Mesenchymal Stem Cell Constructs for Repair of Focal Cartilage Defects in an Ovine Model

Focal cartilage defects (FCD) of the knee joint remain a difficult area of treatment for orthopaedic surgeons, as they often progress to generalized osteoarthritis (OA). Osteochondral autograft transfer (OAT) to the damaged cartilage area has shown promise, but this has been associated with pain and bleeding at the site of graft harvest. The use of mesenchymal stem cells (MSCs) in a matrix to regenerate articular cartilage has been proposed. This work describes a prospective case-control series comparing OAT with a novel, MSC-seeded scaffold graft in the stifle joints of healthy merino sheep. The triphasic grafts were composed of a beta-tricalcium phosphate osseous phase, an intermediate activated plasma phase and a collagen I hydrogel cartilage phase. The osseous and cartilage phases were seeded with autologous MSCs. All sheep underwent creation of a full-thickness, 4.0 mm diameter FCD (n=20) followed by six weeks of unrestricted activity, allowing the defects to degenerate naturally. At six weeks, half of the lesions were treated with OAT and half with the triphasic engineered grafts. At 6-month and 12-month follow-up, no significant differences were noted between groups with regard to overall histological scores. Macroscopic and biomechanical analysis at 12 months showed no significant differences between groups. In summary, autologous MSC-seeded implants showed comparable repair quality to OAT without the associated donor site morbidity