Treatment of cartilage defects in the knee using alginate beads containing human mature allogenic chondrocytes.
BACKGROUND
The repair of osteochondral lesions is imperfect and transient; chondral lesions do not heal in mature cartilage. Attempts have been made to restore cartilage lesions by filling the defects with a temporary artificial biocompatible matrix.


OBJECTIVE
To determine whether the implantation of alginate beads containing human mature allogenic chondrocytes is feasible and safe for the treatment of symptomatic cartilage defects in the knee.


METHODS
Case series; Level of evidence, 4.


METHODS
A biodegradable, alginate-based, biocompatible scaffold containing human mature allogenic chondrocytes was used for the treatment of chondral and osteochondral lesions in the knee. Twenty-one patients were clinically and prospectively evaluated with use of the Western Ontario and McMaster Universities Osteoarthritis Index and a visual analog scale for pain preoperatively and at 3, 6, 9, 12, 18, and 24 months of follow-up. Of the 21 patients, 13 consented to having a biopsy sample taken for investigative purposes from the area of implantation at 12 months of follow-up, allowing histologic assessment of the repair tissue.


RESULTS
A statistically significant clinical improvement became apparent after 6 months, and patients improved during the 24 months of follow-up. Adverse reactions to the alginate/fibrin matrix seeded with the allogenic cartilage cells were not observed. Histologic analysis of the biopsy specimens rated the repair tissue as hyaline-like in 15.3% of the samples, as mixed tissue in 46.2%, as fibrocartilage in 30.8%, and as fibrous in 7.7%.


CONCLUSIONS
The results of this short-term pilot study show that the alginate-based scaffold containing human mature allogenic chondrocytes is feasible and safe for the treatment of symptomatic cartilage defects of the knee. The described technique provides clinical and histologic outcomes that are equal but not superior to those of other cartilage repair techniques.
Almqvist
Karl Fredrik
KF
Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, Ghent, Belgium. fredrik.almqvist@ugent.be
Dhollander
Aad A M
AA
Verdonk
Peter C M
PC
Forsyth
Ramses
R
Verdonk
René
R
Verbruggen
Gust
G
D000293:Adolescent; D000328:Adult; D000464:Alginates / Q000627:therapeutic use*; D001672:Biocompatible Materials / Q000627:therapeutic use*; D002358:Cartilage, Articular / Q000293:injuries; D002478:Cells, Cultured; D002648:Child; D019902:Chondrocytes / Q000637:transplantation*; D005260:Female; D020723:Glucuronic Acid / Q000627:therapeutic use; D006603:Hexuronic Acids / Q000627:therapeutic use; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D054457:Tissue Scaffolds; D014184:Transplantation, Homologous; D055815:Young Adult
D000464:Alginates; D001672:Biocompatible Materials; D006603:Hexuronic Acids; D020723:Glucuronic Acid