Cell Co-Implantations With Chondrocytes for Cartilage Repair: A Systematic Review of In Vivo Results.
Willem Theodoor Olijve, Thomas William Penn, Willem Cornelis de Jong et al.
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In 30 seconds
This systematic review assessed in vivo cartilage repair using chondrocytes implanted with a second cell type, drawing on 48 studies across 46 publications: 44 animal studies and four clinical trials. In all 27 experiments that included chondrocyte-only controls, co-implantation produced synergistic cartilage formation. Cartilage formation was also reported in 15 of 17 experiments without that control and in all four clinical trials. The authors concluded that adding another cell type, including mesenchymal stromal cells, may improve repair and supports further clinical exploration of single-stage approaches.
Key findings
- All 27 experiments with chondrocyte-only controls found synergistic cartilage formation with co-implantation.
- Cartilage formation was reported in 15 of 17 experiments without chondrocyte-only controls.
- Cartilage formation was reported in all four clinical trials.
- The review included 44 animal studies—26 ectopic and 18 orthotopic—and four clinical trials.
Why it matters
Conventional chondrocyte therapy requires laboratory expansion and two surgical procedures. Co-implanting chondrocytes with another cell type is a potential basis for single-stage repair, and the reviewed in vivo findings provide a rationale for continued clinical investigation. However, the evidence base includes substantial animal research, and the review identified concerns about study reporting quality and risk of bias.
What to keep in mind
Ectopic animal studies scored poorly for reporting quality and risk of bias; orthotopic studies were only moderately better. The clinical evidence comprised four trials.