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Autologous Chondrocyte Cartilage Repair

  • Chapter
Musculoskeletal Tissue Regeneration

Part of the book series: Orthopedic Biology and Medicine ((OBM))

Abstract

Articular cartilage injuries are one of the most common types of injuries seen in orthopaedic practice. The treatment of articular cartilage damage remains a challenge because cartilage has a limited capacity for spontaneous repair after traumatic insult or degenerative joint disease. As a result, several therapeutic strategies have been developed to restore articular cartilage and produce a durable repair. Surgical therapeutic efforts to treat cartilage defects have focused on delivering new cells capable of chondrogenesis into the lesions. Autologous chondrocyte transplantation (ACT) is an advanced, cell-based, orthobiologic technology used for the treatment of chondral defects of the knee, which has been in clinical use since 1987. With ACT, good to excellent clinical results are seen in isolated posttraumatic lesions of the knee joint in the younger patient, with the formation of hyaline or hyaline-like repair tissue. In the classic ACT technique, chondrocytes are isolated from small slices of cartilage harvested arthroscopically from a minor weight bearing area of the injured knee. The cells are expanded in vitro in cell culture and re-implanted beneath a periosteal patch covering the cartilage defect. ACT provides significant and long-term benefits for patients, with diminished pain and improved function in most cases. Most complications are directly related to the periosteal graft with periosteal hypertrophy, delamination of the transplant, arthrofibrosis and transplant failure. The need for a periosteal flap, and the complications associated with the periosteal flap, have led to the development of biomaterials as carriers for chondrocytes. Thus, efforts are now focused toward a tissue engineering approach, which combines laboratory-grown cells with appropriate three-dimensional biocompatible scaffolds, as in matrix-associated autologous chondrocyte transplantation (MACT). These biomaterials secure the cells in the defect area and enhance their proliferation and differentiation.

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  1. Department of Traumatology, Medical University of Vienna, Vienna, Austria

    Stefan Marlovits

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  1. Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, USA

    William S. Pietrzak Ph.D.

  2. Biomet, Inc., Warsaw, IN, USA

    William S. Pietrzak Ph.D.

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Marlovits, S. (2008). Autologous Chondrocyte Cartilage Repair. In: Pietrzak, W.S. (eds) Musculoskeletal Tissue Regeneration. Orthopedic Biology and Medicine. Humana Press. https://doi.org/10.1007/978-1-59745-239-7_18

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  • DOI: https://doi.org/10.1007/978-1-59745-239-7_18

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