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.
Department of Orthopedic Surgery, Maastricht University Medical Centre, Maastricht, 6200 MD, Netherlands. Pj.Emans@orthop.unimaas.nl
Pieter J
PJ
Emans
Lodewijk W
LW
van Rhijn
Tim J M
TJ
Welting
Andy
A
Cremers
Nina
N
Wijnands
Frank
F
Spaapen
J Willem
JW
Voncken
V Prasad
VP
Shastri
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