title: Clinical feasibility of a novel biphasic osteochondral composite for matrix-associated autologous chondrocyte implantation.
abstract: OBJECTIVE
  Matrix-associated autologous chondrocyte implantation has been used to treat cartilage defects. We developed a biphasic cylindrical osteochondral composite construct for such use, and conducted this study to determine its feasibility for treating osteochondral lesions in human knees.
  
  
  METHODS
  Ten patients with symptomatic osteochondral lesions at femoral condyles were treated by replacing pathological tissue with the construct of dl-poly-lactide-co-glycolide, whose lower body was impregnated with β-tricalcium phosphate and served as osseous phase. The construct had a chamber to load double-minced autologous cartilage, serving as source of chondrocytes. Osteochondral lesion was drill-fashioned a pit of identical dimension as the construct. Chondrocyte-laden construct was press-fit to fill the pit. Postoperative outcome was evaluated using Knee Injury and Osteoarthritis Outcome Score (KOOS) scale up to 24 months. Magnetic resonance image was taken, and sample tissue was collected with second-look arthroscopic needle biopsy at 12 months. Outcome parameters were primarily safety of surgery, and secondarily postoperative change in KOOS and regeneration of hyaline cartilage and cancellous bone.
  
  
  RESULTS
  No patient experienced serious adverse events. Postoperative mean KOOS in "symptoms" subscale had not changed significantly from pre-operation until 24 months; whereas those in the other four subscales were significantly higher than pre-operation at 12 and 24 months. Second-look arthroscopy showed completely filled grafted sites, with regenerate cartilaginous surfaces flushed with surrounding native joint surface. Microscopically, regenerated cartilage appeared hyaline.
  
  
  CONCLUSIONS
  This novel construct for chondrocyte implantation is safe for surgical application in knee. It repairs osteochondral lesions of femoral condyles by successful regeneration of hyaline cartilage.
authors: National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors: H
authors: H
authors: Chiang
authors: C-J
authors: CJ
authors: Liao
authors: C-H
authors: CH
authors: Hsieh
authors: C-Y
authors: CY
authors: Shen
authors: Y-Y
authors: YY
authors: Huang
authors: C-C
authors: CC
authors: Jiang
mesh_terms: D000328:Adult; D001182:Arthroscopy; D001861:Bone Regeneration / Q000502:physiology; D002358:Cartilage, Articular / Q000293:injuries / Q000473:pathology / Q000502:physiology; D019902:Chondrocytes / Q000637:transplantation*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D007719:Knee Joint / Q000473:pathology / Q000502:physiology / Q000601:surgery*; D019344:Lactic Acid; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010008:Osteochondritis Dissecans / Q000601:surgery; D011100:Polyglycolic Acid; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011183:Postoperative Complications; D012038:Regeneration; D012720:Severity of Illness Index; D023822:Tissue Engineering / Q000379:methods; D054457:Tissue Scaffolds; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011100:Polyglycolic Acid; D019344:Lactic Acid