Combined surgery and chondrocyte cell-sheet transplantation improves clinical and structural outcomes in knee osteoarthritis

Treatments using a combination of conventional surgical interventions and transplantation of chondrocyte sheets were performed. a Chondrocyte sheets were fabricated from autologous articular cartilage (1.5？g) obtained from nonloading regions of the knee and synovium (3？g) collected during arthroscopy. In the cell-processing center, isolated chondrocytes and synovial cells were cocultured for 14–17 days using temperature-responsive culture inserts and were subsequently layered by detaching each chondrocyte sheet by changing the temperature from 37 to 20？°C. The layered chondrocyte sheets were cultured for another 7–8 days before transplantation. b OAK patients were first treated with conventional surgical treatments OWHTO or ACL reconstruction, followed by the removal of unhealthy tissue, marrow stimulation, and chondrocyte sheet transplantation (RMSC method). c The overall protocol for the clinical study meant that the final decision about entry into the clinical study was made during arthroscopic evaluation. For patients meeting the inclusion criteria, LIPA was used to assess their cartilage defects, and cartilage and synovial tissues were collected for the fabrication of chondrocyte sheet