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Cell carriers as the next generation of cell therapy for cartilage repair: a review of the matrix-induced autologous chondrocyte implantation procedure.

Abstract

BACKGROUND

Since the first patient was implanted with autologous cultured chondrocytes more than 20 years ago, new variations of cell therapies for cartilage repair have appeared. Autologous chondrocyte implantation, a first-generation cell therapy, uses suspended autologous cultured chondrocytes in combination with a periosteal patch. Collagen-covered autologous cultured chondrocyte implantation, a second-generation cell therapy, uses suspended cultured chondrocytes with a collagen type I/III membrane. Today's demand for transarthroscopic procedures has resulted in the development of third-generation cell therapies that deliver autologous cultured chondrocytes using cell carriers or cell-seeded scaffolds.

PURPOSE

To review the current evidence of the matrix-induced autologous chondrocyte implantation procedure, the most widely used carrier system to date. Also discussed are the characteristics of type I/III collagen membranes, behavior of cells associated with the membrane, surgical technique, rehabilitation, clinical outcomes, and quality of repair tissue.

STUDY DESIGN

Systematic review.

METHODS

Relevant publications were identified by searching Medline from its inception (1949) to December 2007; peer-reviewed publications of preclinical and clinical cell behavior, manufacturing process, surgical technique, and rehabilitation protocols were identified. Preclinical and clinical studies were included if they contained primary data and used a type I/III collagen membrane.

RESULTS

Data from these studies demonstrate that patients treated with matrix-induced autologous chondrocyte implantation have an overall improvement in clinical outcomes. Reduced visual analog scale pain levels (range, 1.7-5.32 points) and improvements in the modified Cincinnati (range, 3.8-34.2 points), Lysholm-Gillquist (range, 23.09-47.6 points), Tegner-Lysholm (range, 1.39-3.9 points), and International Knee Documentation Classification scale (P <.05) were observed. Patients had good-quality (hyaline-like) repair tissue as assessed by arthroscopic evaluation (including International Cartilage Repair Society score), magnetic resonance imaging, and histology, as well as a low incidence of postoperative complications.

CONCLUSION

The findings suggest that matrix-induced autologous chondrocyte implantation is a promising third-generation cell therapy for the repair of symptomatic, full-thickness articular cartilage defects.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    Kungsbacka Hospital Cartilage Research Unit, University of Gothenburg, Department of Orthopaedics, Kungsbacka Hospital, Kungsbacka, Sweden. mats.brittberg@telia.com

    Source

    MeSH

    Arthroscopy
    Cartilage
    Cartilage, Articular
    Cell- and Tissue-Based Therapy
    Chondrocytes
    Collagen Type I
    Collagen Type III
    Humans
    Knee Joint
    Orthopedic Procedures
    Transplantation, Autologous
    Treatment Outcome
    United States

    Pub Type(s)

    Journal Article
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    19966108

    Citation

    Brittberg, Mats. "Cell Carriers as the Next Generation of Cell Therapy for Cartilage Repair: a Review of the Matrix-induced Autologous Chondrocyte Implantation Procedure." The American Journal of Sports Medicine, vol. 38, no. 6, 2010, pp. 1259-71.
    Brittberg M. Cell carriers as the next generation of cell therapy for cartilage repair: a review of the matrix-induced autologous chondrocyte implantation procedure. Am J Sports Med. 2010;38(6):1259-71.
    Brittberg, M. (2010). Cell carriers as the next generation of cell therapy for cartilage repair: a review of the matrix-induced autologous chondrocyte implantation procedure. The American Journal of Sports Medicine, 38(6), pp. 1259-71. doi:10.1177/0363546509346395.
    Brittberg M. Cell Carriers as the Next Generation of Cell Therapy for Cartilage Repair: a Review of the Matrix-induced Autologous Chondrocyte Implantation Procedure. Am J Sports Med. 2010;38(6):1259-71. PubMed PMID: 19966108.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Cell carriers as the next generation of cell therapy for cartilage repair: a review of the matrix-induced autologous chondrocyte implantation procedure. A1 - Brittberg,Mats, Y1 - 2009/12/04/ PY - 2009/12/8/entrez PY - 2009/12/8/pubmed PY - 2010/9/30/medline SP - 1259 EP - 71 JF - The American journal of sports medicine JO - Am J Sports Med VL - 38 IS - 6 N2 - BACKGROUND: Since the first patient was implanted with autologous cultured chondrocytes more than 20 years ago, new variations of cell therapies for cartilage repair have appeared. Autologous chondrocyte implantation, a first-generation cell therapy, uses suspended autologous cultured chondrocytes in combination with a periosteal patch. Collagen-covered autologous cultured chondrocyte implantation, a second-generation cell therapy, uses suspended cultured chondrocytes with a collagen type I/III membrane. Today's demand for transarthroscopic procedures has resulted in the development of third-generation cell therapies that deliver autologous cultured chondrocytes using cell carriers or cell-seeded scaffolds. PURPOSE: To review the current evidence of the matrix-induced autologous chondrocyte implantation procedure, the most widely used carrier system to date. Also discussed are the characteristics of type I/III collagen membranes, behavior of cells associated with the membrane, surgical technique, rehabilitation, clinical outcomes, and quality of repair tissue. STUDY DESIGN: Systematic review. METHODS: Relevant publications were identified by searching Medline from its inception (1949) to December 2007; peer-reviewed publications of preclinical and clinical cell behavior, manufacturing process, surgical technique, and rehabilitation protocols were identified. Preclinical and clinical studies were included if they contained primary data and used a type I/III collagen membrane. RESULTS: Data from these studies demonstrate that patients treated with matrix-induced autologous chondrocyte implantation have an overall improvement in clinical outcomes. Reduced visual analog scale pain levels (range, 1.7-5.32 points) and improvements in the modified Cincinnati (range, 3.8-34.2 points), Lysholm-Gillquist (range, 23.09-47.6 points), Tegner-Lysholm (range, 1.39-3.9 points), and International Knee Documentation Classification scale (P <.05) were observed. Patients had good-quality (hyaline-like) repair tissue as assessed by arthroscopic evaluation (including International Cartilage Repair Society score), magnetic resonance imaging, and histology, as well as a low incidence of postoperative complications. CONCLUSION: The findings suggest that matrix-induced autologous chondrocyte implantation is a promising third-generation cell therapy for the repair of symptomatic, full-thickness articular cartilage defects. SN - 1552-3365 UR - https://www.unboundmedicine.com/medline/citation/19966108/Cell_carriers_as_the_next_generation_of_cell_therapy_for_cartilage_repair:_a_review_of_the_matrix_induced_autologous_chondrocyte_implantation_procedure_ L2 - http://journals.sagepub.com/doi/full/10.1177/0363546509346395?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -