title: A histological comparison of the repair tissue formed when using either Chondrogide(®) or periosteum during autologous chondrocyte implantation.
abstract: OBJECTIVE
  In this study, we compare the clinical and histological outcome between periosteum and Chondrogide(®) during autologous chondrocyte implantation (ACI).
  
  
  METHODS
  This study consisted of 88 patients having received ACI in the knee; 33 treated with Chondrogide(®) (ACI-C) and 55 with periosteum (ACI-P). Post-operative biopsies were taken at a mean of 16.6 ± 8 months (range 7-37 months) and 19 ± 18.4 months (range 4-114) for ACI-C and ACI-P respectively. Histological assessment was performed using the ICRS II and OsScore scoring systems. The immunolocalisation of elastin and collagen types I and II was analysed using specific antibodies. Lysholm scores, a measure of knee function, were obtained pre- and post-operatively at the time of biopsy and annually thereafter.
  
  
  RESULTS
  Compared with ACI-P, the repair tissue formed from patients treated with ACI-C demonstrated a significantly higher score for cellular morphology (ICRS II score), significantly better surface morphology from medial femoral condyle treated defects (ICRS II score) and a significantly higher proportion of hyaline cartilage formation (OsScore). Elastin fibres were present in both ACI-C and ACI-P samples, although their presence was very variable in quantity, distribution, orientation, thickness and length. Patients treated with ACI-C demonstrated significantly more collagen type II immunolocalisation compared with ACI-P. Both groups exhibited a significant increase in Lysholm score post-ACI.
  
  
  CONCLUSIONS
  This study demonstrates a significantly better quality of repair tissue formed with ACI-C compared with ACI-P. Hence Chondrogide(®) is perhaps a better alternative to periosteum during ACI.
authors.affiliation: Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Trust and ISTM, Keele University, Oswestry, Shropshire SY10 7AG, UK. Electronic address: Helen.mccarthy@rjah.nhs.uk.
authors.forename: H S
authors.initials: HS
authors.lastname: McCarthy
authors.forename: S
authors.initials: S
authors.lastname: Roberts
mesh_terms: D000328:Adult; D054544:Arthroplasty, Subchondral / Q000379:methods*; D001672:Biocompatible Materials / Q000627:therapeutic use*; D002357:Cartilage Diseases / Q000601:surgery*; D002358:Cartilage, Articular / Q000473:pathology*; D019902:Chondrocytes / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010521:Periosteum / Q000637:transplantation*; D012189:Retrospective Studies; D014182:Transplantation, Autologous / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D001672:Biocompatible Materials
keywords: Autologous chondrocyte implantation; Cartilage repair; Chondrogide(®); Histology; Periosteum