Repair of articular cartilage defect by cell transplantation |
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Authors: | Shigeyuki Wakitani MD PhD |
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Institution: | (1) Department of Orthopaedic Surgery, Osaka-Minami National Hospital, 2-1 Kidohigashi-machi, 586-8521 Kawachinagano, Japan |
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Abstract: | Full-thickness articular cartilage defects are a major clinical problem; however, at present there is no treatment that is
widely accepted to regeneratively repair these lesions. The current therapeutic approach is to drill or abrade the base of
the defect to expose the bone marrow with its cells and growth factors. This usually results in a repaired tissue of fibrocartilage
that functions poorly in the loaded joint environment. Recently, autologous cultured chondrocyte transplantation and mosaic
plasty were explored. We can repair small articular cartilage defects using these methods, although their effectiveness is
still controversial. We have reported that transplantation of allogeneic chondrocytes embedded in collagen gels or allogeneic
chondrocytes cultured in collagen gels could repair articular cartilage defect in a rabbit model. We also reported that autologous
culture-expanded bone marrow mesenchymal cell transplantation could repair articular cartilage defect in a rabbit model. This
procedure offers expedient clinical use, given that autologous bone marrow cells are easily obtained and can be culture-expanded.
We transplanted autologous culture-expanded bone marrow cells into the cartilage defect of the osteoarthritic knee joint on
11 patients at the time of high tibial osteotomy. As early as 6.8 weeks after transplantation, the defect was covered with
white soft tissue, in which slight metachromasia was histologically observed. Thirty-three weeks after transplantation, the
repaired tissue had hardened. Histologically, repaired tissues showed stronger metachromasia and a partial hyaline cartilage-like
appearance. This procedure may prove a promising method by which to repair articular cartilage defects. |
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Keywords: | Articular cartilage defect Cell transplantation Articular chondrocyte Autologous bone marrow mesenchymal cell Collagen gel |
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