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Cartilage restoration techniques of the hip
Published in K. Mohan Iyer, Hip Preservation Techniques, 2019
Rodrigo Mardones, Catalina Larrain
When chondral lesions are larger than 2 cm2, microfractures will be an insufficient treatment. In these cases, bone marrow concentrate in a PRP clot seems to be a good alternative. Other treatment options include autologous chondrocyte implantation (ACI), matrix-induced ACI (MACI), autologous matrix-induced chondrogenesis (AMIC), and membrane seeded with expanded mesenchymal stem cells.
Mesenchymal Stem Cell Treatment of Cartilage Lesions in the Hip
Published in K. Mohan Iyer, Hip Joint in Adults: Advances and Developments, 2018
George Hourston, Stephen McDonnell, Wasim Khan
In the hip, debridement and microfracture have remained the treatment of choice, although this has seen improvement in the same way as ACI. Again, the use of a type I/III collagen matrix has enhanced the microfracture technique, resulting in a novel approach known as autologous matrix-induced chondrogenesis (AMIC). The matrix used in AMIC, Chondro-Gide (Geistlich Pharma AG, Wolhusen, Switzerland), helps to stabilise the clot and provides a platform for structure in the scar tissue formed [29]. In 2012, AMIC was performed fully arthroscopically in the hip by a group in Italy, in a single-step procedure, thereby avoiding several of the limitations and risks associated with chondrocyte implantation [28]. Long-term clinical data are not yet available. This novel technique has been repeated with some success in the ankle [30] and shoulder [31].
Autologous adipose stem cell therapy for knee osteoarthritis: where are we now?
Published in The Physician and Sportsmedicine, 2020
Alessio Biazzo, Riccardo D’Ambrosi, Francesco Masia, Vincenzo Izzo, Francesco Verde
Treatment options for low-grade OA and chondral defects range from conservative to surgical interventions such as microfractures (MFX), autologous chondrocyte implantation (ACI), matrix-induced autologous chondrocyte implantation (MACI), autologous matrix-induced chondrogenesis (AMIC) or osteochondral autograft transfer (OATS) [2]. These latter methods are characterized by high failure rate [3,4]. MFX is the most used technique because it is cheap and easy to perform, exposing bone marrow-derived pluripotent cells to the articular surface and creating an environment amenable to healing; however, the resulting fibrocartilage is characterized by poor load-bearing quality and consequently no good results in the long-term follow-up and lesions >1.5 cm2 are reported [5]. In the effort to regenerate articular cartilage, mesenchymal stem cells (MSC) have been used in various forms, with promising long-term results [6–8]. The most commonly used tissue sources for isolating MSCs apart from bone marrow are the adipose tissue, umbilical cord, placenta, and dental pulp. However, autologous or allogeneic bone marrow MSCs are currently the most widely used cell type in clinical trials for various disease indications. They are considered the ‘gold standard’ MSC type because of their extensive characterization that took place for over 5 decades.
An overview of various treatment strategies, especially tissue engineering for damaged articular cartilage
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2020
Azizeh Rahmani Del Bakhshayesh, Soraya Babaie, Hamid Tayefi Nasrabadi, Nahideh Asadi, Abolfazl Akbarzadeh, Ali Abedelahi
In the orthopaedic field, cartilage damage is often created due to congenital, trauma, cancer, or ageing diseases [1–4]. After the injury, cartilage tissue has a minimal ability to repair [5,6]. Traditional methods of cartilage repair include autograft transplantation of periosteum/perichondrium [7], allograft/autograft transplantation of osteochondral [8,9], microfracturing [10] and autologous chondrocyte implantation (ACI) [11]. Major limitations of these methods are morbidity of donor-site and lack of integration of transplanted tissue [12–14]. The treatment used to overcome these limitations is particulated juvenile articular cartilage (PJAC) method, which is an allograft articular cartilage graft in which 1-mm cartilage cubes are taken from 13 years old donors [15]. Also, Autologous matrix-induced chondrogenesis (AMIC), which combines the microfracture method with matrix-based techniques, is another procedure that has been used for repair of cartilage defects [16]. As an alternative strategy, tissue engineering using stem cells and biodegradable scaffolds has raised many hopes [17] (Figure 1).