One-stage focal cartilage defect treatment with bone marrow mononuclear cells and chondrocytes leads to better macroscopic cartilage regeneration compared to microfracture in goats

J E J Bekkers; L B Creemers; A I Tsuchida; M H P van Rijen; R J H Custers; W J A Dhert; D B F Saris

doi:10.1016/j.joca.2013.03.015

One-stage focal cartilage defect treatment with bone marrow mononuclear cells and chondrocytes leads to better macroscopic cartilage regeneration compared to microfracture in goats

J E J Bekkers, L B Creemers, A I Tsuchida, M H P van Rijen, R J H Custers, W J A Dhert, D B F Saris

University Medical Center Utrecht

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: The combination of chondrocytes and mononuclear fraction (MNF) cells might solve the expansion induced dedifferentiation problem of reimplanted cells in autologous chondrocytes implantation as sufficient cells would be available for direct, one-stage, implantation. Earlier in vitro work already showed a positive stimulation of cartilage specific matrix production when chondrocytes and MNF cells were combined. Therefore, this study aimed to evaluate cartilage regeneration using a one-stage procedure combining MNF cells and primary chondrocytes for the treatment of focal cartilage lesions in goats compared to microfracture treatment.

DESIGN: Freshly created focal cartilage defects were treated with either a combination of chondrocytes and MNF cells embedded in fibrin glue or microfracture treatment. After 6 months follow-up local regeneration as well as the general joint cartilage health were evaluated using validated scores and biochemical assays.

RESULTS: Macroscopic (P = 0.015) scores for the cartilage surface at the treated defect were, after 6 months, significantly higher for the chondrocyteMNF treatment compared to microfracture-treated defects, but microscopic scores were not (P = 0.067). The articulating cartilage showed more (P = 0.005) degeneration following microfracture treatment compared to chondrocyteMNF treatment. Biochemical glycosaminoglycans (GAG) evaluation did not reveal differences between the treatments. Both treatments had resulted in a slight to moderate cartilage degeneration at other locations in the joint.

CONCLUSION: In conclusion, treatment of focal articular cartilage lesions in goats using a combination of MNF cells from bone marrow and unexpanded chondrocytes leads to better macroscopic regeneration compared to microfracture, however needs further fine-tuning to decrease the negative influence on other joint compartments.

Original language	English
Pages (from-to)	950-956
Number of pages	7
Journal	Osteoarthritis and Cartilage
Volume	21
Issue number	7
DOIs	https://doi.org/10.1016/j.joca.2013.03.015
Publication status	Published - Jul 2013

Keywords

Animals
Bone Marrow Transplantation
Cartilage, Articular
Chondrocytes
Follow-Up Studies
Glycosaminoglycans
Goats
Orthopedic Procedures
Regeneration
Stifle
Treatment Outcome

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10.1016/j.joca.2013.03.015

http://www.ncbi.nlm.nih.gov/pubmed/23583464

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Bekkers, J. E. J., Creemers, L. B., Tsuchida, A. I., van Rijen, M. H. P., Custers, R. J. H., Dhert, W. J. A., & Saris, D. B. F. (2013). One-stage focal cartilage defect treatment with bone marrow mononuclear cells and chondrocytes leads to better macroscopic cartilage regeneration compared to microfracture in goats. Osteoarthritis and Cartilage, 21(7), 950-956. https://doi.org/10.1016/j.joca.2013.03.015

@article{abd42c091fe44769aacfde1f0e8b588c,

title = "One-stage focal cartilage defect treatment with bone marrow mononuclear cells and chondrocytes leads to better macroscopic cartilage regeneration compared to microfracture in goats",

abstract = "OBJECTIVE: The combination of chondrocytes and mononuclear fraction (MNF) cells might solve the expansion induced dedifferentiation problem of reimplanted cells in autologous chondrocytes implantation as sufficient cells would be available for direct, one-stage, implantation. Earlier in vitro work already showed a positive stimulation of cartilage specific matrix production when chondrocytes and MNF cells were combined. Therefore, this study aimed to evaluate cartilage regeneration using a one-stage procedure combining MNF cells and primary chondrocytes for the treatment of focal cartilage lesions in goats compared to microfracture treatment.DESIGN: Freshly created focal cartilage defects were treated with either a combination of chondrocytes and MNF cells embedded in fibrin glue or microfracture treatment. After 6 months follow-up local regeneration as well as the general joint cartilage health were evaluated using validated scores and biochemical assays.RESULTS: Macroscopic (P = 0.015) scores for the cartilage surface at the treated defect were, after 6 months, significantly higher for the chondrocyteMNF treatment compared to microfracture-treated defects, but microscopic scores were not (P = 0.067). The articulating cartilage showed more (P = 0.005) degeneration following microfracture treatment compared to chondrocyteMNF treatment. Biochemical glycosaminoglycans (GAG) evaluation did not reveal differences between the treatments. Both treatments had resulted in a slight to moderate cartilage degeneration at other locations in the joint.CONCLUSION: In conclusion, treatment of focal articular cartilage lesions in goats using a combination of MNF cells from bone marrow and unexpanded chondrocytes leads to better macroscopic regeneration compared to microfracture, however needs further fine-tuning to decrease the negative influence on other joint compartments.",

keywords = "Animals, Bone Marrow Transplantation, Cartilage, Articular, Chondrocytes, Follow-Up Studies, Glycosaminoglycans, Goats, Orthopedic Procedures, Regeneration, Stifle, Treatment Outcome",

author = "Bekkers, {J E J} and Creemers, {L B} and Tsuchida, {A I} and {van Rijen}, {M H P} and Custers, {R J H} and Dhert, {W J A} and Saris, {D B F}",

year = "2013",

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language = "English",

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Bekkers, JEJ, Creemers, LB, Tsuchida, AI, van Rijen, MHP, Custers, RJH , Dhert, WJA & Saris, DBF 2013, 'One-stage focal cartilage defect treatment with bone marrow mononuclear cells and chondrocytes leads to better macroscopic cartilage regeneration compared to microfracture in goats', Osteoarthritis and Cartilage, vol. 21, no. 7, pp. 950-956. https://doi.org/10.1016/j.joca.2013.03.015

One-stage focal cartilage defect treatment with bone marrow mononuclear cells and chondrocytes leads to better macroscopic cartilage regeneration compared to microfracture in goats. / Bekkers, J E J; Creemers, L B; Tsuchida, A I et al.
In: Osteoarthritis and Cartilage, Vol. 21, No. 7, 07.2013, p. 950-956.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - One-stage focal cartilage defect treatment with bone marrow mononuclear cells and chondrocytes leads to better macroscopic cartilage regeneration compared to microfracture in goats

AU - Bekkers, J E J

AU - Creemers, L B

AU - Tsuchida, A I

AU - van Rijen, M H P

AU - Custers, R J H

AU - Dhert, W J A

AU - Saris, D B F

PY - 2013/7

Y1 - 2013/7

N2 - OBJECTIVE: The combination of chondrocytes and mononuclear fraction (MNF) cells might solve the expansion induced dedifferentiation problem of reimplanted cells in autologous chondrocytes implantation as sufficient cells would be available for direct, one-stage, implantation. Earlier in vitro work already showed a positive stimulation of cartilage specific matrix production when chondrocytes and MNF cells were combined. Therefore, this study aimed to evaluate cartilage regeneration using a one-stage procedure combining MNF cells and primary chondrocytes for the treatment of focal cartilage lesions in goats compared to microfracture treatment.DESIGN: Freshly created focal cartilage defects were treated with either a combination of chondrocytes and MNF cells embedded in fibrin glue or microfracture treatment. After 6 months follow-up local regeneration as well as the general joint cartilage health were evaluated using validated scores and biochemical assays.RESULTS: Macroscopic (P = 0.015) scores for the cartilage surface at the treated defect were, after 6 months, significantly higher for the chondrocyteMNF treatment compared to microfracture-treated defects, but microscopic scores were not (P = 0.067). The articulating cartilage showed more (P = 0.005) degeneration following microfracture treatment compared to chondrocyteMNF treatment. Biochemical glycosaminoglycans (GAG) evaluation did not reveal differences between the treatments. Both treatments had resulted in a slight to moderate cartilage degeneration at other locations in the joint.CONCLUSION: In conclusion, treatment of focal articular cartilage lesions in goats using a combination of MNF cells from bone marrow and unexpanded chondrocytes leads to better macroscopic regeneration compared to microfracture, however needs further fine-tuning to decrease the negative influence on other joint compartments.

AB - OBJECTIVE: The combination of chondrocytes and mononuclear fraction (MNF) cells might solve the expansion induced dedifferentiation problem of reimplanted cells in autologous chondrocytes implantation as sufficient cells would be available for direct, one-stage, implantation. Earlier in vitro work already showed a positive stimulation of cartilage specific matrix production when chondrocytes and MNF cells were combined. Therefore, this study aimed to evaluate cartilage regeneration using a one-stage procedure combining MNF cells and primary chondrocytes for the treatment of focal cartilage lesions in goats compared to microfracture treatment.DESIGN: Freshly created focal cartilage defects were treated with either a combination of chondrocytes and MNF cells embedded in fibrin glue or microfracture treatment. After 6 months follow-up local regeneration as well as the general joint cartilage health were evaluated using validated scores and biochemical assays.RESULTS: Macroscopic (P = 0.015) scores for the cartilage surface at the treated defect were, after 6 months, significantly higher for the chondrocyteMNF treatment compared to microfracture-treated defects, but microscopic scores were not (P = 0.067). The articulating cartilage showed more (P = 0.005) degeneration following microfracture treatment compared to chondrocyteMNF treatment. Biochemical glycosaminoglycans (GAG) evaluation did not reveal differences between the treatments. Both treatments had resulted in a slight to moderate cartilage degeneration at other locations in the joint.CONCLUSION: In conclusion, treatment of focal articular cartilage lesions in goats using a combination of MNF cells from bone marrow and unexpanded chondrocytes leads to better macroscopic regeneration compared to microfracture, however needs further fine-tuning to decrease the negative influence on other joint compartments.

KW - Animals

KW - Bone Marrow Transplantation

KW - Cartilage, Articular

KW - Chondrocytes

KW - Follow-Up Studies

KW - Glycosaminoglycans

KW - Goats

KW - Orthopedic Procedures

KW - Regeneration

KW - Stifle

KW - Treatment Outcome

U2 - 10.1016/j.joca.2013.03.015

DO - 10.1016/j.joca.2013.03.015

M3 - Article

C2 - 23583464

SN - 1063-4584

VL - 21

SP - 950

EP - 956

JO - Osteoarthritis and Cartilage

JF - Osteoarthritis and Cartilage

IS - 7

ER -

One-stage focal cartilage defect treatment with bone marrow mononuclear cells and chondrocytes leads to better macroscopic cartilage regeneration compared to microfracture in goats

Abstract

Keywords

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