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Open Access Highly Accessed Research article

Autologous chondrocyte implantation for cartilage repair: monitoring its success by magnetic resonance imaging and histology

Sally Roberts12*, Iain W McCall23, Alan J Darby4, Janis Menage1, Helena Evans1, Paul E Harrison5 and James B Richardson26

Author Affiliations

1 Centre for Spinal Studies, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Trust, Oswestry, Shropshire, UK

2 Keele University, Keele, Staffordshire, UK

3 Department of Diagnostic Imaging, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Trust, Oswestry, Shropshire, UK

4 Department of Histopathology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, UK

5 Arthritis Research Centre, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Trust, Oswestry, Shropshire, UK

6 Institute of Orthopaedics, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Trust, Oswestry, Shropshire, UK

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Arthritis Res Ther 2003, 5:R60-R73  doi:10.1186/ar613

Published: 13 November 2002

Abstract

Autologous chondrocyte implantation is being used increasingly for the treatment of cartilage defects. In spite of this, there has been a paucity of objective, standardised assessment of the outcome and quality of repair tissue formed. We have investigated patients treated with autologous chondrocyte implantation (ACI), some in conjunction with mosaicplasty, and developed objective, semiquantitative scoring schemes to monitor the repair tissue using MRI and histology. Results indicate repair tissue to be on average 2.5 mm thick. It was of varying morphology ranging from predominantly hyaline in 22% of biopsy specimens, mixed in 48%, through to predominantly fibrocartilage, in 30%, apparently improving with increasing time postgraft. Repair tissue was well integrated with the host tissue in all aspects viewed. MRI scans provide a useful assessment of properties of the whole graft area and adjacent tissue and is a noninvasive technique for long-term follow-up. It correlated with histology (P = 0.02) in patients treated with ACI alone.

Keywords:
cartilage repair; collagens; glycosaminoglycans histology; MRI