Chondrocytes Transplantation in Articular Cartilage Regeneration

master's thesis

• Title (croatian): Transplantacija hondrocita u regeneraciji zglobne hrskavice
• Author: Tal Menaged
• Mentor: Mislav Jelić (mentor)
• Committee member: Mislav Jelić (predsjednik povjerenstva)
• Committee member: Domagoj Delimar (član povjerenstva)
• Committee member: Tomislav Đapić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Orthopedics); Zagreb
• Defense date and country: 2024-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Orthopedics

Abstract

Chondrocytes transplantation in articular cartilage regeneration combines new and recent surgical and scientific advancements in cell therapy which is used to treat acute or overuse injuries of the articular cartilage. This surgical technique is called Autologous Chondrocyte Implantation (ACI) and has been performed, studied and improved over the last thirty years.
Autologous Chondrocyte Implantation is done by harvesting chondrocytes from a healthy area of the cartilage, then the chondrocytes are cultured in a laboratory, before being implanted again in the area of the injured cartilage. ACI is a surgical procedure that mainly targets the repair and regeneration of the articular cartilage of the knee joint.
This procedure can be performed with three slightly different modifications known as three generations. While first generation includes placing a periosteal cover over the defect area of cartilage to house the autologous chondrocytes, second generation uses a collagen membrane as a cover instead of the periosteal cover from the first generation. The third generation is based on biomaterials in which the autologous chondrocytes are embedded before being implanted to the area of the defect.
ACI is the topic of many studies which try to conclude how does this technique fit in the world of articular cartilage surgery, meaning how does this procedure compete with other different available procedures. First, studies were being done to measure the short and mid-term effectiveness of the surgery while later as the different generations emerged studies focused on challenging them against one another. Finally, and still on-going, ACI is being tested and studied in the long-term post-surgery period, to measure the success and the incidence of osteoarthritis as well as preserved function of the joint.
ACI is an expensive option for the patients and also requires them to be actively and highly involved in the long process of physical therapy and rehabilitation. It was concluded at this point that ACI is an effective technique both in the short and mid-term periods as well as the long-term periods post-surgery. Many of the patients that were studied reported excellent or good outcomes and this is also supported with the data provided by clinical scoring methods and imaging done during this studies.

Abstract (croatian)

Transplantacija hondrocita u regeneraciji zglobne hrskavice kombinira novija kirurška i znanstvena dostignuća u staničnoj terapiji koja se koristi za liječenje akutnih ili kroničnih ozljeda zglobne hrskavice. Ovaj kirurška tehnika naziva se autologna transplantacija hondrocita (eng. autologous chondrocyte implantation – ACI) te se izvodi, proučava i poboljšava posljednjih trideset godina.
Metoda autologne transplantacije hondrocita podrazumijeva uzimanje hondrocita iz zdravog područja hrskavice, njihovo obrađivanje i umnožavanje u laboratoriju te ponovnu implantaciju u područje ozlijeđene hrskavice. Cilj autologne transplantacije hondrocita je oporavak i regeneracija zglobne hrskavice koljena.
Ova se metoda može izvesti s tri različite modifikacije, poznatije kao generacije. Dok prva generacija obuhvaća postavljanje periostalnog presadka preko oštećenog područja hrskavice za smještaj autolognih hondrocita, druga generacija kao presadak koristi kolagenu membranu kao pokrov umjesto periostalnog presadka iz prve generacije.Treća generacija koristi biomaterijale u koje su autologni hondrociti dodani prije implantacije u oštećeno područje
Mnoge studije pokušavaju uklopiti ACI metodu u svijet kirurgije zglobne hrskavice, odnosno usporediti je s drugim različitim dostupnim postupcima. Prvo su se studije radile kako bi se izmjerila kratkoročna i srednjoročna učinkovitost operacije, dok su se kasnije, s pojavom različitih generacija, studije usredotočile na njihovu međusobnu usporedbu. Još uvijek su u tijeku studije koje testiraju i proučavaju ACI u dugotrajnom postoperativnom razdoblju kako bi se izmjerila uspješnost i učestalost pojave osteoartritisa te očuvala funkcija zgloba. Studije su došle do zaključka da je ACI učinkovita metoda kako u kratkoročnom, tako i u srednjoročnom te dugotrajnom postoperativnom razdoblju.
Uz to što je skupa opcija za pacijente, ACI također zahtijeva od pacijenata da budu aktivno uključeni u dugi proces fizikalne terapije i rehabilitacije. Međutim, mnogi od pacijenata koji su sudjelovali u ispitivanjima pokazuju izvrsne ili dobre ishode, što je također potkrijepljeno podacima dobivenim kliničkim metodama bodovanja i snimanjima učinjenim tijekom ovih studija.

• Keywords: Chondrocyte implantation; Cartilage regeneration; Autologous Chondrocyte Implantation (ACI); Articular cartilage regeneration
• Keywords (croatian): Implantacija hondrocita; regeneracija hrskavice; autologna transplantacija hondrocita (ACI); regeneracija zglobne hrskavice
• Language: english
• URN:NBN: urn:nbn:hr:105:076101
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-10-18 09:41:11