2016 Barriers to Cartilage Restoration

Overview

Journal J Clin Orthop Trauma

Specialty Orthopedics

Date 2016 Aug 5

PMID 27489414

Citations 11

Authors

Jack Farr

Andreas H Gomoll

Affiliations

Soon will be listed here.

Abstract

Cartilage restoration has flourished since the 1990s. The early pioneering work included cell therapy by Peterson, marrow stimulation by Johnson, osteochondral autograft treatments by Hangody, and osteochondral allografts by Gross. Since those early days, many scientists and clinicians have created "variations on a theme", markedly expanding the potential options for treating patients with symptomatic chondral lesions. Nevertheless, a variety of barriers exist between these new cartilage products and their clinical applications. These barriers may be categorized as cost, regulatory, insurance, and logistical issues. While absolute solutions will remain elusive, the current goal is to define these barriers as the first step toward solving these problems.

Citing Articles

Charting a quarter-century of commercial cartilage regeneration products.

Liu X, Guo X, Pei Y, Pei M, Ge Z J Orthop Translat. 2025; 50:354-363.

PMID: 39968336 PMC: 11833628. DOI: 10.1016/j.jot.2024.10.009.

Effects of glycosaminoglycan content in extracellular matrix of donor cartilage on the functional properties of osteochondral allografts evaluated by micro-CT non-destructive analysis.

Jin Y, Park D, Noh S, Kwon H, Shin D, Park J PLoS One. 2023; 18(5):e0285733.

PMID: 37220126 PMC: 10204946. DOI: 10.1371/journal.pone.0285733.

Surgical management of focal chondral defects of the knee: a Bayesian network meta-analysis.

Migliorini F, Eschweiler J, Schenker H, Baroncini A, Tingart M, Maffulli N J Orthop Surg Res. 2021; 16(1):543.

PMID: 34470628 PMC: 8409000. DOI: 10.1186/s13018-021-02684-z.

Larger Chondral Lesions Treated with Collagen Membrane - Matrix-Induced Autologous Chondrogenesis - Show Larger Increase in Clinical Scores.

Miyahira M, Novaretti J, Astur D, Kaleka C, Amaro J, Cohen M Rev Bras Ortop (Sao Paulo). 2021; 56(3):333-339.

PMID: 34239198 PMC: 8249057. DOI: 10.1055/s-0040-1712493.

Algorithm for Treatment of Focal Cartilage Defects of the Knee: Classic and New Procedures.

Hinckel B, Thomas D, Vellios E, Hancock K, Calcei J, Sherman S Cartilage. 2021; 13(1_suppl):473S-495S.

PMID: 33745340 PMC: 8808924. DOI: 10.1177/1947603521993219.

References

Gross A, SILVERSTEIN E, Falk J, Falk R, Langer F . The allotransplantation of partial joints in the treatment of osteoarthritis of the knee. Clin Orthop Relat Res. 1975; (108):7-14. DOI: 10.1097/00003086-197505000-00003. View

Steadman J, Rodkey W, Rodrigo J . Microfracture: surgical technique and rehabilitation to treat chondral defects. Clin Orthop Relat Res. 2001; (391 Suppl):S362-9. DOI: 10.1097/00003086-200110001-00033. View

Lindahl A, Brittberg M, Peterson L . Health economics benefits following autologous chondrocyte transplantation for patients with focal chondral lesions of the knee. Knee Surg Sports Traumatol Arthrosc. 2001; 9(6):358-63. DOI: 10.1007/s001670100209. View

Clar C, Cummins E, McIntyre L, Thomas S, Lamb J, Bain L . Clinical and cost-effectiveness of autologous chondrocyte implantation for cartilage defects in knee joints: systematic review and economic evaluation. Health Technol Assess. 2005; 9(47):iii-iv, ix-x, 1-82. DOI: 10.3310/hta9470. View

Kreuz P, Steinwachs M, Erggelet C, Krause S, Konrad G, Uhl M . Results after microfracture of full-thickness chondral defects in different compartments in the knee. Osteoarthritis Cartilage. 2006; 14(11):1119-25. DOI: 10.1016/j.joca.2006.05.003. View

Kreuz P, Erggelet C, Steinwachs M, Krause S, Lahm A, Niemeyer P . Is microfracture of chondral defects in the knee associated with different results in patients aged 40 years or younger?. Arthroscopy. 2006; 22(11):1180-6. DOI: 10.1016/j.arthro.2006.06.020. View

Mithoefer K, McAdams T, Williams R, Kreuz P, Mandelbaum B . Clinical efficacy of the microfracture technique for articular cartilage repair in the knee: an evidence-based systematic analysis. Am J Sports Med. 2009; 37(10):2053-63. DOI: 10.1177/0363546508328414. View

CONVERY F, Meyers M, Akeson W . Fresh osteochondral allografting of the femoral condyle. Clin Orthop Relat Res. 1991; (273):139-45. View

Meyers M, AKESON W, CONVERY F . Resurfacing of the knee with fresh osteochondral allograft. J Bone Joint Surg Am. 1989; 71(5):704-13. View

10.

Tirico L, Demange M, Santos L, Rezende M, Helito C, Gobbi R . Development of a Fresh Osteochondral Allograft Program Outside North America. Cartilage. 2016; 7(3):222-8. PMC: 4918066. DOI: 10.1177/1947603515618484. View

11.

Lyman S, Nakamura N, Cole B, Erggelet C, Gomoll A, Farr 2nd J . Cartilage-Repair Innovation at a Standstill: Methodologic and Regulatory Pathways to Breaking Free. J Bone Joint Surg Am. 2016; 98(15):e63. DOI: 10.2106/JBJS.15.00573. View

12.

Johnson L . Arthroscopic abrasion arthroplasty historical and pathologic perspective: present status. Arthroscopy. 1986; 2(1):54-69. DOI: 10.1016/s0749-8063(86)80012-3. View

13.

Malinin T, Wagner J, Pita J, Lo H . Hypothermic storage and cryopreservation of cartilage. An experimental study. Clin Orthop Relat Res. 1985; (197):15-26. View

14.

Mankin H, Doppelt S, Tomford W . Clinical experience with allograft implantation. The first ten years. Clin Orthop Relat Res. 1983; (174):69-86. View

15.

Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L . Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med. 1994; 331(14):889-95. DOI: 10.1056/NEJM199410063311401. View

16.

Malinin T, Mnaymneh W, Lo H, Hinkle D . Cryopreservation of articular cartilage. Ultrastructural observations and long-term results of experimental distal femoral transplantation. Clin Orthop Relat Res. 1994; (303):18-32. View

17.

Hangody L, Kish G, Karpati Z, Szerb I, Udvarhelyi I . Arthroscopic autogenous osteochondral mosaicplasty for the treatment of femoral condylar articular defects. A preliminary report. Knee Surg Sports Traumatol Arthrosc. 1997; 5(4):262-7. DOI: 10.1007/s001670050061. View

18.

Minas T . Chondrocyte implantation in the repair of chondral lesions of the knee: economics and quality of life. Am J Orthop (Belle Mead NJ). 1998; 27(11):739-44. View