Abstract
Objective: To evaluate the use of hypothermically stored human amniotic membrane for cartilage repair in adult sheep. Studies show that human amniotic membrane contains pluripotent mesenchymal stem cells that can be influenced to produce chondrocytes. It is unknown if human amniotic cells can produce hyaline-like cartilage. This study evaluates the use of hypothermically stored amniotic membrane (HSAM) to fill chondral defects in a sheep model. We hypothesized HSAM would fill defects with hyaline-like cartilage with chondrocytes populating the matrix. One sheep was used as a control, and four sheep received amniotic membrane. Two of these sheep were used as a normal control comparison. A 1 cm2 defect was created on the trochlear grove in all specimens. Each membrane was sized and laid over with the stromal layer facing the subchondral bone and covered with Fibrin sealant. The knees were harvested at five months and underwent morphological, histological, and immunohistological evaluation based on the original validated scoring system by O’Driscoll. The control defect didn’t fill in with hyaline cartilage or fibrocartilage. The defects that successfully retained the graft had evidence of diffuse chondrocyte cell proliferation and showed a stromal matrix similar to hyaline cartilage. The graft samples showed a near 100% morphological fill in the HSAM defect contrasting to <10% fill in the control defect. The retained HSAM grafts scored 2.5 on a 0 - 3 cartilage appearance scale compared with 0.5 for the control defects. HSAM is a potential source of pluripotent cells that can influence chondrogenesis in a sheep model. The implications for application in a human model are promising and warrant further study.
Highlights
Addressing articular cartilage defects is challenging, especially when the defect is large (>2.0 - 2.5 cm2)
There are options available that allow for the filling of the defect with hyaline-like cartilage with chondrocytes in the stromal matrix of variable sources, both of autograft and allograft origin [3]
This study evaluates the use of hypothermically stored amniotic membrane (HSAM) [1] to fill cartilage defects in a sheep model
Summary
Addressing articular cartilage defects is challenging, especially when the defect is large (>2.0 - 2.5 cm). There are various methods to address cartilage defects, each with the goal of producing fibro-cartilage or hyaline-like cartilage [2]. There are options available that allow for the filling of the defect with hyaline-like cartilage with chondrocytes in the stromal matrix of variable sources, both of autograft and allograft origin [3]. Autologous Chondrocyte Implantation (ACI) allows for the filling of the defect with hyaline-like cartilage but often results in hypertrophy and adhesions, leading to a minimum of two to three procedures, and it is expensive. Autologous Osteochondral Transplantation (OATS), is an osteochondral autograft, but is limited to treating small chondral defects, is technically difficult and can cause damage to the nearby articular cartilage, resulting in a significant morbidity from the donor sites. A product that is readily available, technically easy, inexpensive and induces minimal morbidity to the patient would be ideal for cartilage restoration and repair [3]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
