Autologous engineering of cartilage.
Treatment of full-thickness damage to hyaline cartilage is hampered by the limited availability of autologous healthy cartilage and the lengthy, cost-prohibitive cell isolation and expansion steps associated with autologous cartilage implantation (ACI). Here we report a strategy for de novo engineering of ectopic autologous cartilage (EAC) within the subperiosteal space (in vivo bioreactor), through the mere introduction of a biocompatible gel that might promote hypoxia-mediated chondrogenesis, thereby effectively overcoming the aforementioned limitations. The EAC is obtained within 3 wk post injection of the gel, and can be press-fit into an osteochondral defect where it undergoes remodeling with good lateral and subchondral integration. The implanted EAC showed no calcification even after 9 mo and attained an average O'Driscoll score of 11 (versus 4 for controls). An "on demand" autologous source of autologous cartilage with remodeling capacity is expected to significantly impact the clinical options in repair of trauma to articular cartilage.
Emans
Pieter J
PJ
Department of Orthopedic Surgery, Maastricht University Medical Centre, Maastricht, 6200 MD, Netherlands. Pj.Emans@orthop.unimaas.nl
van Rhijn
Lodewijk W
LW
Welting
Tim J M
TJ
Cremers
Andy
A
Wijnands
Nina
N
Spaapen
Frank
F
Voncken
J Willem
JW
Shastri
V Prasad
VP
D000693:Anaerobiosis; D000818:Animals; D019149:Bioreactors; D002358:Cartilage, Articular / Q000166:cytology / Q000254:growth & development* / Q000378:metabolism; D015687:Cell Hypoxia; D020219:Chondrogenesis; D024043:Collagen Type II / Q000096:biosynthesis; D010007:Osteochondritis / Q000601:surgery; D011817:Rabbits; D023822:Tissue Engineering / Q000379:methods*; D016378:Tissue Transplantation
D024043:Collagen Type II