David Grevenstein1, Andreas Mamilos2, Volker H Schmitt3, Tanja Niedermair2, Willi Wagner4, C James Kirkpatrick5, Christoph Brochhausen6. 1. Departement for Orthopaedic Surgery, University Medical Centre of Cologne, Regensburg, Germany. 2. REPAIR-Lab, Institute of Pathology, University of Regensburg, Franz-Josef-Strauß Allee 11, 93053, Regensburg, Germany. 3. Cardiology I, Centre for Cardiology, University Medical Centre, Johannes Gutenberg University of Mainz, Mainz, Germany. 4. Departement for Radiology, University Medical Centre Heidelberg, Heidelberg, Germany. 5. Department of Biomaterials, Sahlgrenska Academy, University of Gothenburg, Gothenborg, Sweden. 6. REPAIR-Lab, Institute of Pathology, University of Regensburg, Franz-Josef-Strauß Allee 11, 93053, Regensburg, Germany. christoph.brochhausen@ukr.de.
Abstract
PURPOSE: Traumatic lesions of articular cartilage represent a crucial risk factor for osteoarthritis. Even if several strategies exist to treat such damages, the optimal solution has not yet been found. A new strategy represents the scaffold-free spheroid-based autologous chondrocyte transplantation. In this method, spheroids of chondrocytes are synthesized after chondrocyte isolation and expansion, followed by the implantation in a second intervention. METHODS: Fine Jamshidi-needle biopsies from five patients (one from each patient, Ø 2 mm) treated with a spheroid-based autologous chondrocyte implantation (ACI) after traumatic lesions of the articular cartilage of the knee were analysed histologically and immunohistologically for collagen II, collagen X and aggrecan expression. The indication for a second look arthroscopy was given by arthrofibrosis or meniscus-lesions, respectively. The time between ACI and second-look arthroscopy ranged between 6 and 16 months. RESULTS: In all patients, the histological examinations revealed an avascular cartilage tissue with a homogenic extracellular matrix. The subchondral bone neither showed bleeding, necrosis nor hypertrophy. A homogenous alcian blue staining indicated high amounts of mucopolysaccharides and glycosaminoglycans. Collagen II staining was highly positive, whereas collagen X staining was negative in every patient, ruling out hypertrophic chondrocyte differentiation. In addition, intense aggrecan staining indicated a strong expression of this extracellular matrix component. CONCLUSION: The present case series represents the first histological and immunohistological analyses of spheroid-based ACI in humans. Spheroid-based ACI revealed excellent histological results regarding the regeneration of hyaline articular cartilage. These results indicate that spheroid based ACI is a promising strategy for treating traumatic lesions of the articular cartilage of the knee.
PURPOSE:Traumatic lesions of articular cartilage represent a crucial risk factor for osteoarthritis. Even if several strategies exist to treat such damages, the optimal solution has not yet been found. A new strategy represents the scaffold-free spheroid-based autologous chondrocyte transplantation. In this method, spheroids of chondrocytes are synthesized after chondrocyte isolation and expansion, followed by the implantation in a second intervention. METHODS: Fine Jamshidi-needle biopsies from five patients (one from each patient, Ø 2 mm) treated with a spheroid-based autologous chondrocyte implantation (ACI) after traumatic lesions of the articular cartilage of the knee were analysed histologically and immunohistologically for collagen II, collagen X and aggrecan expression. The indication for a second look arthroscopy was given by arthrofibrosis or meniscus-lesions, respectively. The time between ACI and second-look arthroscopy ranged between 6 and 16 months. RESULTS: In all patients, the histological examinations revealed an avascular cartilage tissue with a homogenic extracellular matrix. The subchondral bone neither showed bleeding, necrosis nor hypertrophy. A homogenous alcian blue staining indicated high amounts of mucopolysaccharides and glycosaminoglycans. Collagen II staining was highly positive, whereas collagen X staining was negative in every patient, ruling out hypertrophic chondrocyte differentiation. In addition, intense aggrecan staining indicated a strong expression of this extracellular matrix component. CONCLUSION: The present case series represents the first histological and immunohistological analyses of spheroid-based ACI in humans. Spheroid-based ACI revealed excellent histological results regarding the regeneration of hyaline articular cartilage. These results indicate that spheroid based ACI is a promising strategy for treating traumatic lesions of the articular cartilage of the knee.
Authors: Philipp Niemeyer; Volker Laute; Thilo John; Christoph Becher; Peter Diehl; Thomas Kolombe; Jakob Fay; Rainer Siebold; Milan Niks; Stefan Fickert; Wolfgang Zinser Journal: Am J Sports Med Date: 2016-05-20 Impact factor: 6.202
Authors: Abhijit M Bhosale; Jan Herman Kuiper; W Eustace B Johnson; Paul E Harrison; James B Richardson Journal: Am J Sports Med Date: 2009-10-27 Impact factor: 6.202
Authors: Syed Z Nawaz; George Bentley; Timothy W R Briggs; Richard W J Carrington; John A Skinner; Kieran R Gallagher; Baljinder S Dhinsa Journal: J Bone Joint Surg Am Date: 2014-05-21 Impact factor: 5.284
Authors: Arnd Hoburg; Philipp Niemeyer; Volker Laute; Wolfgang Zinser; Thilo John; Christoph Becher; Kaywan Izadpanah; Peter Diehl; Thomas Kolombe; Jakob Fay; Rainer Siebold; Stefan Fickert Journal: Orthop J Sports Med Date: 2022-01-18