Repair of full-thickness articular cartilage defects using injectable type II collagen gel embedded with cultured chondrocytes in a rabbit model.
BACKGROUND
Recently, tissue-engineered chondrocyte transplantation has been tried to treat full-thickness cartilage defects. We developed an injectable type II collagen gel scaffold by chemically reacting type II collagen with polyethylene glycol crosslinker. This type II collagen was prepared from the nasal septa of cattle. In the present study, chondrocytes embedded in type II collagen gel were injected into rabbit full-thickness cartilage defects without a periosteal graft, and the feasibility for clinical application of the gel was evaluated.


METHODS
Chondrocytes were isolated from 1-kg New Zealand white rabbits. A full-thickness articular cartilage defect (5 mm diameter, 4 mm depth) was created on the patellar groove of the femur of 16 male 3-kg New Zealand white rabbits. A type II collagen solution of mixed chondrocytes at a density of 1 x 10(7) cells/ml was injected and transplanted into the defect in the right knee. The controls were the defect only in the left knee. At 4, 8, 12, and 24 weeks after operation, four cases from each group were evaluated macroscopically and histologically.


RESULTS
After injection into the cartilage defect, the gel bonded to the adjacent cartilage and bone within several minutes. Macroscopic examination revealed that the surface of the transplanted area was smooth and exhibited similar coloration and good integration with the surrounding cartilage at 12 and 24 weeks after transplantation. Histological examination at 8 weeks revealed favorable hyaline cartilage regeneration with good chondrocyte morphology. At 12 and 24 weeks, reparative cartilage remained rich in type II collagen. According to O'Driscoll histological scores, significant differences between the transplanted and control groups were apparent at 12 and 24 weeks. Immunohistochemical staining indicated sufficient type II collagen synthesis in regenerated cartilage 8 weeks after transplantation, and it was maintained until 24 weeks.


CONCLUSIONS
These results indicate that type II collagen gel is suitable for injection into cartilage defects without any covering of a graft and offers a useful scaffold during chondrocyte transplantation.
Department of Orthopedic Surgery, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan.
Atsushi
A
Funayama
Yasuo
Y
Niki
Hideo
H
Matsumoto
Shinichi
S
Maeno
Taku
T
Yatabe
Hideo
H
Morioka
Shigeru
S
Yanagimoto
Tetsushi
T
Taguchi
Junzo
J
Tanaka
Yoshiaki
Y
Toyama
D000818:Animals; D002417:Cattle; D019902:Chondrocytes / Q000637:transplantation*; D024043:Collagen Type II / Q000302:isolation & purification / Q000627:therapeutic use*; D004195:Disease Models, Animal; D005782:Gels; D051457:Hyaline Cartilage / Q000293:injuries / Q000637:transplantation*; D007270:Injections, Intra-Articular; D008297:Male; D011817:Rabbits; D054457:Tissue Scaffolds; D014180:Transplantation / Q000379:methods; D019737:Transplants
D024043:Collagen Type II; D005782:Gels