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Repair of kissing cartilage lesions in the knee using nasal chondrocyte-based therapies – the first results

The complex “kissing lesions” that include cartilage damage on both articulating joint surfaces are considered as pre-osteoarthritic pathologies, and therefore listed as exclusion criteria for treatment by cell-based products. A sheep animal model was designed to test the possibility of extending the indications for tissue grafts to more challenging conditions. Chondrocytes were isolated from sheep nasal septum cartilage biopsy, and expanded for 13 days. The expanded cells were then seeded on a collagen scaffold (Chondro-Gide membrane) in static conditions. Two types of grafts were manufactured: a) N-CAM representing cell therapy with nasal chondrocytes (NC) seeded on a scaffold and cultured for 2 days, and b) N- TEC representing tissue therapy with NC seeded on a scaffold and cultured for 2 weeks.Six mm full thickness cartilage defects (2-3 mm depth) were made on the articular surfaces of the femoral trochlea and patella of the sheep right knee using a drill bit. The autologous grafts were cut to an appropriate size and implanted into the defects using press-fit method. Six weeks after the implantation, animals were euthanized and specimens obtained for analysis.All animals recovered well after the surgery. At necropsy there were no evidences of graft instability or dislocation. In each defect location there was apparent new tissue formation. The average ICRS (International Cartilage Repair Society) macroscopic score was higher in N-CAM group (6.3 points) than in N- TEC group (4.3 points) but both are grade III (abnormal cartilage).Early results showed good graft stability and new tissue formation in kissing lesions. Macroscopically, there is better healing in N-CAM than in N-TEC group. This could be consequence of better integration intrinsic to less mature tissues (N-CAM). Analysis at later time points are necessary to see how these therapies will withstand prolonged biomechanical forces in the joint. Funding for this research has been received from the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 681103, BIO-CHIP.

Kissing lesion, osteoarthritis, cartilage, cartilage tissue engineering, nasal chondrocytes

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