The use of autologous adult, allogenic juvenile, and combined juvenile-adult cartilage fragments for the repair of chondral defects.

Autor: Bonasia DE; 1st Department of Orthopaedics and Traumatology, University of Torino, Via Lamarmora 26, 10128, Turin, Italy. davidebonasia@virgilio.it., Martin JA; University of Iowa, Iowa City, IA, USA., Marmotti A; 1st Department of Orthopaedics and Traumatology, University of Torino, Via Lamarmora 26, 10128, Turin, Italy., Kurriger GL; University of Iowa, Iowa City, IA, USA., Lehman AD; University of Iowa, Iowa City, IA, USA., Rossi R; 1st Department of Orthopaedics and Traumatology, University of Torino, Via Lamarmora 26, 10128, Turin, Italy., Amendola A; University of Iowa, Iowa City, IA, USA.
Jazyk: angličtina
Zdroj: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2016 Dec; Vol. 24 (12), pp. 3988-3996. Date of Electronic Publication: 2015 Feb 10.
DOI: 10.1007/s00167-015-3536-5
Abstrakt: Purpose: The goal of the study was to evaluate the repair of chondral lesions treated with combined autologous adult/allogenic juvenile cartilage fragments, compared with isolated adult and isolated juvenile cartilage fragments.
Methods: Fifty-eight adult (>16 week old) and five juvenile (<6 week old) New Zealand White female rabbits were used. A large osteochondral defect was created in the center of the femoral trochlea of adult rabbits. The rabbits were divided in four groups: Group 1 = untreated defects (controls); Group 2 = adult cartilage fragments; Group 3 = juvenile cartilage fragments; and Group 4 = adult + juvenile cartilage fragments. Killings were performed at 3 and 6 months. The defects were evaluated with ICRS macroscopic score, modified O'Driscoll score, and Collagen type II immunostaining.
Results: At 3 months, Group 4 performed better than Group 1, in terms of modified O'Driscoll score (p = 0.001) and Collagen type II immunostaining (p = 0.015). At 6 months, Group 4 showed higher modified O'Driscoll score (p = 0.003) and Collagen type II immunostaining score (p < 0.001) than Group 1. Histologically, also Group 3 performed better than Group 1 (p = 0.03), and Group 4 performed better than Group 2 (p = 0.004).
Conclusions: Mixing adult and juvenile cartilage fragments improved cartilage repair in a rabbit model. In the clinical setting, a new "one-stage" procedure combining the two cartilage sources can be hypothesized, with the advantages of improved chondral repair and large defect coverage, because of the use of an off-the-shelf juvenile allograft. Further studies on larger animals and clinical trials are required to confirm these results.
Databáze: MEDLINE
Externí odkaz: