title: Is the transplant quality at the time of surgery adequate for matrix-guided autologous cartilage transplantation? A pilot study.
abstract: BACKGROUND
  Matrix-guided autologous chondrocyte transplantation (MACT) has been proposed as an option for treating large full-thickness cartilage defects. However, little is known about the chondrogenic potential of transplants for MACT at the time of implantation, although cell quality and chondrogenic differentiation of the implants are crucial for restoration of function after MACT.
  
  
  OBJECTIVE
  We therefore asked: (1) Do MACT implants allow deposition of extracellular cartilage matrix in an in vitro culture model? (2) Are these implants associated with improved knee function 1 year after MACT in large cartilage defects?
  
  
  METHODS
  We retrospectively reviewed all 125 patients with large localized cartilage defects (mean defect size 5 cm(2)) of the knee who were treated with MACT from 2005 to 2010. The mean age was 31 years (range, 16-53 years). Portions of the cell-matrix constructs (n = 50) that were not implanted in the cartilage defects were further cultured and tested for their potential to form articular cartilage. Knee function of all patients was analyzed preoperatively, 3 months, and 1 year postoperatively with the International Knee Documentation Committee (IKDC) score.
  
  
  RESULTS
  In vitro assessment of the cell-matrix implants showed chondrogenic differentiation with positive staining for glycosaminoglycans and collagen II in all cultures. Enzyme-linked immunosorbent assay showed an increase of collagen II production. We observed an improvement in median IKDC score from 41 to 67 points at last followup.
  
  
  CONCLUSIONS
  Cartilage extracellular matrix deposition shows adequate implant quality for MACT at the time of implantation and justifies the use for treatment of large cartilage defects.
authors.affiliation: Department of Trauma Surgery, University Hospital of Regensburg, Franz-Josef-Strauss-Allee 11, 93042, Regensburg, Germany. johannes.zellner@klinik.uni-regensburg.de
authors.forename: Johannes
authors.initials: J
authors.lastname: Zellner
authors.forename: Peter
authors.initials: P
authors.lastname: Angele
authors.forename: Florian
authors.initials: F
authors.lastname: Zeman
authors.forename: Richard
authors.initials: R
authors.lastname: Kujat
authors.forename: Michael
authors.initials: M
authors.lastname: Nerlich
mesh_terms: D000293:Adolescent; D000328:Adult; D002356:Cartilage / Q000378:metabolism / Q000637:transplantation*; D002358:Cartilage, Articular / Q000378:metabolism*; D020219:Chondrogenesis / Q000502:physiology*; D024043:Collagen Type II / Q000378:metabolism; D005109:Extracellular Matrix / Q000378:metabolism; D005260:Female; D006025:Glycosaminoglycans / Q000378:metabolism; D006801:Humans; D007719:Knee Joint / Q000378:metabolism / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012189:Retrospective Studies; D014182:Transplantation, Autologous
chemical_list: D024043:Collagen Type II; D006025:Glycosaminoglycans
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