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Treatment of a patellar chondral defect using juvenile articular cartilage allograft implantation.

ABSTRACT: Focal articular cartilage defects of the knee commonly occur. Various arthroscopic and open procedures have been developed to address these lesions when they are symptomatic, all aimed at defect filling. Juvenile cartilage transplantation procedures have recently been described as an option for managing symptomatic cartilage lesions. We present a technique using transfer of juvenile cartilage allograft transplantation into the defect with subsequent second-look arthroscopy and biopsy results after implantation.

SUBMITTER: Griffin JW

PROVIDER: S-EPMC3882672 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Treatment of a patellar chondral defect using juvenile articular cartilage allograft implantation.

Griffin Justin W JW Gilmore C Jan CJ Miller Mark D MD

Arthroscopy techniques 20130913 4

Focal articular cartilage defects of the knee commonly occur. Various arthroscopic and open procedures have been developed to address these lesions when they are symptomatic, all aimed at defect filling. Juvenile cartilage transplantation procedures have recently been described as an option for managing symptomatic cartilage lesions. We present a technique using transfer of juvenile cartilage allograft transplantation into the defect with subsequent second-look arthroscopy and biopsy results aft ...[more]

PMID: 24400181

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Project description:BackgroundSynovium has been confirmed to be the primary contributor to meniscal repair. Particulated Juvenile Allograft Cartilage (PJAC) has demonstrated promising clinical effect on repairing cartilage. The synergistic effect of synovium and PJAC transplant on meniscal fibrocartilaginous repair is unclear. We hypothesize that the transplantation of synovium and PJAC synergistically facilitates meniscal regeneration and the donor cells within graft tissues still survive in the regenerated tissue at the last follow up (16 weeks postoperatively).MethodsThe study included 24 mature female rabbits, which were randomly divided into experimental and control groups. A cylindrical full-thickness defect measuring 2.0 mm was prepared in the avascular portion of the anterior horn of medial meniscus in both knees. The synovium and PJAC transplant were harvested from juvenile male rabbits (2 months after birth). The experimental group received synovium and PJAC transplant encapsulated with fibrin gel. The control groups received synovium transplant encapsulated with fibrin gel, pure fibrin gel and nothing. The macroscopic, imageological and histological evaluations of repaired tissue were performed at 8 weeks and 16 weeks postoperatively. The in situ hybridization (ISH) of male-specific sex-determining region Y-linked (SRY) gene was performed to detect the transplanted cells.ResultsThe regenerated tissue in experimental group showed superior structural integrity, superficial smoothness, and marginal integration compared to control groups at 8 weeks or 16 weeks postoperatively. More meniscus-like fibrochondrocytes filled the repaired tissue in the experimental group, and the matrix surrounding these cell clusters demonstrated strongly positive safranin O and type 2 collagen immunohistochemistry staining. By SRY gene ISH, the positive SRY signal of experimental group could be detected at 8 weeks (75.72%, median) and 16 weeks (48.69%, median). The expression of SOX9 in experimental group was the most robust, with median positive rates of 65.52% at 8 weeks and 67.55% at 16 weeks.ConclusionThe transplantation of synovium and PJAC synergistically facilitates meniscal regeneration. The donor cells survive for at least 16 weeks in the recipient.The translational potential of this articleThis study highlighted the positive effect of PJAC and synovium transplant on meniscal repair. We also clarified the potential repair mechanisms reflected by the survival of donor cells and upregulated expression of meniscal fibrochondrocytes related genes. Thus, based on our study, further clinical experiments are needed to investigate synovium and PJAC transplant as a possible treatment to meniscal defects.

Dataset Information

Treatment of a patellar chondral defect using juvenile articular cartilage allograft implantation.

Publications

Treatment of a patellar chondral defect using juvenile articular cartilage allograft implantation.

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