Autologous engineering of cartilage

Pieter J. Emans*, Lodewijk W. van Rhijn, Tim J. M. Welting, Andy Cremers, Nina Wijnands, Frank Spaapen, J. Willem Voncken, V. Prasad Shastri

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Treatment of full-thickness damage to hyaline cartilage is hampered by the limited availability of autologous healthy cartilage and the lengthy, cost-prohibitive cell isolation and expansion steps associated with autologous cartilage implantation (ACI). Here we report a strategy for de novo engineering of ectopic autologous cartilage (EAC) within the subperiosteal space (in vivo bioreactor), through the mere introduction of a biocompatible gel that might promote hypoxia-mediated chondrogenesis, thereby effectively overcoming the aforementioned limitations. The EAC is obtained within 3 wk post injection of the gel, and can be press-fit into an osteochondral defect where it undergoes remodeling with good lateral and subchondral integration. The implanted EAC showed no calcification even after 9 mo and attained an average O'Driscoll score of 11 (versus 4 for controls). An "on demand" autologous source of autologous cartilage with remodeling capacity is expected to significantly impact the clinical options in repair of trauma to articular cartilage.
Original languageEnglish
Pages (from-to)3418-3423
JournalProceedings of the National Academy of Sciences of the United States of America
Issue number8
Publication statusPublished - 23 Feb 2010


  • agarose
  • hypoxia
  • in vivo bioreactor
  • periosteum
  • regenerative therapies

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