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dc.contributor.authorEpanomeritakis, Ilias Ektor
dc.contributor.authorLee, Ernest
dc.contributor.authorLu, Victor
dc.contributor.authorKhan, Wasim
dc.date.accessioned2022-04-08T02:30:41Z
dc.date.available2022-04-08T02:30:41Z
dc.date.issued2022-04-06
dc.identifier.issn1422-0067
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/335902
dc.description.abstractFocal chondral defects of the knee occur commonly in the young, active population due to trauma. Damage can insidiously spread and lead to osteoarthritis with significant functional and socioeconomic consequences. Implants consisting of autologous chondrocytes or mesenchymal stem cells (MSC) seeded onto scaffolds have been suggested as promising therapies to restore these defects. However, the degree of integration between the implant and native cartilage still requires optimization. A PRISMA systematic review and meta-analysis was conducted using five databases (PubMed, MEDLINE, EMBASE, Web of Science, CINAHL) to identify studies that used autologous chondrocyte implants (ACI) or MSC implant therapies to repair chondral defects of the tibiofemoral joint. Data on the integration of the implant-cartilage interface, as well as outcomes of clinical scoring systems, were extracted. Most eligible studies investigated the use of ACI only. Our meta-analysis showed that, across a total of 200 patients, 64% (95% CI (51%, 75%)) achieved complete integration with native cartilage. In addition, a pooled improvement in the mean MOCART integration score was observed during post-operative follow-up (standardized mean difference: 1.16; 95% CI (0.07, 2.24), p = 0.04). All studies showed an improvement in the clinical scores. The use of a collagen-based scaffold was associated with better integration and clinical outcomes. This review demonstrated that cell-seeded scaffolds can achieve good quality integration in most patients, which improves over time and is associated with clinical improvements. A greater number of studies comparing these techniques to traditional cartilage repair methods, with more inclusion of MSC-seeded scaffolds, should allow for a standardized approach to cartilage regeneration to develop.
dc.languageen
dc.publisherMDPI AG
dc.subjectautologous chondrocyte implantation
dc.subjectmesenchymal stem cells
dc.subjectcartilage
dc.subjectfemoral condyle
dc.subjectimplant
dc.subjectscaffold
dc.subjectcartilage to cartilage integration
dc.titleThe Use of Autologous Chondrocyte and Mesenchymal Stem Cell Implants for the Treatment of Focal Chondral Defects in Human Knee Joints-A Systematic Review and Meta-Analysis.
dc.typeArticle
dc.date.updated2022-04-08T02:30:40Z
prism.issueIdentifier7
prism.publicationNameInt J Mol Sci
prism.volume23
dc.identifier.doi10.17863/CAM.83336
dcterms.dateAccepted2022-04-03
rioxxterms.versionofrecord10.3390/ijms23074065
rioxxterms.versionVoR
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0/
dc.contributor.orcidEpanomeritakis, Ilias Ektor [0000-0002-4810-4197]
dc.contributor.orcidLee, Ernest [0000-0003-2509-013X]
dc.contributor.orcidLu, Victor [0000-0002-6818-1683]
dc.contributor.orcidKhan, Wasim [0000-0003-3106-5424]
dc.identifier.eissn1422-0067
pubs.funder-project-idARTHRITIS RESEARCH UK (21156)
cam.issuedOnline2022-04-06


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