Department of Orthopedic Surgery, Otto-von-Guericke University, Magdeburg, Germany.
Meidrix biomedicals GmbH, Esslingen, Germany.
Knee Surg Sports Traumatol Arthrosc. 2024 Apr;32(4):821-828. doi: 10.1002/ksa.12101. Epub 2024 Feb 28.
Minced cartilage implantation (MCI) is an evolving technique for the treatment of osteochondral lesions. It was hypothesised that mincing of cartilage may affect chondrocyte viability and phenotype and that embedding in collagen 1 gel results in an improved outcome. The objective of this study was to evaluate the impact of cartilage mincing and whether collagen 1 gel mediates beneficial effects on the chondrocyte phenotype and viability.
Human cartilage samples from 11 patients undergoing total knee arthroplasty were collected and minced according to the MCI protocol. Minced cartilage was cultured for 1 week with and without embedding in collagen 1 gel and was compared with unminced cartilage flakes as control. Quantitative reverse transcription-PCR and immunohistochemical staining for the chondrocyte marker genes SOX9, COL2, ACAN, COL10 and MMP13 were used to examine the chondrocyte phenotype. Cell death was assessed by the terminal deoxynucleotidyl transferase dUTP nick-end labeling assay.
Increased chondrocyte cell death of cultured cartilage after mincing was observed. Chondrocytes from minced cartilage exhibited significantly decreased expression and protein levels of homeostatic and hypertrophic chondrocyte markers. Embedding in collagen 1 gel showed no positive effect on viability. However, remarkable is the increased expression of ACAN and the preserved protein level of SOX9 in the collagen 1-embedded minced cartilage.
This study shows that the mincing of cartilage leads to increased chondrocyte death and decreased expression of chondrocyte phenotypic marker genes after 7 days. The use of collagen 1 gel may improve the stability of the phenotype, which needs to be further elucidated.
Level III (therapeutic).
碎软骨植入（MCI）是一种治疗骨软骨病变的新兴技术。研究假设软骨的粉碎可能会影响软骨细胞的活力和表型，而嵌入胶原 1 凝胶中会产生更好的结果。本研究的目的是评估软骨粉碎的影响，以及胶原 1 凝胶是否会对软骨细胞表型和活力产生有益影响。
从 11 例行全膝关节置换术的患者中收集软骨样本，并根据 MCI 方案进行粉碎。粉碎后的软骨在有和没有嵌入胶原 1 凝胶的情况下培养 1 周，并与未粉碎的软骨片作为对照进行比较。使用定量逆转录聚合酶链反应和免疫组织化学染色检测软骨细胞标志物基因 SOX9、COL2、ACAN、COL10 和 MMP13，以检查软骨细胞表型。通过末端脱氧核苷酸转移酶 dUTP 缺口末端标记法评估细胞死亡。
培养的粉碎软骨中的软骨细胞死亡增加。从粉碎软骨中分离的软骨细胞表现出明显降低的稳态和肥大性软骨细胞标志物的表达和蛋白水平。嵌入胶原 1 凝胶对活力没有积极影响。然而，令人瞩目的是，嵌入胶原 1 的粉碎软骨中 ACAN 的表达增加和 SOX9 蛋白水平的保持。
本研究表明，软骨的粉碎会导致软骨细胞死亡增加和软骨细胞表型标志物基因表达降低，培养 7 天后会出现这种情况。使用胶原 1 凝胶可能会改善表型的稳定性，这需要进一步阐明。
III 级（治疗）。
