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Early postoperative adherence of matrix-induced autologous chondrocyte implantation for the treatment of full-thickness cartilage defects of the femoral condyle

  • Knee
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Matrix-induced autologous chondrocyte implantation (MACI) is a tissue-engineering technique for the treatment of full-thickness articular cartilage defects and requires the use of a three-dimensional collagen type I–III membrane seeded with cultured autologous chondrocytes. The cell-scaffold construct is implanted in the debrided cartilage defect and fixed only with fibrin glue, with no periosteal cover or further surgical fixation. In a clinical pilot study, the MACI technique was used for the treatment of full-thickness, weight-bearing chondral defects of the femoral condyle in 16 patients. All patients were followed prospectively and the early postoperative attachment rate, 34.7 days (range: 22–47) after the scaffold implantation, was determined. With the use of high-resolution magnetic resonance imaging (MRI), the transplant was graded as completely attached, partially attached, or detached. In 14 of 16 patients (87.5%), a completely-attached graft was found, and the cartilage defect site was totally covered by the implanted scaffold and repair tissue. In one patient (6.25%), a partial attachment occurred with partial filling of the chondral defect. A complete detachment of the graft was found in one patient (6.25%), which resulted in an empty defect site with exposure of the subchondral bone. Interobserver variability for the MRI grading of the transplants showed substantial agreement (κ=0.775) and perfect agreement (κw=0.99). In conclusion, the implantation and fixation of a cell-scaffold construct in a deep cartilage defect of the femoral condyle with fibrin glue and with no further surgical fixation leads to a high attachment rate 34.7 days after the implantation, as determined with high resolution MRI.

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References

  1. Alparslan L, Minas T, Winalski CS (2001) Magnetic resonance imaging of autologous chondrocyte implantation. Semin Ultrasound CT MR 22:341–351

    Article  CAS  PubMed  Google Scholar 

  2. Behrens P, Ehlers EM, Kochermann KU, Rohwedel J, Russlies M, Plotz W (1999) New therapy procedure for localized cartilage defects. Encouraging results with autologous chondrocyte implantation. MMW Fortschr Med 141:49–51

    CAS  Google Scholar 

  3. 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 331:889–895

    Article  CAS  PubMed  Google Scholar 

  4. Brittberg M, Peterson L, Sjogren-Jansson E, Tallheden T, Lindahl A (2003) Articular cartilage engineering with autologous chondrocyte transplantation. A review of recent developments. J Bone Joint Surg Am 85 (suppl 3):109–115

    Article  Google Scholar 

  5. Cherubino P, Grassi FA, Bulgheroni P, Ronga M (2003) Autologous chondrocyte implantation using a bilayer collagen membrane: a preliminary report. J Orthop Surg (Hong Kong) 11:10–15

    CAS  Google Scholar 

  6. Cohen J (1968) Weighted kappa: nominal scale agreement with provision for scaled disagreement or partial credit. Psychol Bull 70:213–220

    Google Scholar 

  7. Driesang IM, Hunziker EB (2000) Delamination rates of tissue flaps used in articular cartilage repair. J Orthop Res 18:909–911

    CAS  PubMed  Google Scholar 

  8. Erggelet C, Sittinger M, Lahm A (2003) The arthroscopic implantation of autologous chondrocytes for the treatment of full-thickness cartilage defects of the knee joint. Arthroscopy 19:108–110

    Article  PubMed  Google Scholar 

  9. Fleiss J (1971) Measuring nominal scale agreement among many raters. Psychol Bull 76:378–382

    Google Scholar 

  10. Freed LE, Marquis JC, Nohria A, Emmanual J, Mikos AG, Langer R (1993) Neocartilage formation in vitro and in vivo using cells cultured on synthetic biodegradable polymers. J Biomed Mater Res 27:11–23

    CAS  PubMed  Google Scholar 

  11. Freshney RI (1994) Culture of animal cells: a manual of basic technique. Wiley-Liss, New York

    Google Scholar 

  12. Grigolo B, Roseti L, Fiorini M, Fini M, Giavaresi G, Aldini NN, Giardino R, Facchini A (2001) Transplantation of chondrocytes seeded on a hyaluronan derivative (hyaff-11) into cartilage defects in rabbits. Biomaterials 22:2417–2424

    Article  CAS  PubMed  Google Scholar 

  13. Grigolo B, Lisignoli G, Piacentini A, Fiorini M, Gobbi P, Mazzotti G, Duca M, Pavesio A, Facchini A (2002) Evidence for redifferentiation of human chondrocytes grown on a hyaluronan-based biomaterial (HYAff 11): molecular, immunohistochemical and ultrastructural analysis. Biomaterials 23:1187–1195

    Article  CAS  PubMed  Google Scholar 

  14. Hendrickson DA, Nixon AJ, Grande DA, Todhunter RJ, Minor RM, Erb H, Lust G (1994) Chondrocyte-fibrin matrix transplants for resurfacing extensive articular cartilage defects. J Orthop Res 12:485–497

    CAS  PubMed  Google Scholar 

  15. Hunziker EB (2002) Articular cartilage repair: basic science and clinical progress. A review of the current status and prospects. Osteoarthritis Cartilage 10:432–463

    Article  CAS  PubMed  Google Scholar 

  16. Imhof H, Nobauer-Huhmann IM, Krestan C, Gahleitner A, Sulzbacher I, Marlovits S, Trattnig S (2002) MRI of the cartilage. Eur Radiol 12:2781–2793

    CAS  PubMed  Google Scholar 

  17. Koch GG, Landis JR, Freeman JL, Freeman DH Jr, Lehnen RC (1977) A general methodology for the analysis of experiments with repeated measurement of categorical data. Biometrics 33:133–158

    CAS  PubMed  Google Scholar 

  18. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174

    CAS  PubMed  Google Scholar 

  19. Lindahl A, Brittberg M, Peterson L (2003) Cartilage repair with chondrocytes: clinical and cellular aspects. Novartis Found Symp 249:175–186, Discussion 186–189, 234–238, 239–241

    Article  PubMed  Google Scholar 

  20. Minas T, Peterson L (1999) Advanced techniques in autologous chondrocyte transplantation. Clin Sports Med 18:13–44

    CAS  PubMed  Google Scholar 

  21. Pavesio A, Abatangelo G, Borrione A, Brocchetta D, Hollander AP, Kon E, Torasso F, Zanasi S, Marcacci M (2003) Hyaluronan-based scaffolds (Hyalograft C) in the treatment of knee cartilage defects: preliminary clinical findings. Novartis Found Symp 249:203–217, Discussion 229–233, 234–238, 239–241

    Article  PubMed  Google Scholar 

  22. Peterfy CG, Linares R, Steinbach LS (1994) Recent advances in magnetic resonance imaging of the musculoskeletal system. Radiol Clin North Am 32:291–311

    CAS  PubMed  Google Scholar 

  23. Peterson L, Minas T, Brittberg M, Nilsson A, Sjogren-Jansson E, Lindahl A (2000) Two- to 9-year outcome after autologous chondrocyte transplantation of the knee. Clin Orthop 23:212–234

    Article  Google Scholar 

  24. Peterson L, Brittberg M, Kiviranta I, Akerlund EL, Lindahl A (2002) Autologous chondrocyte transplantation. Biomechanics and long-term durability. Am J Sports Med 30:2–12

    PubMed  Google Scholar 

  25. Recht M et al (2001) Magnetic resonance imaging of articular cartilage. Clin Orthop 391(suppl):379–396

    Article  Google Scholar 

  26. Recht M, White LM, Winalski CS, Miniaci A, Minas T, Parker RD (2003) MR imaging of cartilage repair procedures. Skeletal Radiol 32:185–200

    PubMed  Google Scholar 

  27. Russlies M, Behrens P, Wunsch L, Gille J, Ehlers EM (2002) A cell-seeded biocomposite for cartilage repair. Ann Anat 184:317–323

    CAS  PubMed  Google Scholar 

  28. van Susante JL, Buma P, van Osch GJ, Versleyen D, van der Kraan PM, van der Berg WB, Homminga GN (1995) Culture of chondrocytes in alginate and collagen carrier gels. Acta Orthop Scand 66:549–556

    PubMed  Google Scholar 

  29. Trattnig S (1997) Overuse of hyaline cartilage and imaging. Eur J Radiol 25:188–198

    Article  CAS  PubMed  Google Scholar 

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Acknowledgment

This study was supported by a grant from the Lorenz-Boehler-Society (grant 10/02).

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Authors and Affiliations

  1. Department of Traumatology, Medical University of Vienna, Waehringer Guertel 18–20, 1090, Vienna, Austria

    Stefan Marlovits, Gabriele Striessnig, Florian Kutscha-Lissberg, Christoph Resinger, Silke M. Aldrian & Vilmos Vécsei

  2. Ludwig Boltzmann Institute for Biomechanics and Cell Biology, Waehringer Guertel 18–20, 1090, Vienna, Austria

    Stefan Marlovits & Vilmos Vécsei

  3. Department of Radiology, Medical University of Vienna, Waehringer Guertel 18–20, 1090, Vienna, Austria

    Siegfried Trattnig

Authors
  1. Stefan Marlovits
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  2. Gabriele Striessnig
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  7. Siegfried Trattnig
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Correspondence to Stefan Marlovits.

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Marlovits, S., Striessnig, G., Kutscha-Lissberg, F. et al. Early postoperative adherence of matrix-induced autologous chondrocyte implantation for the treatment of full-thickness cartilage defects of the femoral condyle. Knee Surg Sports Traumatol Arthrosc 13, 451–457 (2005). https://doi.org/10.1007/s00167-004-0535-3

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  • DOI: https://doi.org/10.1007/s00167-004-0535-3

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