title: One-stage focal cartilage defect treatment with bone marrow mononuclear cells and chondrocytes leads to better macroscopic cartilage regeneration compared to microfracture in goats.
abstract: OBJECTIVE
  The combination of chondrocytes and mononuclear fraction (MNF) cells might solve the expansion induced dedifferentiation problem of reimplanted cells in autologous chondrocytes implantation as sufficient cells would be available for direct, one-stage, implantation. Earlier in vitro work already showed a positive stimulation of cartilage specific matrix production when chondrocytes and MNF cells were combined. Therefore, this study aimed to evaluate cartilage regeneration using a one-stage procedure combining MNF cells and primary chondrocytes for the treatment of focal cartilage lesions in goats compared to microfracture treatment.
  
  
  METHODS
  Freshly created focal cartilage defects were treated with either a combination of chondrocytes and MNF cells embedded in fibrin glue or microfracture treatment. After 6 months follow-up local regeneration as well as the general joint cartilage health were evaluated using validated scores and biochemical assays.
  
  
  RESULTS
  Macroscopic (P = 0.015) scores for the cartilage surface at the treated defect were, after 6 months, significantly higher for the chondrocyteMNF treatment compared to microfracture-treated defects, but microscopic scores were not (P = 0.067). The articulating cartilage showed more (P = 0.005) degeneration following microfracture treatment compared to chondrocyteMNF treatment. Biochemical glycosaminoglycans (GAG) evaluation did not reveal differences between the treatments. Both treatments had resulted in a slight to moderate cartilage degeneration at other locations in the joint.
  
  
  CONCLUSIONS
  In conclusion, treatment of focal articular cartilage lesions in goats using a combination of MNF cells from bone marrow and unexpanded chondrocytes leads to better macroscopic regeneration compared to microfracture, however needs further fine-tuning to decrease the negative influence on other joint compartments.
authors.affiliation: Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands. j.bekkers@umcutrecht.nl
authors.forename: J E J
authors.initials: JE
authors.lastname: Bekkers
authors.forename: L B
authors.initials: LB
authors.lastname: Creemers
authors.forename: A I
authors.initials: AI
authors.lastname: Tsuchida
authors.forename: M H P
authors.initials: MH
authors.lastname: van Rijen
authors.forename: R J H
authors.initials: RJ
authors.lastname: Custers
authors.forename: W J A
authors.initials: WJ
authors.lastname: Dhert
authors.forename: D B F
authors.initials: DB
authors.lastname: Saris
mesh_terms: D000818:Animals; D016026:Bone Marrow Transplantation / Q000379:methods*; D002358:Cartilage, Articular / Q000502:physiology / Q000601:surgery*; D019902:Chondrocytes / Q000637:transplantation*; D005500:Follow-Up Studies; D006025:Glycosaminoglycans / Q000378:metabolism; D006041:Goats; D019637:Orthopedic Procedures / Q000379:methods*; D012038:Regeneration / Q000502:physiology; D013264:Stifle / Q000502:physiology / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D006025:Glycosaminoglycans