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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 8, 1099-1109.
doi: 10.1302/0301-620X.89B8.18451  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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Articular cartilage restoration in load-bearing osteochondral defects by implantation of autologous chondrocyte-fibrin constructs

AN EXPERIMENTAL STUDY IN SHEEP

S. Munirah, B Biomed Sci, PhD Candidate1; O. C. Samsudin, MD, BSc, MS(Orth), Orthopaedic Surgeon2; H. C. Chen, DVM, MVM, DVSc, Veterinary Anaesthetist3; S. H. Sharifah Salmah, DVM, MVM, Veterinarian3; B. S. Aminuddin, MD, MS(ORL), Ear, Nose and Throat Consultant4; and B. H. I. Ruszymah, MD, PhD, Professor of Physiology1

1 Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia.
2 Department of Orthopaedics and Traumatology, Faculty of Medicin, 9th Floor, Clinical Block, Jalan Yaacob Latiff, 56000 Cheras, Kuala Lumpur, Malaysia.
3 Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine University Putra Malaysia, 43400 Serdang, Selangor, Darul Ehsan, Malaysia.
4 Ear, Nose and Throat Clinic Ampang Puteri Specialist Hospital, Ampang, Selangor, Malaysia.

Correspondence should be sent to Professor B. H. I. Ruszymah; e-mail: ruszy{at}medic.ukm.my

Ovine articular chondrocytes were isolated from cartilage biopsy and culture expanded in vitro. Approximately 30 million cells per ml of cultured chondrocytes were incorporated with autologous plasma-derived fibrin to form a three-dimensional construct. Full-thickness punch hole defects were created in the lateral and medial femoral condyles. The defects were implanted with either an autologous ‘chondrocyte-fibrin’ construct (ACFC), autologous chondrocytes (ACI) or fibrin blanks (AF) as controls. Animals were killed after 12 weeks. The gross appearance of the treated defects was inspected and photographed. The repaired tissues were studied histologically and by scanning electron microscopy analysis.

All defects were assessed using the International Cartilage Repair Society (ICRS) classification. Those treated with ACFC, ACI and AF exhibited median scores which correspond to a nearly-normal appearance. On the basis of the modified O’Driscoll histological scoring scale, ACFC implantation significantly enhanced cartilage repair compared to ACI and AF. Using scanning electron microscopy, ACFC and ACI showed characteristic organisation of chondrocytes and matrices, which were relatively similar to the surrounding adjacent cartilage.

Implantation of ACFC resulted in superior hyaline-like cartilage regeneration when compared with ACI. If this result is applicable to humans, a better outcome would be obtained than by using conventional ACI.




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T. A. S. Selmi, P. Verdonk, P. Chambat, F. Dubrana, J.-F. Potel, L. Barnouin, and P. Neyret
Autologous chondrocyte implantation in a novel alginate-agarose hydrogel: OUTCOME AT TWO YEARS
J Bone Joint Surg Br, May 1, 2008; 90-B(5): 597 - 604.
[Abstract] [Full Text] [PDF]

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Articular cartilage restoration in load-bearing osteochondral defects
Benedict A Rogers, et al.
J Bone Joint Surg Br Online, 15 Oct 2007 [Full text]

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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General