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

Knee Surg Sports Traumatol Arthrosc. 2016 Dec;24(12):3988-3996. doi: 10.1007/s00167-015-3536-5. Epub 2015 Feb 10.

Abstract

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.

Keywords: Adult; Cartilage repair; Chondral fragments; In vivo; Juvenile; Rabbit.

MeSH terms

  • Age Factors
  • Animals
  • Cartilage / injuries
  • Cartilage / metabolism
  • Cartilage / pathology
  • Cartilage / transplantation*
  • Cartilage Diseases / metabolism
  • Cartilage Diseases / pathology
  • Cartilage Diseases / surgery*
  • Cartilage, Articular / metabolism
  • Cartilage, Articular / pathology
  • Cartilage, Articular / surgery*
  • Collagen Type II / metabolism
  • Female
  • Femur
  • Immunohistochemistry
  • Rabbits
  • Random Allocation
  • Transplantation, Autologous
  • Transplantation, Homologous

Substances

  • Collagen Type II