Summary and Conclusions

1
Summary and Conclusions

• Peter Roughley

2
Repair Techniques

• Current
• Microfracture stem cell
• ACI
• MACI articular chondrocyte stem cell
• AMIC
• Future
• Chondrocytes from stem cell
• Source BM, fat, synovium, cartilage
• Conditions TGFbeta, TGFbeta/BMP6
• Oxygen 5
• High density
• Scaffold - Membrane 2D
• Matrix 3D
• Loading - Cyclic compression
• Gene therapy - ex vivo
• in situ

3
Molecular Organization

• Endochondral ossification wnt, PTHRP,
  Ihh,
• site 1 proteinase
• Matrix regulated COMP/collagen
• integrated Col6, biglycan, matrillin, Col2,
  fibromodulin, PRELP, HSPG, cell
• stable X-links
• Surface - Lubricin
• Shear loading
• Lost in OC graft
• Degardation - Proteases
• workhorse, cathepsin K
• sophisticated MMPs, ADAMTSs
• hyaluronidase
• NO IL-1 5 oxygen

4
Animal Models

• None Ideal quadrupeds primates (human)
• Age cost, young
• Size cost, MRI/arthroscopy
• Cartilage thickness
• Cartilage cell density
• Functional assessment pain
• Too emotive dogs, horses, primates
• Purpose - Adult onset OA
• Focal lesions
• Predisposition - limb deformity
• Genetic