Restore by Mesenchymal Cells

The necessity of two operations and high costs required by autologous chondrocyte implantation (ACI) procedure prompted the search for new methods for cartilage repair. Bone marrow-derived cell transplantation (BMDCT) has been proposed as a technique capable of providing a repair of the lesion by hyaline cartilage in a one-step procedure. Mesenchymal stem cells have the ability to differentiate into osteoblasts and chondroblasts. The rationale of the “one-step technique” is to transplant the entire bone-marrow cellular pool instead of isolated and expanded mesenchymal stem cells allowing cells to be processed directly in the operating room, without the need for a laboratory phase. A scaffold and the instrumentation previously used for ACI are employed for an entirely arthroscopic implantation. Autologous platelet-rich fibrin (PRF) is added in order to provide a supplement of growth factors. Results of this technique are encouraging at mid-term although long-term follow-up is still needed.