Skip to main content
SpringerLink
Log in

Cell-Based Cartilage Regeneration

  • Chapter
  • First Online:
Cartilage

  • 769 Accesses

Abstract

Since decades various regenerative cell-based treatment options have been developed for cartilage repair. With the introduction of the autologous chondrocyte transplantation, also large-sized chondral defects can be successfully addressed. This chapter gives a short overview about current procedures for cell-based treatment strategies like bone marrow stimulation techniques, osteochondral transplantation, and chondrocyte transplantation. Requirements and outcome parameters for a successful treatment and future directions in cartilage regeneration are discussed. Finally treatment recommendations according to cartilage defect size and depth are given.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Anders S, Volz M, Frick H, Gellissen J (2013) A randomized, controlled trial comparing autologous matrix-induced chondrogenesis (AMIC(R)) to microfracture: analysis of 1- and 2-year follow-up data of 2 centers. Open Orthop J 7:133–143. doi:10.2174/1874325001307010133

    Article  PubMed  PubMed Central  Google Scholar 

  • Angele P, Fritz J, Albrecht D, Koh J, Zellner J (2015) Defect type, localization and marker gene expression determines early adverse events of matrix-associated autologous chondrocyte implantation. Injury 46(Suppl 4):S2–S9. doi:10.1016/S0020-1383(15)30012-7

    Article  PubMed  Google Scholar 

  • Basad E, Ishaque B, Bachmann G, Sturz H, Steinmeyer J (2010) Matrix-induced autologous chondrocyte implantation versus microfracture in the treatment of cartilage defects of the knee: a 2-year randomised study. Knee Surg Sports Traumatol Arthrosc 18(4):519–527. doi:10.1007/s00167-009-1028-1

    Article  PubMed  Google Scholar 

  • Behery O, Siston RA, Harris JD, Flanigan DC (2014) Treatment of cartilage defects of the knee: expanding on the existing algorithm. Clin J Sport Med 24(1):21–30. doi:10.1097/JSM.0000000000000004

    Article  PubMed  Google Scholar 

  • Bentley G, Biant LC, Vijayan S, Macmull S, Skinner JA, Carrington RW (2012) Minimum ten-year results of a prospective randomised study of autologous chondrocyte implantation versus mosaicplasty for symptomatic articular cartilage lesions of the knee. J Bone Joint Surg 94(4):504–509. doi:10.1302/0301-620X.94B4.27495

    Article  CAS  Google Scholar 

  • Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L (1994) Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med 331(14):889–895. doi:10.1056/NEJM199410063311401

    Article  CAS  PubMed  Google Scholar 

  • Chen H, Sun J, Hoemann CD, Lascau-Coman V, Ouyang W, McKee MD, Shive MS, Buschmann MD (2009) Drilling and microfracture lead to different bone structure and necrosis during bone-marrow stimulation for cartilage repair. J Orthop Res 27(11):1432–1438. doi:10.1002/jor.20905

    Article  PubMed  Google Scholar 

  • Crawford DC, DeBerardino TM, Williams RJ 3rd (2012) NeoCart, an autologous cartilage tissue implant, compared with microfracture for treatment of distal femoral cartilage lesions: an FDA phase-II prospective, randomized clinical trial after two years. J Bone Joint Surg Am 94(11):979–989. doi:10.2106/JBJS.K.00533

    Article  PubMed  Google Scholar 

  • Dhollander AA, Verdonk PC, Lambrecht S, Verdonk R, Elewaut D, Verbruggen G, Almqvist KF (2012) Midterm results of the treatment of cartilage defects in the knee using alginate beads containing human mature allogenic chondrocytes. Am J Sports Med 40(1):75–82. doi:10.1177/0363546511423013

    Article  PubMed  Google Scholar 

  • Eldracher M, Orth P, Cucchiarini M, Pape D, Madry H (2014) Small subchondral drill holes improve marrow stimulation of articular cartilage defects. Am J Sports Med 42(11):2741–2750. doi:10.1177/0363546514547029

    Article  PubMed  Google Scholar 

  • Farr J, Tabet SK, Margerrison E, Cole BJ (2014) Clinical, radiographic, and histological outcomes after cartilage repair with particulated juvenile articular cartilage: a 2-year prospective study. Am J Sports Med 42(6):1417–1425. doi:10.1177/0363546514528671

    Article  PubMed  Google Scholar 

  • Fortier LA, Cole BJ, McIlwraith CW (2012) Science and animal models of marrow stimulation for cartilage repair. J Knee Surg 25(1):3–8

    Article  PubMed  Google Scholar 

  • Gille J, Schuseil E, Wimmer J, Gellissen J, Schulz AP, Behrens P (2010) Mid-term results of autologous matrix-induced chondrogenesis for treatment of focal cartilage defects in the knee. Knee Surg Sports Traumatol Arthrosc 18(11):1456–1464. doi:10.1007/s00167-010-1042-3

    Article  CAS  PubMed  Google Scholar 

  • Gille J, Behrens P, Volpi P, de Girolamo L, Reiss E, Zoch W, Anders S (2013) Outcome of autologous matrix induced chondrogenesis (AMIC) in cartilage knee surgery: data of the AMIC Registry. Arch Orthop Trauma Surg 133(1):87–93. doi:10.1007/s00402-012-1621-5

    Article  CAS  PubMed  Google Scholar 

  • Gomoll AH, Madry H, Knutsen G, van Dijk N, Seil R, Brittberg M, Kon E (2010) The subchondral bone in articular cartilage repair: current problems in the surgical management. Knee Surg Sports Traumatol Arthrosc 18(4):434–447. doi:10.1007/s00167-010-1072-x

    Article  PubMed  PubMed Central  Google Scholar 

  • Gudas R, Gudaite A, Pocius A, Gudiene A, Cekanauskas E, Monastyreckiene E, Basevicius A (2012) Ten-year follow-up of a prospective, randomized clinical study of mosaic osteochondral autologous transplantation versus microfracture for the treatment of osteochondral defects in the knee joint of athletes. Am J Sports Med 40(11):2499–2508. doi:10.1177/0363546512458763

    Article  PubMed  Google Scholar 

  • Hangody L, Dobos J, Balo E, Panics G, Hangody LR, Berkes I (2010) Clinical experiences with autologous osteochondral mosaicplasty in an athletic population: a 17-year prospective multicenter study. Am J Sports Med 38(6):1125–1133. doi:10.1177/0363546509360405

    Article  PubMed  Google Scholar 

  • Harris JD, Siston RA, Brophy RH, Lattermann C, Carey JL, Flanigan DC (2011) Failures, re-operations, and complications after autologous chondrocyte implantation--a systematic review. Osteoarthritis Cartilage 19(7):779–791

    Article  CAS  PubMed  Google Scholar 

  • Henderson I, Lavigne P, Valenzuela H, Oakes B (2007) Autologous chondrocyte implantation: superior biologic properties of hyaline cartilage repairs. Clin Orthop Relat Res 455:253–261. doi:10.1097/01.blo.0000238829.42563.56

    Article  PubMed  Google Scholar 

  • Kon E, Filardo G, Berruto M, Benazzo F, Zanon G, Della Villa S, Marcacci M (2011) Articular cartilage treatment in high-level male soccer players: a prospective comparative study of arthroscopic second-generation autologous chondrocyte implantation versus microfracture. Am J Sports Med 39(12):2549–2557. doi:10.1177/0363546511420688

    Article  PubMed  Google Scholar 

  • Kreuz PC, Erggelet C, Steinwachs MR, Krause SJ, Lahm A, Niemeyer P, Ghanem N, Uhl M, Sudkamp N (2006) Is microfracture of chondral defects in the knee associated with different results in patients aged 40 years or younger? Arthroscopy 22(11):1180–1186. doi:10.1016/j.arthro.2006.06.020

    Article  PubMed  Google Scholar 

  • Kusano T, Jakob RP, Gautier E, Magnussen RA, Hoogewoud H, Jacobi M (2012) Treatment of isolated chondral and osteochondral defects in the knee by autologous matrix-induced chondrogenesis (AMIC). Knee Surg Sports Traumatol Arthrosc 20(10):2109–2115. doi:10.1007/s00167-011-1840-2

    Article  PubMed  Google Scholar 

  • Lattermann C, Luckett MR (2011) Staging and comorbidities. J Knee Surg 24(4):217–224

    Article  PubMed  PubMed Central  Google Scholar 

  • Makris EA, Hadidi P, Athanasiou KA (2011) The knee meniscus: structure-function, pathophysiology, current repair techniques, and prospects for regeneration. Biomaterials 32(30):7411–7431. doi:10.1016/j.biomaterials.2011.06.037

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Marcacci M, Filardo G, Kon E (2013) Treatment of cartilage lesions: what works and why? Injury 44(Suppl 1):S11–S15. doi:10.1016/S0020-1383(13)70004-4

    Article  PubMed  Google Scholar 

  • McDermott ID, Amis AA (2006) The consequences of meniscectomy. J Bone Joint Surg 88(12):1549–1556. doi:10.1302/0301-620X.88B12.18140

    Article  CAS  Google Scholar 

  • Mithoefer K, Hambly K, Della Villa S, Silvers H, Mandelbaum BR (2009a) Return to sports participation after articular cartilage repair in the knee: scientific evidence. Am J Sports Med 37(Suppl 1):167S–176S. doi:10.1177/0363546509351650

    Article  PubMed  Google Scholar 

  • Mithoefer K, McAdams T, Williams RJ, Kreuz PC, Mandelbaum BR (2009b) Clinical efficacy of the microfracture technique for articular cartilage repair in the knee: an evidence-based systematic analysis. Am J Sports Med 37(10):2053–2063. doi:10.1177/0363546508328414

    Article  PubMed  Google Scholar 

  • Nehrer S, Spector M, Minas T (1999) Histologic analysis of tissue after failed cartilage repair procedures. Clin Orthop Relat Res 365:149–162

    Article  Google Scholar 

  • Nejadnik H, Hui JH, Feng Choong EP, Tai BC, Lee EH (2010) Autologous bone marrow-derived mesenchymal stem cells versus autologous chondrocyte implantation: an observational cohort study. Am J Sports Med 38(6):1110–1116. doi:10.1177/0363546509359067

    Article  PubMed  Google Scholar 

  • Niemeyer P, Koestler W, Sudkamp NP (2011) Problems and complications of surgical techniques for treatment of full-thickness cartilage defects. Z Orthop Unfall 149(1):45–51. doi:10.1055/s-0030-1250104

    Article  CAS  PubMed  Google Scholar 

  • Niemeyer P, Albrecht D, Andereya S, Angele P, Ateschrang A, Aurich M, Baumann M, Bosch U, Erggelet C, Fickert S, Gebhard H, Gelse K, Gunther D, Hoburg A, Kasten P, Kolombe T, Madry H, Marlovits S, Meenen NM, Muller PE, Noth U, Petersen JP, Pietschmann M, Richter W, Rolauffs B, Rhunau K, Schewe B, Steinert A, Steinwachs MR, Welsch GH, Zinser W, Fritz J (2016) Autologous chondrocyte implantation (ACI) for cartilage defects of the knee: a guideline by the working group “Clinical Tissue Regeneration” of the German Society of Orthopaedics and Trauma (DGOU). Knee 23(3):426–435. doi:10.1016/j.knee.2016.02.001

    Article  CAS  PubMed  Google Scholar 

  • Stanish WD, McCormack R, Forriol F, Mohtadi N, Pelet S, Desnoyers J, Restrepo A, Shive MS (2013) Novel scaffold-based BST-CarGel treatment results in superior cartilage repair compared with microfracture in a randomized controlled trial. J Bone Joint Surg Am 95(18):1640–1650. doi:10.2106/JBJS.L.01345

    Article  PubMed  Google Scholar 

  • Steadman JR, Rodkey WG, Rodrigo JJ (2001) Microfracture: surgical technique and rehabilitation to treat chondral defects. Clin Orthop Relat Res (391 Suppl):S362–S369

    Google Scholar 

  • Vanlauwe J, Saris DB, Victor J, Almqvist KF, Bellemans J, Luyten FP, TIG/ACT/01/2000&EXT Study Group (2011) Five-year outcome of characterized chondrocyte implantation versus microfracture for symptomatic cartilage defects of the knee: early treatment matters. Am J Sports Med 39(12):2566–2574. doi:10.1177/0363546511422220

    Article  PubMed  Google Scholar 

  • Vavken P, Samartzis D (2010) Effectiveness of autologous chondrocyte implantation in cartilage repair of the knee: a systematic review of controlled trials. Osteoarthritis Cartilage 18(6):857–863. doi:10.1016/j.joca.2010.03.005

    Article  CAS  PubMed  Google Scholar 

  • Widuchowski W, Widuchowski J, Trzaska T (2007) Articular cartilage defects: study of 25,124 knee arthroscopies. Knee 14(3):177–182. doi:10.1016/j.knee.2007.02.001

    Article  CAS  PubMed  Google Scholar 

  • Zellner J, Angele P, Zeman F, Kujat R, Nerlich M (2013) Is the transplant quality at the time of surgery adequate for matrix-guided autologous cartilage transplantation? A pilot study. Clin Orthop Relat Res 471(9):2852–2861. doi:10.1007/s11999-013-2958-y

    Article  PubMed  PubMed Central  Google Scholar 

  • Zellner J, Krutsch W, Pfeifer CG, Koch M, Nerlich M, Angele P (2015) Autologous chondrocyte implantation for cartilage repair: current perspectives. Orthop Res Rev 7:149–158

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University Medical Center Regensburg, Department of Trauma Surgery, Regensburg, Germany

    Johannes Zellner & Peter Angele

  2. Sporthopaedicum Regensburg, Regensburg, Germany

    Peter Angele

Authors
  1. Johannes Zellner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter Angele
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter Angele .

Editor information

Editors and Affiliations

  1. Orthopädische Klinik für die Universität Regensburg, Universitätsklinikum Regensburg, Regensburg, Germany

    Susanne Grässel

  2. Department of General, Trauma, and Reconstruction Surgery, Ludwig-Maximilians-University, Munich, Germany

    Attila Aszódi

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Zellner, J., Angele, P. (2017). Cell-Based Cartilage Regeneration. In: Grässel, S., Aszódi, A. (eds) Cartilage. Springer, Cham. https://doi.org/10.1007/978-3-319-53316-2_5

Download citation

Publish with us

Policies and ethics

Search

Navigation