Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 4/2018

01-04-2018 | Knee

Biophysical stimulation improves clinical results of matrix-assisted autologous chondrocyte implantation in the treatment of chondral lesions of the knee

Authors: Marco Collarile, Andrea Sambri, Giada Lullini, Matteo Cadossi, Claudio Zorzi

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2018

Login to get access

Abstract

Purpose

The purpose of the present study was to evaluate the effects of pulsed electromagnetic fields (PEMFs) on clinical outcome in patients who underwent arthroscopic matrix-assisted autologous chondrocyte implantation (MACI) for chondral lesions of the knee.

Methods

Thirty patients affected by grade III and IV International Cartilage Repair Society chondral lesions of the knee underwent MACI. After surgery, patients were randomly assigned to either experimental group (PEMFs 4 h per day for 60 days) or control group . Clinical outcome was evaluated through International Knee Documentation Committee (IKDC) subjective knee evaluation form, Visual Analog Scale, Short Form-36 (SF-36) and EuroQoL before surgery and 1, 2, 6, and 60 months postoperative.

Results

Mean size of chondral lesion was 2.4 ± 0.6 cm2 in the PEMFs group and 2.5 ± 0.5 cm2 in the control one. No differences were found between groups at baseline. IKDC score increased in both groups till 6 months, but afterward improvement was observed only in the experimental group with a significant difference between groups at 60 months (p = 0.001). A significant difference between groups was recorded at 60 months for SF-36 (p = 0.006) and EuroQol (p = 0.020). A significant pain reduction was observed in the experimental group at 1-, 2- and 60-month follow-up.

Conclusion

Biophysical stimulation with PEMFs improves clinical outcome after arthroscopic MACI for chondral lesions of the knee in the short- and long-term follow-up. Biophysical stimulation should be considered as an effective tool in order to ameliorate clinical results of regenerative medicine. The use of PEMFs represents an innovative therapeutic approach for the survival of cartilage-engineered constructs and consequently the success of orthopaedic surgery.

Level of evidence

II.
Literature
1.
Ebert JR, Robertson WB, Lloyd DG, Zheng MH, Wood DJ, Ackland T (2010) A prospective, randomized comparison of traditional and accelerated approaches to postoperative rehabilitation following autologous chondrocyte implantation: 2-year clinical outcomes. Cartilage 1:180–187CrossRefPubMedPubMedCentral
2.
Ebert JR, Robertson WB, Woodhouse J, Fallon M, Zheng MH, Ackland T et al (2011) Clinical and magnetic resonance imaging-based outcomes to 5 years after matrix-induced autologous chondrocyte implantation to address articular cartilage defects in the knee. Am J Sports Med 39:753–763CrossRefPubMed
3.
Marlovits S, Aldrian S, Wondrasch B, Zak L, Albrecht C, Welsch G et al (2012) Clinical and radiological outcomes 5 years after matrix-induced autologous chondrocyte implantation in patients with symptomatic, traumatic chondral defects. Am J Sports Med 40:2273–2280CrossRefPubMed
4.
Siebold R, Suezer F, Schmitt B, Trattnig S, Essig M (2017) Good clinical and MRI outcome after arthroscopic autologous chondrocyte implantation for cartilage repair in the knee. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-017-4491-0
5.
Peterson L, Brittberg M, Kiviranta I, Akerlund EL, Lindahl A (2002) Autologous chondrocyte transplantation. Biomechanics and long-term durability. Am J Sports Med 30:2–12CrossRefPubMed
6.
Bosnakovski D, Mizuno M, Kim G, Takagi S, Okumura M, Fujinaga T (2006) Chondrogenic differentiation of bovine bone marrow mesenchymal stem cells (MSCs) in different hydrogels: influence of collagen type II extracellular matrix on MSC chondrogenesis. Biotechnol Bioeng 93:1152–1163CrossRefPubMed
7.
Longobardi L, O’Rear L, Aakula S, Johnstone B, Shimer K, Chytil A et al (2006) Effect of IGF-I in the chondrogenesis of bone marrow mesenchymal stem cells in the presence or absence of TGF-beta signaling. J Bone Miner Res 21:626–636CrossRefPubMed
8.
Schmal H, Mehlhorn A, Stoffel F, Kostler W, Sudkamp NP, Niemeyer P (2009) In vivo quantification of intraarticular cytokines in knees during natural and surgically induced cartilage repair. Cytotherapy 11:1065–1075CrossRefPubMed
9.
Lima EG, Tan AR, Tai T, Bian L, Stoker AM, Ateshian GA et al (2008) Differences in interleukin-1 response between engineered and native cartilage. Tissue Eng Part A 14:1721–1730CrossRefPubMed
10.
De Mattei M, Fini M, Setti S, Ongaro A, Gemmati D, Stabellini G et al (2007) Proteoglycan synthesis in bovine articular cartilage explants exposed to different low-frequency low-energy pulsed electromagnetic fields. Osteoarthr Cartil 15:163–168CrossRefPubMed
11.
Benazzo F, Cadossi M, Cavani F, Fini M, Giavaresi G, Setti S et al (2008) Cartilage repair with osteochondral autografts in sheep: effect of biophysical stimulation with pulsed electromagnetic fields. J Orthop Res 26:631–642CrossRefPubMed
12.
De Mattei M, Pellati A, Pasello M, Ongaro A, Setti S, Massari L et al (2004) Effects of physical stimulation with electromagnetic field and insulin growth factor-I treatment on proteoglycan synthesis of bovine articular cartilage. Osteoarthr Cartil 12:793–800CrossRefPubMed
13.
Jahns ME, Lou E, Durdle NG, Bagnall K, Raso VJ, Cinats D et al (2007) The effect of pulsed electromagnetic fields on chondrocyte morphology. Med Biol Eng Comput 45:917–925CrossRefPubMed
14.
Ongaro A, Varani K, Masieri FF, Pellati A, Massari L, Cadossi R et al (2012) Electromagnetic fields (EMFs) and adenosine receptors modulate prostaglandin E(2) and cytokine release in human osteoarthritic synovial fibroblasts. J Cell Physiol 227:2461–2469CrossRefPubMed
15.
Sakkas LI, Scanzello C, Johanson N, Burkholder J, Mitra A, Salgame P et al (1998) T cells and T-cell cytokine transcripts in the synovial membrane in patients with osteoarthritis. Clin Diagn Lab Immunol 5:430–437PubMedPubMedCentral
16.
De Mattei M, Varani K, Masieri FF, Pellati A, Ongaro A, Fini M et al (2009) Adenosine analogs and electromagnetic fields inhibit prostaglandin E2 release in bovine synovial fibroblasts. Osteoarthr Cartil 17:252–262CrossRefPubMed
17.
Varani K, De Mattei M, Vincenzi F, Gessi S, Merighi S, Pellati A et al (2008) Characterization of adenosine receptors in bovine chondrocytes and fibroblast-like synoviocytes exposed to low frequency low energy pulsed electromagnetic fields. Osteoarthr Cartil 16:292–304CrossRefPubMed
18.
Varani K, Vincenzi F, Ravani A, Pasquini S, Merighi S, Gessi S, et al. (2017) Adenosine receptors as a biological pathway for the anti-inflammatory and beneficial effects of low frequency low energy pulsed electromagnetic fields. Mediat Inflamm 2017. doi:10.​1155/​2017/​2740963
19.
Zorzi C, Dall’Oca C, Cadossi R, Setti S (2007) Effects of pulsed electromagnetic fields on patients’ recovery after arthroscopic surgery: prospective, randomized and double-blind study. Knee Surg Sports Traumatol Arthrosc 15:830–834CrossRefPubMed
20.
Cadossi M, Buda RE, Ramponi L, Sambri A, Natali S, Giannini S (2014) Bone marrow-derived cells and biophysical stimulation for talar osteochondral lesions: a randomized controlled study. Foot Ankle Int 35:981–987CrossRefPubMed
21.
Filardo G, Kon E, Di Martino A, Iacono F, Marcacci M (2011) Arthroscopic second-generation autologous chondrocyte implantation: a prospective 7-year follow-up study. Am J Sports Med 39:2153–2160CrossRefPubMed
22.
Outerbridge RE, Dunlop JA (1975) The problem of chondromalacia patellae. Clin Orthop Relat Res (110):177–196
23.
Colebatch AN, Hart DJ, Zhai G, Williams FM, Spector TD, Arden NK (2009) Effective measurement of knee alignment using AP knee radiographs. Knee 16:42–45CrossRefPubMed
24.
Marcacci M, Zaffagnini S, Kon E, Visani A, Iacono F, Loreti I (2002) Arthroscopic autologous chondrocyte transplantation: technical note. Knee Surg Sports Traumatol Arthrosc 10:154–159CrossRefPubMed
25.
26.
Ciombor DM, Aaron RK, Wang S, Simon B (2003) Modification of osteoarthritis by pulsed electromagnetic field–a morphological study. Osteoarthr Cartil 11:455–462CrossRefPubMed
27.
Cadossi M, Chiarello E, Savarino L, Tedesco G, Baldini N, Faldini C et al (2013) A comparison of hemiarthroplasty with a novel polycarbonate-urethane acetabular component for displaced intracapsular fractures of the femoral neck: a randomised controlled trial in elderly patients. Bone Joint J 95-B(5):609–615CrossRefPubMed
28.
Servodio Iammarrone C, Cadossi M, Sambri A, Grosso E, Corrado B, Servodio Iammarrone F (2016) Is there a role of pulsed electromagnetic fields in management of patellofemoral pain syndrome? Randomized controlled study at one year follow-up. Bioelectromagnetics 37:81–88CrossRefPubMed
29.
Kon E, Filardo G, Condello V, Collarile M, Di Martino A, Zorzi C et al (2011) Second-generation autologous chondrocyte implantation: results in patients older than 40 years. Am J Sports Med 39:1668–1675CrossRefPubMed
30.
Benazzo F, Zanon G, Pederzini L, Modonesi F, Cardile C, Falez F et al (2008) Effects of biophysical stimulation in patients undergoing arthroscopic reconstruction of anterior cruciate ligament: prospective, randomized and double blind study. Knee Surg Sports Traumatol Arthrosc 16:595–601CrossRefPubMedPubMedCentral
31.
Rossini M, Viapiana O, Gatti D, de Terlizzi F, Adami S (2010) Capacitively coupled electric field for pain relief in patients with vertebral fractures and chronic pain. Clin Orthop Relat Res 468:735–740CrossRefPubMed
32.
Wright JG, Swiontkowski MF, Heckman JD (2003) Introducing levels of evidence to the journal. J Bone Joint Surg Am 85-A(1):1–3CrossRefPubMed
33.
34.
Niethammer TR, Pietschmann MF, Horng A, Rossbach BP, Ficklscherer A, Jansson V et al (2014) Graft hypertrophy of matrix-based autologous chondrocyte implantation: a two-year follow-up study of NOVOCART 3D implantation in the knee. Knee Surg Sports Traumatol Arthrosc 22:1329–1336CrossRefPubMed
35.
Zak L, Albrecht C, Wondrasch B, Widhalm H, Vekszler G, Trattnig S et al (2014) Results 2 years after matrix-associated autologous chondrocyte transplantation using the Novocart 3D scaffold: an analysis of clinical and radiological data. Am J Sports Med 42:1618–1627CrossRefPubMed
36.
Zaslav K, Cole B, Brewster R, DeBerardino T, Farr J, Fowler P et al (2009) A prospective study of autologous chondrocyte implantation in patients with failed prior treatment for articular cartilage defect of the knee: results of the study of the treatment of articular repair (STAR) clinical trial. Am J Sports Med 37:42–55CrossRefPubMed
Metadata
Title
Biophysical stimulation improves clinical results of matrix-assisted autologous chondrocyte implantation in the treatment of chondral lesions of the knee
Authors
Marco Collarile
Andrea Sambri
Giada Lullini
Matteo Cadossi
Claudio Zorzi
Publication date
01-04-2018
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2018
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-017-4605-8

Other articles of this Issue 4/2018

Knee Surgery, Sports Traumatology, Arthroscopy 4/2018 Go to the issue

Knee

Medial meniscal and chondral pathology at the time of revision anterior cruciate ligament reconstruction results in inferior mid-term patient-reported outcomes

Knee

Medial meniscal extrusion: a validation study comparing different methods of assessment

Knee

Anterior cruciate ligament graft fixation first in anterior and posterior cruciate ligament reconstruction best restores knee kinematics

Knee

Anterior meniscopexy: a meniscal sparing technique for the treatment of locking but intact discoid lateral meniscus

Knee

Good clinical results with autologous matrix-induced chondrogenesis (Amic) technique in large knee chondral defects

Knee

Surgical reconstruction is a cost-efficient treatment option for isolated PCL injuries