Sadlik Boguslaw, Jaroslawski Grzegorz, Puszkarz Mariusz, Blasiak Adrian, Oldak Tomasz, Gladysz Dominika, Whyte Graeme P
Biological Joint Reconstruction Department, St. Luke's Hospital, Bielsko-Biala, Poland.
Polish Stem Cell Bank, Warsaw, Poland.
Arthrosc Tech. 2017 Dec 25;7(1):e57-e63. doi: 10.1016/j.eats.2017.08.055. eCollection 2018 Jan.
Cell-based cartilage repair procedures are becoming more widely available and have shown promising potential to treat a wide range of cartilage lesion types and sizes, particularly in the knee joint. More recently, techniques have evolved from 2-step techniques that use autologous chondrocyte expansion to 1-step techniques that make use of mesenchymal stem cells (MSCs) embedded onto biocompatible scaffolding. Our 1-step technique has been further developed to provide cell-based cartilage repair using MSCs that have the potential to be used in an off-the-shelf manner, without the need for autologous tissue harvest. Precursor MSCs can be isolated in abundance from the Wharton's jelly of umbilical cord tissue. These cells have been shown to have the desired capacity for proliferation, differentiation, and release of trophic factors that make them an excellent candidate for use in the clinical setting to provide cell-based restoration of hyaline-like cartilage. Although allogeneic in nature, these cells stimulate little or no host immune response and can be stored for long periods while maintaining viability. We present a technique of cartilage repair in the knee using Wharton's jelly-derived MSCs embedded onto scaffolding and implanted in a minimally invasive fashion using dry arthroscopy.
基于细胞的软骨修复手术正变得越来越普及,并已显示出治疗各种类型和大小的软骨损伤的潜力,尤其是在膝关节中。最近,技术已从使用自体软骨细胞扩增的两步技术发展为利用嵌入生物相容性支架的间充质干细胞(MSC)的一步技术。我们的一步技术已进一步发展,以提供使用MSC的基于细胞的软骨修复,这些MSC有可能以现成的方式使用,而无需采集自体组织。前体MSC可以从脐带组织的华通氏胶中大量分离出来。这些细胞已被证明具有所需的增殖、分化和释放营养因子的能力,这使它们成为临床环境中用于提供透明样软骨基于细胞修复的极佳候选者。尽管本质上是同种异体的,但这些细胞几乎不会刺激宿主免疫反应,并且可以长时间储存同时保持活力。我们展示了一种在膝关节中使用嵌入支架并通过干式关节镜以微创方式植入的华通氏胶来源的MSC进行软骨修复的技术。