One Step Tissue Engineering for Cartilage Reconstruction in Severe Osteoarthritis of the Knee and Ankle: A Comprehensive Review of the Technique Resorting to Isolated BMAC or ADSCS and their Last Combination
Journal Title: NanoWorld Journal - Year 2017, Vol 3, Issue 3
Abstract
An innovative clinical procedure has provided evidence that wide areas of severe cartilage defects due to osteoarthritis of the inferior limb, Kellgren stage I to III, in particular knee and ankle, can be successfully restored through transplant of human bone marrow combined with a defined human fat tissue product, like the Lipogems product. The latter is microfractured autologous human fat, containing an intact stromal vascular niche including elements of pericyte identity (Lipogems EU, http://lipogems.eu). Both are embedded within nanofabricated scaffolds with tailored-oriented architecture and fiber diameter (Chondrotissue by Biotissue, Freiburg, D http://www.biotissue.de). Such approach yields a significantly more enhanced cartilage regeneration, as compared with the rescuing effects elicited by either bone marrow or the Lipogems product alone. All these clinical outcomes are well documented by 1.5 T NMR, elastosonography and in randomized histological samples showing a higher percentage of hyaline cartilage and rare fibrous tissue compared to the outcome of the single, not combined procedures. On these bases, the combined use of autologous non-expanded tissue products made of whole bone marrow and human white adipose tissue derivatives, such as the Lipogems product, can be considered as an autologous/homologous strategy for improving the natural capacity for self-healing in damaged osteo-articular tissues.
Authors and Affiliations
Stefano Zanasi, Carlo Ventura
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