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Solid agarose-alginate scaffold enhances autologous chondrocyte implantation
Cartipatch aided in-vitro chondrocyte differentiation, researchers said.
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INNSBRUCK, Austria — A solid scaffold implant showed improved subjective scores and MRIs in a French two-year prospective multicenter phase 2 clinical study.
Cartipatch (TBF Tissue Engineering; Bron, France) is a solid scaffold with an agarose-alginate matrix designed to ease surgical procedures and let chondrocytes differentiate in vitro, reported lead author Philippe Neyret, MD. The authors presented their findings in a poster presentation here at the 12th ESSKA Congress.
The matrix is designed to facilitate chondrocyte growth in lesions of the femoral condyle.
“Stabilization, distribution and phenotype of transplanted cells in articular defects remain a technical problem for ACI,” the authors wrote in their abstract.
The study group comprised 17 patients with a mean age of 28.9 years (range 17 to 42 years). The study included patients with one isolated femoral lesion. Surgeons took cartilage biopsies from the injured knees to get autologous chondrocytes.
Researchers multiplied the cells in a monolayer culture for 3 weeks and seeded in hydrogel matrix to produce cylindrical grafts 10 mm, 14 mm and 18 mm in diameter.
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| Image: Neyret P, AitSiSelmi T. | Image: TBF Tissue Engineering |
Knee scores rise
The grafts incubated for an additional 14 days and were implanted as a mosaic press-fit to fill the lesion, the authors said. Surgery took a maximum of 1 hour, with no sutures. Researchers evaluated the patients’ International Knee Documentation Committee (IKDC) scores, arthroscopically evaluated biopsies and took MRIs at one-year postop, the authors said.
When patients were included in the study, their average IKDC score was 36.3 (range 18 to 64). At 12 months follow-up, the average IKDC score improved to 75.4 (range 39 to 97), and 94% of patients had improved their scores.
What a difference a year makes
The authors also noted a slight improvement in the mean score between 1 and 2-year follow-ups.
The average grafted area was 3.2 cm, and researchers used 1.9 grafts per patient. Arthroscopies and biopsies showed healthy cartilage and subchondral bone at 2 years, the investigators said.
“Arthroscopic looks at 2 years showed mostly a white and smooth repair tissue,” they wrote. “Biopsies confirmed a well-integrated cartilage tissue to the subchondral bone, and immunohistochemistry showed collagen II and aggrecan impregnation of cartilage.”
They added: “This modification of standard ACI technique showed significant clinical improvement at 2 years follow-up. Biopsies and arthroscopic evaluation were encouraging.”
Cartipatch is designed for both cartilage and deep subchondral lesions, according to Sophie Mathonnière, export product manager for TBF Tissue Engineering.
The scaffold’s 3-D environment also helps spur good cell differentiation, she told Orthopaedics Today.
Image: TBF Tissue Engineering |
For more information:
- Neyret P, Ait Si Selmi T, Bussiere C, et al. A solid implant to optimize autologous chondrocyle implantation: Cartipatch. Poster presentation P-430. Presented at the 12th ESSKA Congress and 5th World Congress on Sports Trauma. May 24-27, 2006. Innsbruck, Austria.
- Orthopaedics Today was unable to determine whether the physician-author has a direct financial interest in the products discussed in this article or if he is a paid consultant for any companies mentioned.