Evolution of Autologous Chondrocyte Repair and Comparison to Other Cartilage Repair Techniques
Table 1
Summary of techniques.
Category/technique
Schematic representation
Notes
Commercial products
Surgical bone marrow access
Pridie drilling
Cell source: autologous bone marrow constituents Scaffold: none (i) 1 stage (ii) Open procedure (iii) 2- to 2.5-mm drill holes to access bone marrow (iv) Inconsistent results (v) Long recovery (vi) High complication rate
Microfracture
Cell source: autologous bone marrow constituents Scaffold: none (i) 1 stage (ii) Arthroscopic procedure (iii) 0.5- to 1-mm drill holes to access bone marrow (iv) Less impact than Pridie drilling on biomechanics of underlying subchondral bone
Abrasion chondroplasty
Cell source: autologous bone marrow constituents Scaffold: none (i) 1 stage (ii) Arthroscopic procedure (iii) Irreproducible, unreliable (iv) Loss of underlying subchondral mechanical support
Mosaicplasty
Cell source: osteochondral autograft and autologous bone marrow constituents Scaffold: N/A (i) 1 stage (ii) Morbidity at harvest site (iii) Osteochondral plugs 15–20 mm deep (iv) Blood clot in interspaces
Autologous matrix-induced chondrogenesis
Cell source: autologous bone marrow constituents Scaffold: hydrogel (i) 1 stage (ii) Arthroscopic procedure (iii) 0.5- to 1-mm drill holes to access bone marrow (iv) Less impact than Pridie drilling on biomechanics of underlying subchondral bone
ChonDux CART-PATCH BST-CarGel
Chondrocyte implantation
First generation
Cell Source: autologous chondrocytes Scaffold: none (i) 2 stages (ii) Periosteal patch or collagen membrane (iii) Secured by sutures and/or fibrin glue (iv) Greatest clinical experience
Chondro-Gide Carticel
Second generation
Cell source: autologous chondrocytes Scaffold: hydrogel, fibrous scaffold, decellularized ECM, or composite (i) 1 or 2 stages (ii) ±Cells expanded and seeded in scaffold or matrix (iii) Also known as matrix-induced autologous chondrocyte implantation (MACI)
Hyalograft C BioSeed-C Histogenics NeoCart CaReS Cartilage Autograft Implantation System
Third generation
Cell source: allogenic stem cells, autologous stem cells Scaffold: hydrogel, fibrous scaffold, decellularized ECM, or composite (i) 1 stage (ii) Differentiation of pluripotent stem cells induced by environment (iii) Least clinical experience
