The book presents research in treating focal joint cartilage defects. Keywords: Biomaterials, Osteochondral Repair, Lipoaspirate Fluid (LAF) Cells, Arthrosis, Focal Joint Cartilage Defects, Physiopathology of Cartilage Lesions, Diagnosis of Cartilage Lesions, Treatment of Cartilage Lesions, Plastic Surgery, Vascular Surgery, Repair Surgery, Orthopedics, Biological Arthroplasties.

• Table of Contents
• Preface
• List of Abbreviations
• Introduction
• 1. Normal articular cartilage
  • 1.1 Anatomy and histology
  • 1.1.1 Generalities
  • 1.1.2 Types of cartilage
  • 1.1.3 Articular cartilage composition
  • 1.1.3.1 Chondrocytes
  • 1.1.3.2 The extracellular matrix of the articular cartilage
  • 1.1.4 Histology of articular cartilage
  • 1.2 Physiology of cartilaginous tissue
  • 1.2.1 Chondrogenesis
  • 1.2.2 Metabolism
  • 1.2.3 Mechanical properties of articular cartilage
  • 1.2.4 Extracellular matrix remodeling
• 2. Physiopathology of cartilage lesions
  • 2.1 Response of chondral tissue to lesions – spontaneous repair
  • 2.2 Traumatic lesions
  • 2.3 Ischemic lesions
  • 2.4 Factors associated with cartilage lesions
  • 2.5 Iatrogenic injuries
  • 2.6 Degenerative lesions – osteoarthritis physiopathology
• 3. Diagnosis of cartilage lesions
  • 3.1 Clinic diagnosis elements
  • 3.2 Paraclinic investigations
  • 3.2.1 Radiology
  • 3.2.2 Ultrasound
  • 3.2.3 Computed tomography
  • 3.2.4 Computed tomography and magnetic resonance imaging arthrography
  • 3.2.5 Magnetic resonance imaging
  • 3.2.6 Biological markers
  • 3.2.7 Arthroscopy
• 4. Treatment of cartilage lesions
  • 4.1 Conservative treatment
  • 4.2 Surgical treatment
  • 4.2.1 Direct treatment
  • 4.2.1.1 Intraarticular lavage and chondral lesions debridement
  • 4.2.1.2 Radiofrequency ablation
  • 4.2.1.3 Microfractures (BMS - Bone Marrow Stimulation)
  • 4.2.1.4 Osteochondral Autograft Transfer
  • 4.2.1.5 Osteochondral allograft transplantation
  • 4.2.1.6 Xenografts
  • 4.2.1.7 Loco-regional transfer of pedicled osteochondral graft
  • 4.2.1.8 Osteochondral biphasic prosthetic implants
  • 4.2.1.9 Prosthetic arthroplasty
  • 4.2.2 Notions of tissue engineering
  • 4.2.2.1 ACI - autologous chondrocyte implantation
  • 4.2.2.2 Multipotent mesenchymal stem cells
  • 4.2.2.3 Scaffolds utilized in clinical practice
  • 4.2.3 Corrective treatment of associated factors
  • 4.2.3.1 Resolving ligamentous instability
  • 4.2.3.2 Realignment osteotomies
  • 4.2.3.3 Treatment of other protective factors
• 5. Study 1. In vitro behavior of mesenchymal stem cells on different biomaterials
  • 5.1 Introduction
  • 5.2 Work hypothesis
  • 5.3 Materials and methods
  • 5.3.1 Cellular biological material
  • 5.3.2 Tested biomaterials
  • 5.3.3 Morphological characterization of the collagen matrix surface
  • 5.3.4 Evaluation of cell adhesion, proliferation and migration capacity of mesenchymal cells on demineralized MatriBone Ortho implants (B3)
  • 5.3.5 Evaluation of cellular adhesion and cytotoxicity on biomaterial
  • 5.4 Results
  • 5.4.1 Characterization of stem cell populations
  • 5.4.2 Assessment of the degree of proliferation and mesenchymal cell migration capacity on demineralized MatriBone Ortho implants
  • 5.4.3 Morphological characterization of collagen membranes
  • 5.4.4 Comparative microscopic evaluation on plate of cellular adhesion on biomaterials
  • 5.4.5 Evaluation by electronic microscopy (SEM) of cellular adhesion and the implied cytotoxicity on biomaterial
  • 5.5 Discussions
  • 5.6 Conclusions
• 6. Study 2. Lipoaspirate fluid derived stem cells use for the treatment of cartilage defects. Pilot study on rabbit model
  • 6.1 Introduction
  • 6.2 Work hypothesis
  • 6.3 Materials and methods
  • 6.3.1 Ethical statement
  • 6.3.2 Implants
  • 6.3.3 Cells isolation
  • 6.3.4 Seeding of cells on collagen membranes
  • 6.3.5 Animals and their housing
  • 6.3.6 Surgical technique
  • 6.3.7 Evaluation of results
  • 6.3.8 Data analysis
  • 6.4 Results
  • 6.4.1 Macroscopic evaluation
  • 6.4.2 Histological evaluation
  • 6.4.3 Analysis of gene expression
  • 6.4.4 MicroCT scan
  • 6.5 Discussions
  • 6.6 Conclusions
• 7. Study 3. Comparative assessment of the healing of focal lesions of articular cartilage on an animal model, by using stem cells from the iliac crest versus stem cells from adipose tissue
  • 7.1 Introduction
  • 7.2 Work hypothesis
  • 7.3 Materials and methods
  • 7.3.1 Ethical considerations
  • 7.3.2 Animals and experimental environment
  • 7.3.3 Group randomization
  • 7.3.4 Preoperative preparation
  • 7.3.5 Harvest, separation, concentration and characterization of stem cells
  • 7.3.5.1 BMC harvesting
  • 7.3.5.2 ASC harvesting
  • 7.3.5.3 PRP preparation
  • 7.3.6 Preparation of implants
  • 7.3.7 Surgical technique
  • 7.3.8 Criteria for evaluating results
  • 7.3.8.1 Macroscopic evaluation
  • 7.3.8.2 Microscopic evaluation
  • 7.3.8.3 Immunohistochemical evaluation
  • 7.3.8.4 Imagery
  • 7.3.8.5 Data processing and analysis
  • 7.4 Results
  • 7.4.1 Macroscopic and microscopic evaluation
  • 7.4.2 Immunohistochemical evaluation
  • 7.4.3 Imaging evaluation
  • 7.4.3.1 Radiological investigations
  • 7.4.3.2 Computed tomography (CT)
  • 7.4.3.3 Magnetic resonance imaging (MRI)
  • 7.5 Discussions
  • 7.6 Conclusions
• 8. Study 4. Static analysis with finite elements on the sheep knee treated by osteochondral reconstruction
  • 8.1 Introduction
  • 8.2 Evaluation of CT images
  • 8.2.1 Methodology
  • 8.2.2 Results of CT imaging
  • 8.2.3 General stage conclusions
  • 8.3 3D reconstructions of the knee
  • 8.3.1 FEA static analysis conditions
  • 8.3.2 FEA static simulation results
  • 8.4 Conclusions
• 9. Study 5. Retrospective observational study on articular cartilage therapies performed in clinical practice
  • 9.1 Introduction
  • 9.2 Work hypothesis
  • 9.3 Materials and methods
  • 9.4 Results
  • 9.4.1 Particular clinical cases
  • 9.5 Discussions
  • 9.6 Conclusions
• 10. General Conclusions
• Acknowledgements
• References
• Keyword index
• About the author
• ANNEX 8.1
• ANNEX 8.2
• ANNEX 8.3