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Clinical Orthopaedics and Related Research®

Published in:

01-09-2013 | Symposium: Tscherne Festschrift

Is the Transplant Quality at the Time of Surgery Adequate for Matrix-guided Autologous Cartilage Transplantation? A Pilot Study

Authors: Johannes Zellner, MD, Peter Angele, MD, Florian Zeman, PhD, Richard Kujat, PhD, Michael Nerlich, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 9/2013

Abstract

Background

Matrix-guided autologous chondrocyte transplantation (MACT) has been proposed as an option for treating large full-thickness cartilage defects. However, little is known about the chondrogenic potential of transplants for MACT at the time of implantation, although cell quality and chondrogenic differentiation of the implants are crucial for restoration of function after MACT.

Questions/purposes

We therefore asked: (1) Do MACT implants allow deposition of extracellular cartilage matrix in an in vitro culture model? (2) Are these implants associated with improved knee function 1 year after MACT in large cartilage defects?

Methods

We retrospectively reviewed all 125 patients with large localized cartilage defects (mean defect size 5 cm²) of the knee who were treated with MACT from 2005 to 2010. The mean age was 31 years (range, 16–53 years). Portions of the cell-matrix constructs (n = 50) that were not implanted in the cartilage defects were further cultured and tested for their potential to form articular cartilage. Knee function of all patients was analyzed preoperatively, 3 months, and 1 year postoperatively with the International Knee Documentation Committee (IKDC) score.

Results

In vitro assessment of the cell-matrix implants showed chondrogenic differentiation with positive staining for glycosaminoglycans and collagen II in all cultures. Enzyme-linked immunosorbent assay showed an increase of collagen II production. We observed an improvement in median IKDC score from 41 to 67 points at last followup.

Conclusions

Cartilage extracellular matrix deposition shows adequate implant quality for MACT at the time of implantation and justifies the use for treatment of large cartilage defects.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Title: Is the Transplant Quality at the Time of Surgery Adequate for Matrix-guided Autologous Cartilage Transplantation? A Pilot Study
Authors: Johannes Zellner, MD
Peter Angele, MD
Florian Zeman, PhD
Richard Kujat, PhD
Michael Nerlich, MD
Publication date: 01-09-2013
Publisher: Springer US
Published in: Clinical Orthopaedics and Related Research® / Issue 9/2013
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-013-2958-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Is the Transplant Quality at the Time of Surgery Adequate for Matrix-guided Autologous Cartilage Transplantation? A Pilot Study

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

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