Osteochondral Autograft Plugs versus Paste Graft: Ex Vivo Morselization Increases Chondral Matrix Production.

Autor:	Grande D; Feinstein Institute for Medical Research, Manhasset, NY, USA., Goldstein T; Feinstein Institute for Medical Research, Manhasset, NY, USA., Turek TJ; Stone Research Foundation, San Francisco, CA, USA., Hennessy S; Stone Research Foundation, San Francisco, CA, USA., Walgenbach AW; The Stone Clinic, San Francisco, CA, USA., Do LHD; Stone Research Foundation, San Francisco, CA, USA., Greene D; Stone Research Foundation, San Francisco, CA, USA., Stone KR; Stone Research Foundation, San Francisco, CA, USA.; The Stone Clinic, San Francisco, CA, USA.
Jazyk:	angličtina
Zdroj:	Cartilage [Cartilage] 2021 Dec; Vol. 13 (1_suppl), pp. 1058S-1065S. Date of Electronic Publication: 2020 May 12.
DOI:	10.1177/1947603520916552
Abstrakt:	Objective: Patients undergoing articular cartilage paste grafting have been shown in studies to have significant improvement in pain and function in long-term follow-ups. We hypothesized that ex vivo impacting of osteochondral autografts results in higher chondrocyte matrix production versus intact osteochondral autograft plugs. Design: This institutional review board-approved study characterizes the effects of impacting osteochondral plugs harvested from the intercondylar notch of 16 patients into a paste, leaving one graft intact as a control. Cell viability/proliferation, collagen type I/II, SOX-9, and aggrecan gene expression via qRT-PCR (quantitative reverse transcription-polymerase chain reaction) were analyzed at 24 and 48 hours. Matrix production and cell morphology were evaluated using histology. Results: Paste samples from patients (mean age 39.7) with moderate (19%) to severe (81%) cartilage lesions displayed 34% and 80% greater cell proliferation compared to plugs at 24 and 48 hours post processing, respectively ( P = 0.015 and P = 0.021). qRT-PCR analysis yielded a significant ( P = 0.000) increase of aggrecan, SOX-9, collagen type I and II at both 24 and 48 hours. Histological examination displayed cell division throughout paste samples, with accumulation of aggrecan around multiple chondrocyte lacunae. Conclusions: Paste graft preparation resulted in increased mobility of chondrocytes by matrix disruption without loss of cell viability. The impaction procedure stimulated chondrocyte proliferation resulting in a cellular response to reestablish native extracellular matrix. Analysis of gene expression supports a regenerative process of cartilage tissue formation and contradicts long-held beliefs that impaction trauma leads to immediate cell death. This mechanism of action translates into clinical benefit for patients with moderate to severe cartilage damage.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu