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Clinical experience of implanting human autologous chondrocyte spheroids for the treatment of knee cartilage defects

https://doi.org/10.17238/issn2226-2016.2025.4.53-61

Abstract

Introduction. Articular cartilage has a very limited capacity for self-repair; therefore, its damage often leads to irreversible changes. Various technologies have been developed for cartilage restoration, including autologous chondrocyte implantation (ACI). The method is based on culturing autologous cells that produce cartilage matrix, followed by their implantation into the articular cartilage defect.

Objective. Presentation of clinical cases of the first use of human autologous chondrocytes in routine practice in Russia.

Materials and Methods. Two clinical cases of articular cartilage defects in different anatomical locations were analyzed. The follow-up period after implantation was 4 months. During routine visits, patients underwent interviews, physical examination, range-of-motion assessment, and objective clinical evaluation. MRI of the target knee joints was performed before the first surgical intervention and 4 months after second surgery. Two surgical procedures were carried out according to the described technique, with intraoperative photographic documentation of the joint before and after autologous chondrosphere implantation.

Results. During the follow-up of two clinical cases with articular cartilage defects treated with implantation of autologous chondrospheres, positive early outcomes were obtained. A reduction in pain, an increase in range of motion, and an improvement in joint function were observed. Follow-up MRI of the operated knee joints at 4 months confirmed the formation of a homogeneous regenerate and satisfactory integration of the chondrospheres with the surrounding cartilage. The postoperative period was uneventful, and the patients reported an improvement in quality of life.

Conclusion. The use of autologous chondrospheres is a promising and effective method for repairing cartilage defects of the knee joint. The technique provides lasting improvement in joint function and morphologically confirmed cartilage regeneration.

About the Authors

A. V. Lychagin
First Moscow State Medical University named after I.M. Sechenov, Ministry of Health of the Russian Federation
Russian Federation

Alexey V. Lychagin – Doctor of Medical Sciences, Professor, Head of Department of traumatology, orthopedics and disaster surgery, I.M. Sechenov First Moscow State Medical University (Sechenov University).

Moscow, 119991



A. A. Svistunov
First Moscow State Medical University named after I.M. Sechenov, Ministry of Health of the Russian Federation
Russian Federation

Andrey A. Svistunov – Doctor of Medical Sciences, Professor, Director of the Institute of Digital Biodesign and Artificial Intelligence in Medicine, Head of the Project Office of the Center for Digital Biodesign and Personalized Healthcare, First Vice-Rector of the I.M. Sechenov First Moscow State Medical University (Sechenov University).

Moscow, 119991



E. B. Kalinsky
First Moscow State Medical University named after I.M. Sechenov, Ministry of Health of the Russian Federation
Russian Federation

Eugene B. Kalinsky – Doctor of Medical Sciences, Docent, Professor at Department of traumatology, orthopedics and disaster surgery, I.M. Sechenov First Moscow State Medical University (Sechenov University).

Moscow, 119991



A. V. Garkavi
First Moscow State Medical University named after I.M. Sechenov, Ministry of Health of the Russian Federation
Russian Federation

Andrey V. Garkavi – Doctor of Medical Sciences, Professor, Professor of Department of Traumatology, Orthopedics and Disaster Surgery I.M.Sechenov First Moscow State Medical University.

Moscow, 119991



G. M. Kavalerskiy
First Moscow State Medical University named after I.M. Sechenov, Ministry of Health of the Russian Federation
Russian Federation

Gennady M. Kavalersky - Doctor of Medical Sciences, Professor, I.M.Sechenov First Moscow State Medical University e Department of Traumatology, Orthopedics and Disaster Surgery, Professor.

Moscow, 119991



T. R. Kudrachev
First Moscow State Medical University named after I.M. Sechenov, Ministry of Health of the Russian Federation
Russian Federation

Tagir R. Kudrachev – Candidate of Medical Sciences, assistant of the Department of traumatology, orthopedics and disaster surgery, I.M. Sechenov First Moscow State Medical University (Sechenov University).

Moscow, 119991



Yu. R. Goncharuk
First Moscow State Medical University named after I.M. Sechenov, Ministry of Health of the Russian Federation
Russian Federation

Yuliya R. Goncharuk – Candidate of Medical Sciences, Associate professor of the Department of traumatology, orthopedics and disaster surgery, I.M. Sechenov First Moscow State Medical University (Sechenov University).

Moscow, 119991



K. M. Azarkin
First Moscow State Medical University named after I.M. Sechenov, Ministry of Health of the Russian Federation
Russian Federation

Kirill M. Azarkin – assistant of the Department of traumatology, orthopedics and disaster surgery, I.M. Sechenov First Moscow State Medical University (Sechenov University).

Moscow, 119991



D. A. Pogosyan
I.M. Sechenov Fist Moscow State Medical University (Sechenov University)
Russian Federation

David A. Pogosyan – assistant of the Department of Life Safety and Disaster Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University).

Moscow, 119991



E. E. Murdalov
JSC “Medsi Group of Companies”
Russian Federation

Emirkhan E. Murdalov – trauma and orthopedic surgeon, MEDSI Clinic on Molodyozhnaya (Odintsovo).

123056, Moscow



References

1. Buckwalter JA, Mankin HJ. Articular cartilage: degeneration and osteoarthritis, repair, regeneration, and transplantation. Instr Course Lect. 1998; 47: 487–504.

2. Hunziker EB. Articular cartilage repair: basic science and clinical progress. A review of the current status and prospects. Osteoarthritis Cartilage. 2002 June; 10 (6): 432–63. https://doi.org/10.1053/joca.2002.0801

3. Houck DA, Kraeutler MJ, Belk JW, Frank RM, McCarty EC, Bravman JT. Do Focal Chondral Defects of the Knee Increase the Risk for Progression to Osteoarthritis? A Review of the Literature. Orthop J Sports Med. 2018 Oct; 6 (10): 2325967118801931. https://doi.org/10.1177/2325967118801931

4. Wang Y, Ding C, Wluka AE, Davis S, Ebeling PR, Jones G, et al. Factors affecting progression of knee cartilage defects in normal subjects over 2 years. Rheumatology (Oxford). 2006 Jan 1; 45 (1): 79–84. https://doi.org/10.1093/rheumatology/kei108

5. Flanigan DC, Harris JD, Trinh TQ, Siston RA, Brophy RH. Prevalence of chondral defects in athletes’ knees: a systematic review. Med Sci Sports Exerc. 2010 Oct; 42 (10): 1795–801. https://doi.org/10.1249/MSS.0b013e3181d9eea0

6. Frank RM, Cotter EJ, Nassar I, Cole B. Failure of Bone Marrow Stimulation Techniques. Sports Med Arthrosc Rev. 2017 Mar; 25 (1): 2–9. https://doi.org/10.1097/JSA.0000000000000134

7. Merkely G, Ackermann J, Lattermann C. Articular Cartilage Defects: Incidence, Diagnosis, and Natural History. Operative Techniques in Sports Medicine. 2018 Sept 1; 26 (3): 156–61. https://doi.org/10.1053/j.otsm.2018.06.008

8. Arøen A, Løken S, Heir S, Alvik E, Ekeland A, Granlund OG, et al. Articular cartilage lesions in 993 consecutive knee arthroscopies. Am J Sports Med. 2004; 32 (1): 211–5. https://doi.org/10.1177/0363546503259345

9. Legalacts [Internet]. [cited 2025 Nov 30]. "Klinicheskie rekomendatsii “Povrezhdeniya khryashcha kolennogo sustavA” (odobreny Minzdravom Rossii). Available from: https://legalacts.ru/doc/klinicheskie-rekomendatsii-povrezhdenija-khrjashcha-kolennogo-sustava-utv-minzdravom-rossii/

10. Lee DH, Kim SJ, Kim SA, Ju G ik. Past, present, and future of cartilage restoration: from localized defect to arthritis. Knee Surg & Relat Res. 2022 Jan 28; 34 (1): 1. https://doi.org/10.1186/s43019-022-00132-8

11. Borodi PG, Russu OM, Feier AM, Georgeanu VA, Zuh SG, Pop TS. Is Microfracture Alone Enough? Applied Sciences. 2021 Jan; 11 (16): 7309. https://doi.org/10.3390/app11167309

12. Boffa A, Previtali D, Altamura SA, Zaffagnini S, Candrian C, Filardo G. Platelet-Rich Plasma Augmentation to Microfracture Provides a Limited Benefit for the Treatment of Cartilage Lesions: A Meta-analysis. Orthop J Sports Med. 2020 Apr 21; 8 (4): 2325967120910504. https://doi.org/10.1177/2325967120910504

13. DiBartola AC, Everhart JS, Magnussen RA, Carey JL, Brophy RH, Schmitt LC, et al. Correlation between histological outcome and surgical cartilage repair technique in the knee: A meta-analysis. The Knee. 2016 June 1; 23 (3): 344–9. https://doi.org/10.1016/j.knee.2016.01.017

14. Kulyaba T.A., Bantser S.A., Trachuk P.A., Vorontsova T.N., Kornilov N.N. Ehffektivnost' razlichnykh khirurgicheskikh metodik pri lechenii lokal'nykh povrezhdenii khryashcha kolennogo sustava (obzor literatury). Travmatologiya i ortopediya Rossii. 2020; 26 (3): 170–81.

15. Rivière C, Iranpour F, Auvinet E, Howell S, Vendittoli PA, Cobb J, et al. Alignment options for total knee arthroplasty: A systematic review. Orthop Traumatol Surg Res. 2017 Nov; 103 (7): 1047–56. https://doi.org/10.1016/j.otsr.2017.07.010

16. Lum ZC, Holland CT, Meehan JP. Systematic review of single stage revision for prosthetic joint infection. World J Orthop. 2020 Dec 18; 11 (12): 559–72. https://doi.org/10.5312/wjo.v11.i12.559

17. Na Y, Shi Y, Liu W, Jia Y, Kong L, Zhang T, et al. Is implantation of autologous chondrocytes superior to microfracture for articular-cartilage defects of the knee? A systematic review of 5-year follow-up data. Int J Surg. 2019 Aug; 68: 56–62. https://doi.org/10.1016/j.ijsu.2019.06.007

18. Zoricheva A.S., Zvonova E.A., Agapova L.S., Lykova M.S., Markova O.A., Leonov V.S. Opyt proizvodstva i klinicheskogo primeneniya biomeditsinskogo kletochnogo produkta IzitenS® dlya vosstanovleniya povrezhdenii khryashchevoi tkani kolennogo sustava cheloveka. BIO-preparaty. Profilaktika, diagnostika, lechenie. 2024; 24 (2): 172-187. https://doi.org/10.30895/2221-996X-2024-24-2-172-187

19. Cabell GH, Hurley ET, Danilkowicz RM, Brittberg M, Flanigan DC, Kon E, et al. Chondrocyte-based approaches and scaffolds for knee cartilage injuries - an international Delphi consensus statement. Journal of Cartilage & Joint Preservation. 2024 Sept 1; 4 (3, Supplement): 100200. https://doi.org/10.1016/j.jcjp.2024.100200

20. Hulme CH, Perry J, McCarthy HS, Wright KT, Snow M, Mennan C, et al. Cell therapy for cartilage repair. Emerg Top Life Sci. 2021 Aug 23; 5 (4): 575–89. https://doi.org/10.1042/ETLS20210015


Review

For citations:


Lychagin A.V., Svistunov A.A., Kalinsky E.B., Garkavi A.V., Kavalerskiy G.M., Kudrachev T.R., Goncharuk Yu.R., Azarkin K.M., Pogosyan D.A., Murdalov E.E. Clinical experience of implanting human autologous chondrocyte spheroids for the treatment of knee cartilage defects. Department of Traumatology and Orthopaedics. 2025;(4):53-61. (In Russ.) https://doi.org/10.17238/issn2226-2016.2025.4.53-61

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ISSN 2226-2016 (Print)