Abstract
Autologous chondrocyte implantation (ACI) is an effective clinical procedure for the regeneration of articular cartilage defects. BioSeed®-C is a second-generation ACI tissue engineering cartilage graft that is based on autologous chondrocytes embedded in a three-dimensional bioresorbable two-component gel-polymer scaffold. In the present prospective study, we evaluated the short-term to mid-term efficacy of BioSeed-C for the arthrotomic and arthroscopic treatment of posttraumatic and degenerative cartilage defects in a group of patients suffering from chronic posttraumatic and/or degenerative cartilage lesions of the knee. Clinical outcome was assessed in 40 patients with a 2-year clinical follow-up before implantation and at 3, 6, 12, and 24 months after implantation by using the modified Cincinnati Knee Rating System, the Lysholm score, the Knee injury and Osteoarthritis Outcome Score, and the current health assessment form (SF-36) of the International Knee Documentation Committee, as well as histological analysis of second-look biopsies. Significant improvement (p < 0.05) in the evaluated scores was observed at 1 and/or 2 years after implantation of BioSeed-C, and histological staining of the biopsies showed good integration of the graft and formation of a cartilaginous repair tissue. The Knee injury and Osteoarthritis Outcome Score showed significant improvement in the subclasses pain, other symptoms, and knee-related quality of life 2 years after implantation of BioSeed-C in focal osteoarthritic defects. The results suggest that implanting BioSeed-C is an effective treatment option for the regeneration of posttraumatic and/or osteoarthritic defects of the knee.
Highlights
Cartilage has a low intrinsic regenerative and reparative capacity
BioSeed®-C is a second-generation Autologous chondrocyte implantation (ACI) tissue engineering cartilage graft that is based on autologous chondrocytes embedded in a three-dimensional bioresorbable two-component gel-polymer scaffold
Clinical outcome was assessed in 40 patients with a 2-year clinical follow-up before implantation and at 3, 6, 12, and 24 months after implantation by using the modified Cincinnati Knee Rating System, the Lysholm score, the Knee injury and Osteoarthritis Outcome Score, and the current health assessment form (SF-36) of the International Knee Documentation Committee, as well as histological analysis of second-look biopsies
Summary
Cartilage has a low intrinsic regenerative and reparative capacity. Cartilage defects may be accompanied by pain, immobility, stiffness, and loss of quality of life, and can potentially lead to severe osteoarthritis in the long term. Because chondral lesions of the knee occur frequently and are a great health problem, several efforts were made to develop techniques for restoration of the cartilage surface and regeneration of the cartilage [1]. These common repair techniques comprise debridement, bone marrow-stimulating techniques, osteochondral grafting, and autologous chondrocyte implantation (ACI) [2,3,4,5]. Some of these techniques may be useful only for small defects [6], whereas others merely provide limited durability of the repair tissue [7,8]. Using the cell-based approach of ACI, such disadvantages were not reported [9,10]
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