Author/Authors :
Nogueira Giglio, Pedro Universidade de São Paulo - School of Medicine - Institute of Orthopedics and Traumatology, (IOT/FMUSP), Sao Paulo, SP, Brazil , Foresto Lizier, Nelson Universidade de São Paulo - School of Medicine - Institute of Orthopedics and Traumatology, (IOT/FMUSP), Sao Paulo, SP, Brazil , Levy, Débora Hospital das Clínicas of the Medical School of Universidade de São Paulo - Instituto do Coração - Immunology Laboratory, Lipids, Oxidation and Cell Biology Group, São Paulo, SP, Brazil , Faraco Sobrado, Marcel Universidade de São Paulo - School of Medicine - Institute of Orthopedics and Traumatology, (IOT/FMUSP), Sao Paulo, SP, Brazil , Gomes Gobbi, Riccardo Universidade de São Paulo - School of Medicine - Institute of Orthopedics and Traumatology, (IOT/FMUSP), Sao Paulo, SP, Brazil , Ricardo Pécora, José Universidade de São Paulo - School of Medicine - Institute of Orthopedics and Traumatology, (IOT/FMUSP), Sao Paulo, SP, Brazil , Paulo Bydlowski, Sergio Hospital das Clínicas of the Medical School of Universidade de São Paulo - Instituto do Coração - Immunology Laboratory, Lipids, Oxidation and Cell Biology Group, São Paulo, SP, Brazil , Kawamura Demange, Marco Universidade de São Paulo - School of Medicine - Institute of Orthopedics and Traumatology, (IOT/FMUSP), Sao Paulo, SP, Brazil
Abstract :
Objective: To describe the first series of cases of autologous chon-
drocyte implantation (ACI) in collagen membrane performed in
Brazil. Methods: ACI was performed in 12 knees of 11 patients,
aged 32.1 ± 10.9 years, with 5.3 ± 2.6 cm2 full-thickness knee
cartilage lesions, with a six-month minimum follow-up. Two sur-
gical procedures were performed: arthroscopic cartilage biopsy
for isolation and expansion of chondrocytes, which were seed-
ed onto collagen membrane and implanted in the lesion site;
the characterization of cultured cells and implant was performed
using immunofluorescence for type II collagen (COL2) for cell via-
bility and electron microscopy of the implant. Clinical safety, KOOS
and IKDC scores and magnetic resonance imaging were evaluated.
We used repeated-measures ANOVA and post-hoc comparisons
at α = 5%. Results: COL2 was identified in the cellular cytoplasm,
cell viability was higher than 95% and adequate distribution and cell
adhesion were found in the membrane. The median follow-up was
10.9 months (7 to 19). We had two cases of arthrofibrosis, one of
graft hypertrophy and one of superficial infection as complications,
but none compromising clinical improvement. KOOS and IKDC
ranged from 71.2 ± 11.44 and 50.72 ± 14.10, in preoperative period,
to 85.0 ± 4.4 and 70.5 ± 8.0, at 6 months (p = 0.007 and 0.005).
MRI showed regenerated tissue compatible with hyaline cartilage.
Conclusion: ACI in collagen membrane was feasible and safe in a
short-term follow-up, presenting regenerated formation visualized
by magnetic resonance imaging and improved clinical function.
Level of evidence IV, Case series.
Keywords :
Cartilage , Cell- and Tissue-Based Therapy , Transplan- tation , Autologous , Chondrocytes