Marrow stimulation and chondrocyte transplantation using a collagen matrix for cartilage repair.
OBJECTIVE
The purpose of the study was to determine whether the implantation of a scaffold would facilitate cartilage repair after microfracture in sheep over a period of 12 months. Furthermore, we investigated the effect of additional autologous cell augmentation of the implanted constructs.


METHODS
Two chondral defects were produced in the medial femoral condyle of sheep without penetrating the subchondral bone. Twenty-seven sheep were divided into the following groups: seven served as untreated controls (Group 1), microfracture was created in 20 animals, seven of them without further treatment (Group 2), in six sheep the defects were additionally covered with a porcine collagen matrix (Group 3), and in seven animals the matrix was augmented with cultured autologous chondrocytes (Group 4). After 4 (11 sheep) and 12 months (16 sheep), the filling of the defects, tissue types, and semiquantitative scores were determined.


RESULTS
The untreated defects revealed the least amount of defect fill. Defects treated with microfractures achieved better defect fill, while the additional use of the matrix did not increase the defect fill. The largest quantity of reparative tissue was found in the cell-augmented group. Semiquantitative scores were best in the cell-augmented group.


CONCLUSIONS
Microfracture treatment was observed to enhance the healing response. The implantation of a cell-seeded matrix further improved the outcome. The implantation of a collagen matrix alone did not enhance repair. Autologous cell implantation appears to be a very important aspect of the tissue engineering approach to cartilage defects.
Dorotka
R
R
Medical University of Vienna, Department of Orthopedic Surgery, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Bindreiter
U
U
Macfelda
K
K
Windberger
U
U
Nehrer
S
S
D000818:Animals; D001853:Bone Marrow / Q000503:physiopathology*; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery*; D019902:Chondrocytes / Q000637:transplantation*; D003094:Collagen; D004195:Disease Models, Animal; D005264:Femoral Fractures / Q000601:surgery*; D017102:Fracture Healing / Q000502:physiology; D007150:Immunohistochemistry / Q000379:methods; D012756:Sheep; D023822:Tissue Engineering / Q000379:methods
D003094:Collagen