Subscribe to RSS
DOI: 10.1055/a-1200-2765
Cartilage Regeneration with Cell-free Type 1 Collagen Matrix – Past, Present and Future (Part 1 – Clinical Aspects)
Article in several languages: English | deutschAbstract
Cartilage regeneration with cell-free matrices has developed from matrix-associated autologous cartilage cell transplantation (MACT) over ten years ago. Adjustments to the legal framework and higher hurdles for cell therapy have led to the procedures being established as an independent alternative to MACT. These procedures, which can be classified as matrix-induced autologous cartilage regeneration (MACR), all rely on the chemotactic stimulus of a cross-linked matrix, which mostly consists of collagens. Given the example of a commercially available type I collagen hydrogel, the state of clinical experience with MACR shall be summarized and an outlook on the development of the method shall be provided. It has been demonstrated in the clinical case series summarized here over the past few years that the use of the matrix is not only safe but also yields good clinical-functional and MR-tomographic results for both small (~ 10 mm) and large (> 10 mm) focal cartilage lesions. Depending on the size of the defect, MACR with a collagen type I matrix plays an important role as an alternative treatment method, in direct competition with both: microfracture and MACT.
Publication History
Article published online:
03 August 2020
© 2020. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References/Literatur
- 1 Pridie KH, Gordon G. A method of resurfacing osteoarthritic knee joints. J Bone Joint Surg Br 1959; 41: 618-619
- 2 Kon E, Roffi A, Filardo G. et al. Scaffold-based cartilage treatments: with or without cells? A systematic review of preclinical and clinical evidence. Arthroscopy 2015; 31: 767-775
- 3 Niemeyer P, Feucht MJ, Fritz J. et al. Cartilage repair surgery for full-thickness defects of the knee in Germany: indications and epidemiological data from the German Cartilage Registry (KnorpelRegister DGOU). Arch Orthop Trauma Surg 2016; 136: 891-897
- 4 Niemeyer P, Schweigler K, Grotejohann B. et al. [The German Cartilage Registry (KnorpelRegister DGOU) for evaluation of surgical treatment for cartilage defects: experience after six months including first demographic data]. Z Orthop Unfall 2015; 153: 67-74
- 5 Brittberg M, Lindahl A, Nilsson A. et al. Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med 1994; 331: 889-895
- 6 Zak L, Krusche-Mandl I, Aldrian S. et al. Clinical and MRI evaluation of medium- to long-term results after autologous osteochondral transplantation (OCT) in the knee joint. Knee Surg Sports Traumatol Arthrosc 2014; 22: 1288-1297
- 7 Sohn DH, Lottman LM, Lum LY. et al. Effect of gravity on localization of chondrocytes implanted in cartilage defects. Clin Orthop Relat Res 2002; (394) 254-262
- 8 Zeifang F, Oberle D, Nierhoff C. et al. Autologous chondrocyte implantation using the original periosteum-cover technique versus matrix-associated autologous chondrocyte implantation: a randomized clinical trial. Am J Sports Med 2010; 38: 924-933
- 9 Gooding CR, Bartlett W, Bentley G. et al. A prospective, randomised study comparing two techniques of autologous chondrocyte implantation for osteochondral defects in the knee: periosteum covered versus type I/III collagen covered. Knee 2006; 13: 203-210
- 10 Bartlett W, Gooding CR, Carrington RWJ. et al. Autologous chondrocyte implantation at the knee using a bilayer collagen membrane with bone graft. A preliminary report. J Bone Joint Surg Br 2005; 87: 330-332
- 11 Peterson L, Minas T, Brittberg M. et al. Two- to 9-year outcome after autologous chondrocyte transplantation of the knee. Clin Orthop Relat Res 2000; (374) 212-234
- 12 Harris JD, Siston RA, Pan X, Flanigan DC. Autologous chondrocyte implantation: a systematic review. J Bone Joint Surg Am 2010; 92: 2220-2233
- 13 Gillogly SD, Wheeler KS. Autologous chondrocyte implantation with collagen membrane. Sports Med Arthrosc 2015; 23: 118-124
- 14 Stoddart MJ, Bara J, Alini M. Cells and secretome – towards endogenous cell re-activation for cartilage repair. Adv Drug Deliv Rev 2015; 84: 135-145
- 15 Behrens P, Ehlers EM, Kochermann KU. et al. [New therapy procedure for localized cartilage defects. Encouraging results with autologous chondrocyte implantation]. MMW Fortschr Med 1999; 141: 49-51
- 16 Kon E, Muttini A, Arcangeli E. et al. Novel nanostructured scaffold for osteochondral regeneration: pilot study in horses. J Tissue Eng Regen Med 2010; 4: 300-308
- 17 Erggelet C, Endres M, Neumann K. et al. Formation of cartilage repair tissue in articular cartilage defects pretreated with microfracture and covered with cell-free polymer-based implants. J Orthop Res 2009; 27: 1353-1360
- 18 Lepage SIM, Robson N, Gilmore H. et al. Beyond cartilage repair: the role of the osteochondral unit in joint health and disease. Tissue Eng Part B Rev 2019; 25: 114-125
- 19 Vasiliadis HS, Danielson B, Ljungberg M. et al. Autologous chondrocyte implantation in cartilage lesions of the knee: long-term evaluation with magnetic resonance imaging and delayed gadolinium-enhanced magnetic resonance imaging technique. Am J Sports Med 2010; 38: 943-949
- 20 Grigolo B, Lisignoli G, Piacentini A. et al. Evidence for redifferentiation of human chondrocytes grown on a hyaluronan-based biomaterial (HYAff 11): molecular, immunohistochemical and ultrastructural analysis. Biomaterials 2002; 23: 1187-1195
- 21 Vannini F, Filardo G, Kon E. et al. Scaffolds for cartilage repair of the ankle joint: the impact on surgical practice. Foot Ankle Surg 2013; 19: 2-8
- 22 Gelse K, Klinger P, Koch M. et al. Thrombospondin-1 prevents excessive ossification in cartilage repair tissue induced by osteogenic protein-1. Tissue Eng Part A 2011; 17: 2101-2112
- 23 Nagai T, Sato M, Kutsuna T. et al. Intravenous administration of anti-vascular endothelial growth factor humanized monoclonal antibody bevacizumab improves articular cartilage repair. Arthritis Res Ther 2010; 12: R178
- 24 Claus S, Aubert-Foucher E, Demoor M. et al. Chronic exposure of bone morphogenetic protein-2 favors chondrogenic expression in human articular chondrocytes amplified in monolayer cultures. J Cell Biochem 2010; 111: 1642-1651
- 25 Angele P, Kujat R, Nerlich M. et al. Engineering of osteochondral tissue with bone marrow mesenchymal progenitor cells in a derivatized hyaluronan-gelatin composite sponge. Tissue Eng 1999; 5: 545-554
- 26 Im G-I, Lee JH. Repair of osteochondral defects with adipose stem cells and a dual growth factor-releasing scaffold in rabbits. J Biomed Mater Res B Appl Biomater 2010; 92: 552-560
- 27 Wang X, Wenk E, Zhang X. et al. Growth factor gradients via microsphere delivery in biopolymer scaffolds for osteochondral tissue engineering. J Control Release 2009; 134: 81-90
- 28 Filardo G, Kon E, Roffi A. et al. Scaffold-based repair for cartilage healing: a systematic review and technical note. Arthroscopy 2013; 29: 174-186
- 29 Stock UA, Vacanti JP. Tissue engineering: current state and prospects. Annu Rev Pathol 2001; 52: 443-451
- 30 DeFrates KG, Moore R, Borgesi J. et al. Protein-based fiber materials in medicine: a review. Nanomaterials (Basel, Switzerland) 2018; 8: 457 doi:10.3390/nano8070457
- 31 Reed S, Wu BM. Biological and mechanical characterization of chitosan-alginate scaffolds for growth factor delivery and chondrogenesis. J Biomed Mater Res B Appl Biomater 2017; 105: 272-282
- 32 Noah EM, Chen J, Jiao X. et al. Impact of sterilization on the porous design and cell behavior in collagen sponges prepared for tissue engineering. Biomaterials 2002; 23: 2855-2861
- 33 Pawelec KM, Best SM, Cameron RE. Collagen: a network for regenerative medicine. J Mater Chem B 2016; 4: 6484-6496
- 34 Friess W. Collagen – biomaterial for drug delivery. Eur J Pharm Biopharm 1998; 45: 113-136
- 35 Andereya S, Maus U, Gavenis K. et al. [First clinical experiences with a novel 3D-collagen gel (CaReS) for the treatment of focal cartilage defects in the knee]. Z Orthop Ihre Grenzgeb 2006; 144: 272-280
- 36 Schneider U, Rackwitz L, Andereya S. et al. A prospective multicenter study on the outcome of type I collagen hydrogel-based autologous chondrocyte implantation (CaReS) for the repair of articular cartilage defects in the knee. Am J Sports Med 2011; 39: 2558-2565
- 37 Timpl R. Processed and non-processed forms of procollagens. Biochem Soc Trans 1984; 12: 924-927
- 38 Ohan MP, Dunn MG. Glucose stabilizes collagen sterilized with gamma irradiation. J Biomed Mater Res A 2003; 67: 1188-1195
- 39 Rackwitz L, Schneider U, Andereya S. et al. [Reconstruction of osteochondral defects with a collagen I hydrogel. Results of a prospective multicenter study]. Orthopade 2012; 41: 268-279
- 40 Vahdati A, Wagner DR. Implant size and mechanical properties influence the failure of the adhesive bond between cartilage implants and native tissue in a finite element analysis. J Biomech 2013; 46: 1554-1560
- 41 Efe T, Füglein A, Heyse TJ. et al. Fibrin glue does not improve the fixation of press-fitted cell-free collagen gel plugs in an ex vivo cartilage repair model. Knee Surg Sports Traumatol Arthrosc 2012; 20: 210-215
- 42 Eyrich D, Brandl F, Appel B. et al. Long-term stable fibrin gels for cartilage engineering. Biomaterials 2007; 28: 55-65
- 43 Strauss EJ, Barker JU, Kercher JS. et al. Augmentation strategies following the microfracture technique for repair of focal chondral defects. Cartilage 2010; 1: 145-152
- 44 Minas T, Gomoll AH, Rosenberger R. et al. Increased failure rate of autologous chondrocyte implantation after previous treatment with marrow stimulation techniques. Am J Sports Med 2009; 37: 902-908
- 45 Niemeyer P, Becher C, Brucker PU. et al. [Significance of matrix-augmented bone marrow stimulation for treatment of cartilage defects of the knee: a consensus statement of the DGOU Working Group on Tissue Regeneration]. Z Orthop Unfall 2018; 56: 513-532
- 46 Niemeyer P, Laute V, Zinser W. et al. A prospective, randomized, open-label, multicenter, phase III noninferiority trial to compare the clinical efficacy of matrix-associated autologous chondrocyte implantation with spheroid technology versus arthroscopic microfracture for cartilage defects of the knee. Orthop J Sports Med 2019; 7: 2325967119854442
- 47 Khan IM, Gilbert SJ, Singhrao SK. et al. Cartilage integration: evaluation of the reasons for failure of integration during cartilage repair. A review. Eur Cell Mater 2008; 16: 26-39
- 48 Huntley JS, Bush PG, McBirnie JM. et al. Chondrocyte death associated with human femoral osteochondral harvest as performed for mosaicplasty. J Bone Joint Surg Am 2005; 87: 351-360
- 49 Schüttler KF, Struewer J, Rominger MB. et al. Repair of a chondral defect using a cell free scaffold in a young patient – a case report of successful scaffold transformation and colonisation. BMC Surg 2013; 13: 11
- 50 Schneider U, Andereya S. [First results of a prospective randomized clinical trial on traditional chondrocyte transplantation vs. CaReS-Technology]. Z Orthop Ihre Grenzgeb 2003; 141: 496-497
- 51 Murray TG, Parker RD. Restoring cartilage defects: microfracture to autologous chondrocyte implantation using investigational 3D scaffold. Orthopedics 2007; 30: 766-767
- 52 Nöth U, Siebenlist S, Rackwitz L. et al. Matrix-based autologous chondrocyte transplantation for the treatment of large osteochondral defects. Eur Musculoskelet Rev 2006; 1: 62-64
- 53 Andereya S, Maus U, Gavenis K. et al. [Treatment of patellofemoral cartilage defects utilizing a 3D collagen gel: two-year clinical results]. Z Orthop Unfall 2007; 145: 139-145
- 54 Maus U, Schneider U, Gravius S. et al. [Clinical results after three years use of matrix-associated ACT for the treatment of osteochondral defects of the knee]. Z Orthop Unfall 2008; 146: 31-37
- 55 Efe T, Theisen C, Fuchs-Winkelmann S. et al. Cell-free collagen type I matrix for repair of cartilage defects-clinical and magnetic resonance imaging results. Knee Surg Sports Traumatol Arthrosc 2012; 20: 1915-1922
- 56 Schüttler KF, Schenker H, Theisen C. et al. Use of cell-free collagen type I matrix implants for the treatment of small cartilage defects in the knee: clinical and magnetic resonance imaging evaluation. Knee Surg Sports Traumatol Arthrosc 2014; 22: 1270-1276
- 57 Roessler PP, Pfister B, Gesslein M. et al. Short-term follow up after implantation of a cell-free collagen type I matrix for the treatment of large cartilage defects of the knee. Int Orthop 2015; 39: 2473-2479
- 58 Schüttler K-F, Götschenberg A, Klasan A. et al. Cell-free cartilage repair in large defects of the knee: increased failure rate 5 years after implantation of a collagen type I scaffold. Arch Orthop Trauma Surg 2019; 139: 99-106
- 59 Usuelli FG, Grassi M, Manzi L. et al. Treatment of osteochondral lesions of the talus with autologous collagen-induced chondrogenesis: clinical and magnetic resonance evaluation at one-year follow-up. Joints 2016; 4: 80-86
- 60 DʼAntimo C, Biggi F, Borean A. et al. Combining a novel leucocyte-platelet-concentrated membrane and an injectable collagen scaffold in a single-step AMIC procedure to treat chondral lesions of the knee: a preliminary retrospective study. Eur J Orthop Surg Traumatol 2017; 27: 673-681
- 61 Stanish WD, McCormack R, Forriol F. et al. Novel scaffold-based BST-CarGel treatment results in superior cartilage repair compared with microfracture in a randomized controlled trial. J Bone Joint Surg Am 2013; 95: 1640-1650
- 62 Hoemann CD, Tran-Khanh N, Chevrier A. et al. Chondroinduction is the main cartilage repair response to microfracture and microfracture with BST-CarGel: results as shown by ICRS-II histological scoring and a novel zonal collagen type scoring method of human clinical biopsy specimens. Am J Sports Med 2015; 43: 2469-2480
- 63 Shive MS, Stanish WD, McCormack R. et al. BST-CarGel® treatment maintains cartilage repair superiority over microfracture at 5 years in a multicenter randomized controlled trial. Cartilage 2015; 6: 62-72
- 64 Gobbi A, Scotti C, Karnatzikos G. et al. One-step surgery with multipotent stem cells and hyaluronan-based scaffold for the treatment of full-thickness chondral defects of the knee in patients older than 45 years. Knee Surg Sports Traumatol Arthrosc 2017; 25: 2494-2501
- 65 Sofu H, Camurcu Y, Ucpunar H. et al. Clinical and radiographic outcomes of chitosan-glycerol phosphate/blood implant are similar with hyaluronic acid-based cell-free scaffold in the treatment of focal osteochondral lesions of the knee joint. Knee Surg Sports Traumatol Arthrosc 2018; 46: 2-9
- 66 Haddo O, Mahroof S, Higgs D. et al. The use of chondrogide membrane in autologous chondrocyte implantation. Knee 2004; 11: 51-55
- 67 Panni AS, Cerciello S, Vasso M. The management of knee cartilage defects with modified amic technique: preliminary results. Int J Immunopath Ph 2011; 24: 149-152
- 68 McCarthy HS, Roberts S. A histological comparison of the repair tissue formed when using either Chondrogide® or periosteum during autologous chondrocyte implantation. Osteoarthritis Cartilage 2013; 21: 2048-2057
- 69 Ebert JR, Smith A, Fallon M. et al. Correlation between clinical and radiological outcomes after matrix-induced autologous chondrocyte implantation in the femoral condyles. Am J Sports Med 2014; 42: 1857-1864
- 70 Patrascu JM, Freymann U, Kaps C. et al. Repair of a post-traumatic cartilage defect with a cell-free polymer-based cartilage implant: a follow-up at two years by MRI and histological review. J Bone Joint Surg Br 2010; 92: 1160-1163
- 71 Becher C, Ettinger M, Ezechieli M. et al. Repair of retropatellar cartilage defects in the knee with microfracture and a cell-free polymer-based implant. Arch Orthop Trauma Surg 2015; 135: 1003-1010
- 72 Chubinskaya S, Levy A, Robinson D. et al. Agili-C induced cartilage regeneration: new insights in to repair of human cartilage. Osteoarthritis Cartilage 2016; 24: 168
- 73 Delcogliano M, de Caro F, Scaravella E. et al. Use of innovative biomimetic scaffold in the treatment for large osteochondral lesions of the knee. Knee Surg Sports Traumatol Arthrosc 2014; 22: 1260-1269
- 74 Christensen BB, Foldager CB, Jensen J. et al. Poor osteochondral repair by a biomimetic collagen scaffold: 1- to 3-year clinical and radiological follow-up. Knee Surg Sports Traumatol Arthrosc 2016; 24: 2380-2387
- 75 Brix M, Kaipel M, Kellner R. et al. Successful osteoconduction but limited cartilage tissue quality following osteochondral repair by a cell-free multilayered nano-composite scaffold at the knee. Int Orthop 2016; 40: 625-632
- 76 Mithoefer K, McAdams T, Williams RJ. et al. Clinical efficacy of the microfracture technique for articular cartilage repair in the knee: an evidence-based systematic analysis. Am J Sports Med 2009; 37: 2053-2063
- 77 Fortier LA, Chapman HS, Pownder SL. et al. BioCartilage improves cartilage repair compared with microfracture alone in an equine model of full-thickness cartilage loss. Am J Sports Med 2016; 44: 2366-2374