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The genesis of autologous chondrocyte transplantation/implantation: From a hypothesis via an animal model to a clinical reality

Författare och institution:
Lars Peterson (Institutionen för kliniska vetenskaper, sektionen för anestesi, biomaterial och ortopedi, Avdelningen för ortopedi)
Publicerad i:
Developing Insights in Cartilage Repair, s. 161-185
ISBN:
978-14-47-15385-6
Publikationstyp:
Kapitel, refereegranskat
Förlag:
Springer-Verlag London Ltd
Publiceringsår:
2014
Språk:
engelska
Fulltextlänk:
Sammanfattning (abstract):
For more then 2000 years articular cartilage lesions have been recognized as a clinical problem and with no intrinsic healing or optimal treatment. In 1987 the first autologous cell transplantation was performed using isolated and cultured chondrocytes which were injected into an articular cartilage lesion covered with autologous periosteum. This first transplantation was based on solid information from in vitro chondrocyte research with animal and human cell culture techniques as well as extensive animal model studies. These animal studies included the first results using a semisynthesized collagen type I sponge injected with chondrocytes and implanted in defects. This research was the beginning for future use of artificial resorbable scaffolds and arthroscopic surgical technique. Since 1994 the results of ACT/ACI have been repeatedly reported. The result of 10-20 years follow up was reported in 2010 showing durable outcomes. The subjective results are supported by objective evaluations of histology of biopsies, immunohistochemistry, mechanical stiffness tests, gadolinium enhanced MRI after 8-20 years showing functional hyaline-like tissue. Even with wider indications towards early posttraumatic osteoarthritis such as large, uncontained, unshouldered lesions, multiple and bipolar lesions, the results have been acceptable. However, this would not have been possible without addressing and correcting concomitant background factors creating an optimal environment for the repair tissue to survive over time. Further improvement and simplifications in the treatment could be expected with optimal cell sources and development of biodegradable scaffolds/membranes and gels allowing arthroscopic technique, early and safe weightbearing but complex cases still may need extensive open surgery for success. © 2014 Springer-Verlag London. All rights are reserved.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
MEDICIN OCH HÄLSOVETENSKAP ->
Klinisk medicin ->
Ortopedi
Nyckelord:
Autologous, Background factors, Chondrocyte, Long term results, Transplantation
Postens nummer:
226810
Posten skapad:
2015-12-01 17:27
Posten ändrad:
2016-05-09 15:36

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