Challenging for cartilage repair

Mitsuo Ochi

doi:10.1186/1758-2555-1-13

Abstract

Editorial When we look back on the past 15-year history of cartilage repair, it is clear that remarkable progress has been made in this area. There is no doubt that a lot of studies have been carried out on cartilage repair and chondrocytes since Brittebergs' report on ACI in 1994 [1]. I would like to introduce our multi-pronged approach to cartilage repair. After the 1994 report [1], we performed implantation of tissue-engineered cartilage made ex vivo for the treatment of osteochondral defects of the joints, to avoid the leakage of grafted cultured chondrocytes in suspension [2,3]. Sixty knees of 57 patients with full-thickness cartilage defects were followed-up over 5 years. The clinical rating improved significantly after implantation of tissue-engineered cartilage and was maintained for an average of 8.3 years. The arthroscopic findings 2 years after implantation were graded as normal or nearly normal according to the ICRS scale in more than 90% of patients. Biomechanically, stiffness of the graft almost equaled the surrounding normal cartilage (87.9 ~102.5%) 2 years after implantation.

Highlights

When we look back on the past 15-year history of cartilage repair, it is clear that remarkable progress has been made in this area
There is no doubt that a lot of studies have been carried out on cartilage repair and chondrocytes since Brittebergs' report on ACI in 1994 [1]
In order to reduce this early stage overload, we have developed external fixators which allow almost full ROM with joint distraction for clinical cases, based on an animal study [6]. This apparatus has been successfully used for 12 patients, each with a large cartilage defect [7]. Another weak point is a small number of mesenchymal stem cells obtained from drilled holes which are used for chondrogenesis

Summary

Introduction

When we look back on the past 15-year history of cartilage repair, it is clear that remarkable progress has been made in this area. Published: 14 July 2009 Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology 2009, 1:13 doi:10.1186/1758-2555-1-13 After the 1994 report [1], we performed implantation of tissue-engineered cartilage made ex vivo for the treatment of osteochondral defects of the joints, to avoid the leakage of grafted cultured chondrocytes in suspension [2,3]. Sixty knees of 57 patients with full-thickness cartilage defects were followed-up over 5 years.

Results

Conclusion