Treatment of focal degenerative cartilage defects with polymer-based autologous chondrocyte grafts: four-year clinical results

被引:119
作者
Kreuz, Peter C. [3 ]
Mueller, Sebastian [2 ]
Ossendorf, Christian [2 ]
Kaps, Christian [1 ]
Erggelet, Christoph [2 ]
机构
[1] Charite Univ Med Berlin, Dept Rheumatol, D-10117 Berlin, Germany
[2] Univ Med Ctr Freiburg, Dept Traumat & Orthopaed Surg, D-79106 Freiburg, Germany
[3] Tech Univ Munich, Univ Med Ctr Rechts Isar, Dept Traumat & Orthopaed Surg, D-81675 Munich, Germany
关键词
THICKNESS CHONDRAL DEFECTS; ARTICULAR-CARTILAGE; KNEE ARTHROSCOPIES; FOLLOW-UP; OSTEOCHONDRAL DEFECTS; PERFUSION CULTURE; GENE-EXPRESSION; SYNOVIAL-FLUID; GROWTH-FACTORS; IMPLANTATION;
D O I
10.1186/ar2638
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction Second-generation autologous chondrocyte implantation with scaffolds stabilizing the grafts is a clinically effective procedure for cartilage repair. In this ongoing prospective observational case report study, we evaluated the effectiveness of BioSeed (R)-C, a cell-based cartilage graft based on autologous chondrocytes embedded in fibrin and a stable resorbable polymer scaffold, for the treatment of clinical symptomatic focal degenerative defects of the knee. Methods Clinical outcome after 4-year clinical follow-up was assessed in 19 patients with preoperatively radiologically confirmed osteoarthritis and a Kellgren-Lawrence score of 2 or more. Clinical scoring was performed before implantation of the graft and 6, 12, and 48 months after implantation using the Lysholm score, the Knee injury and Osteoarthritis Outcome Score (KOOS), the International Knee Documentation Committee (IKDC) score, and the International Cartilage Repair Society (ICRS) score. Cartilage regeneration and articular resurfacing were assessed by magnetic resonance imaging (MRI) 4 years after implantation of the autologous cartilage graft. Results Significant improvement (P < 0.05) of the Lysholm and ICRS scores was observed as early as 6 months after implantation of BioSeed (R)-C and remained stable during follow-up. The IKDC score showed significant improvement compared with the preoperative situation at 12 and 48 months (P < 0.05). The KOOS showed significant improvement in the subclasses pain, activities of daily living, and knee-related quality of life 6 months as well as 1 and 4 years after implantation of BioSeed (R)-C in osteoarthritic defects (P < 0.05). MRI analysis showed moderate to complete defect filling with a normal to incidentally hyperintense signal in 16 out of 19 patients treated with BioSeed (R)-C. Two patients without improvement in the clinical and MRI scores received a total knee endoprosthesis after 4 years. Conclusions The results show that the good clinical outcome achieved 1 year after implantation of BioSeed (R)-C remains stable over the course of a period of 4 years and suggest that implanting BioSeed (R)-C is a promising treatment option for the repair of focal degenerative defects of the knee.
引用
收藏
页数:11
相关论文
共 56 条
[1]  
[Anonymous], 2006, COCHRANE DB SYST REV
[2]   Cartilage healing after microfracture in osteoarthritic knees [J].
Bae, DK ;
Yoon, KH ;
Song, SJ .
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 2006, 22 (04) :367-374
[3]   Treatment of articular cartilage defects in horses with polymer-based cartilage tissue engineering grafts [J].
Barnewitz, D ;
Endres, M ;
Krüger, I ;
Becker, A ;
Zimmermann, M ;
Wilke, I ;
Ringe, J ;
Sittinger, M ;
Kaps, C .
BIOMATERIALS, 2006, 27 (14) :2882-2889
[4]   Autologous chondrocyte implantation versus matrix-induced autologous chondrocyte implantation for osteochondral defects of the knee [J].
Bartlett, W ;
Skinner, JA ;
Gooding, CR ;
Carrington, RWJ ;
Flanagan, AM ;
Briggs, TWR ;
Bentley, G .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2005, 87B (05) :640-645
[5]   Matrix-associated autologous chondrocyte transplantation/implantation (MACT/MACI) - 5-year follow-up [J].
Behrens, Peter ;
Bitter, Thomas ;
Kurz, Bodo ;
Russlies, Martin .
KNEE, 2006, 13 (03) :194-202
[6]   TREATMENT OF DEEP CARTILAGE DEFECTS IN THE KNEE WITH AUTOLOGOUS CHONDROCYTE TRANSPLANTATION [J].
BRITTBERG, M ;
LINDAHL, A ;
NILSSON, A ;
OHLSSON, C ;
ISAKSSON, O ;
PETERSON, L .
NEW ENGLAND JOURNAL OF MEDICINE, 1994, 331 (14) :889-895
[7]   Autologous chondrocyte implantation-technique and long-term follow-up [J].
Brittberg, Mats .
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 2008, 39 :S40-S49
[8]  
Browne JE, 2005, CLIN ORTHOP RELAT R, P237, DOI 10.1097/01.blo.0000164298.63534.64
[9]   ENGINEERING OF CARTILAGE TISSUE USING BIORESORBABLE POLYMER FLEECES AND PERFUSION CULTURE [J].
BUJIA, J ;
SITTINGER, M ;
MINUTH, WW ;
HAMMER, C ;
BURMESTER, G ;
KASTENBAUER, E .
ACTA OTO-LARYNGOLOGICA, 1995, 115 (02) :307-310
[10]   Cartilage injuries: A review of 31,516 knee arthroscopies [J].
Curl, WW ;
Krome, J ;
Gordon, ES ;
Rushing, J ;
Smith, BP ;
Poehling, GG .
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 1997, 13 (04) :456-460