second-look arthroscopy (12 weeks), and necropsy examination (53 weeks). Healing was assessed by arthroscopic scoring, gross assessment, histology and immunohistology, cartilage matrix component assay, and gene expression determination. Toxicity was examined by prostaglandin E2 formation in joint fluid, and lymph node morphology combined with histologic screening of organs. Results: MACI-implanted defects had improved gross healing and composite histologic scores, as well as increases in chondrocyte predominance, toluidine blue-stained matrix, and collagen type-II content compared with scaffold-only implanted or empty defects. There was minimal evidence of reaction to the implant in the synovial membrane (minor perivascular cuffing), subchondral bone, or cartilage. There were no adverse clinical effects, signs of organ toxicity, or evidence of chondrocytes or collagen type-I/III membrane in draining lymph nodes. Conclusions: The MACI implant appeared to improve cartilage healing in a critical-sized defect in the equine model compared with collagen matrix alone. Conclusions: These results indicate that the MACI implant is quick to insert, provides chondrocyte security in the defect, and improves cartilage healing compared with ACI.
Publication Date: 2017-12-06 PubMed ID: 29206788DOI: 10.2106/JBJS.16.00603Google Scholar: Lookup
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- Journal Article
Summary
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The researchers investigated if the use of Matrix-Induced Autologous Chondrocyte Implantation (MACI) using a cell-seeded collagen membrane would improve the healing of cartilage in horses. The study found that the MACI implantation not only improved cartilage repair but also has added advantages such as simpler surgical installation and the elimination of periosteal harvest.
Methods
- The study used 24 horses, where autologous chondrocytes were seeded onto a collagen type-I/III membrane and implanted into one of two 15-mm defects in the femoral trochlear ridge.
- The control defects were either implanted with cell-free collagen type-I/III membrane (12 horses) or were left ungrafted as empty defects (12 horses).
- An additional 3 horses had both 15-mm defects remain empty as nonimplanted joints.
- Healing was examined using arthroscopic scoring, gross assessment, histology and immunohistology, cartilage matrix component assay, and gene expression determination.
- Toxicity was assessed by examining prostaglandin E2 formation in joint fluid, and lymph node morphology combined with a histologic screening of organs.
Results
- MACI-implanted defects showed improved gross healing and composite histologic scores.
- There was an increase in chondrocyte predominance, toluidine blue-stained matrix, and collagen type-II content compared with scaffold-only implanted or empty defects.
- Minimal evidence was found on reaction to the implant in the synovial membrane or the subchondral bone or cartilage.
- There were no adverse clinical effects, signs of organ toxicity, or evidence of chondrocytes or collagen type-I/III membrane in draining lymph nodes.
Conclusion
- MACI implant appeared to improve cartilage healing in a critical-sized defect in the equine model compared with collagen matrix alone.
- The MACI implant is quicker to insert, provides chondrocyte security in the defect, and improves cartilage healing compared with Autologous Chondrocyte Implantation (ACI).
Cite This Article
APA
Nixon AJ, Sparks HD, Begum L, McDonough S, Scimeca MS, Moran N, Matthews GL.
(2017).
Matrix-Induced Autologous Chondrocyte Implantation (MACI) Using a Cell-Seeded Collagen Membrane Improves Cartilage Healing in the Equine Model.
J Bone Joint Surg Am, 99(23), 1987-1998.
https://doi.org/10.2106/JBJS.16.00603 Publication
Researcher Affiliations
- Comparative Orthopaedics Laboratory, Department of Clinical Sciences (A.J.N., H.D.S., L.B., and M.S.S.), and Department of Biomedical Sciences, College of Veterinary Medicine (S.M.), Cornell University, Ithaca, New York.
- Comparative Orthopaedics Laboratory, Department of Clinical Sciences (A.J.N., H.D.S., L.B., and M.S.S.), and Department of Biomedical Sciences, College of Veterinary Medicine (S.M.), Cornell University, Ithaca, New York.
- Comparative Orthopaedics Laboratory, Department of Clinical Sciences (A.J.N., H.D.S., L.B., and M.S.S.), and Department of Biomedical Sciences, College of Veterinary Medicine (S.M.), Cornell University, Ithaca, New York.
- Comparative Orthopaedics Laboratory, Department of Clinical Sciences (A.J.N., H.D.S., L.B., and M.S.S.), and Department of Biomedical Sciences, College of Veterinary Medicine (S.M.), Cornell University, Ithaca, New York.
- Comparative Orthopaedics Laboratory, Department of Clinical Sciences (A.J.N., H.D.S., L.B., and M.S.S.), and Department of Biomedical Sciences, College of Veterinary Medicine (S.M.), Cornell University, Ithaca, New York.
- Histogenics Corporation, Waltham, Massachusetts.
- Histogenics Corporation, Waltham, Massachusetts.
MeSH Terms
- Animals
- Arthroscopy
- Cartilage, Articular / surgery
- Cell Transplantation / methods
- Chondrocytes / transplantation
- Collagen Type I / administration & dosage
- Collagen Type I / pharmacology
- Collagen Type III
- Disease Models, Animal
- Guided Tissue Regeneration / methods
- Horses
- Patellofemoral Joint / surgery
- Transplantation, Autologous
- Wound Healing / physiology
Citations
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