Cartilage Lesion
 
 
 
 
 
 
 
 
 

Cultivation of cells in monolayers for 3-4 weeks
 
 
 
 
 
 
 
 

Injection of cultured  chondrocytes under flap into lesion

Several possible treatment methods for the treatment of joint cartilage deterioration include abrasion arthroplasty, microfracture and drilling. The biologic rationale of these techniques is not clear cut.  Abrasion arthroplasty removes many cartilage fragments the joint  and thus might decrease the inflammation of the joint. Drilling and microfracture techniques generate a healing response. However,  the healing response is inadequate as .no hyaline cartilage is formed but rather fibrocartilage. This issue has a limited life span in joints of about one year. Thus, rapid deterioration after such procedures can be expected and is indeed observed clinically. Perichondrial resurfacing is a promising  technique,  as it might generate hyaline cartilage. Unfortunately, isolated cartilage defects are often too large to be covered by perichondrium. Long term follow-up of such procedures indicate that the implants undergo endochondral ossifiation. Use of synthetic materials such as a carbon fiber mesh is ot successful as it often results in fibrous tissue formation, which is not adequate biomechanically. Such synthetic materials  also are often the cause for synovitis in the joints. Osteocartilaginous grafts are appropriate for he reconstruction of joints. Unfortunately, fresh cartilage is transplanted, the cartilage is dead. Fresh grafts are not commonly used, as they inevitably  carry a risk of disease transmission. Cryopreserved grafts, can survive for many years, but ultimately deteriorate.

Rationale for Chondrocyte Autologous Transplantation

Adult articular chondrocytes are incapable of cell  proliferation in-vivo. However it has been demonsented that de-differentiation of the cells and expansion of cell number can be achieved in-vitro, by alteration of culture conditions. Chondrocytes grown in-vitro can be successfully used for re-surfacing joints. In contrast to osteo-chondral grafts, the newly grown chondrocytes regenerate the cartilage to host bone interface, i.e.. the subchondral bone plate.  The regenerated cartilage does no seem to undergo rejection or destruction.

Expected results

Approximately 80 percent of treated patients will experience improved joint performance in most patients, a decrease in joint related symptoms will occur. 

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