Characterized Chondrocyte Implantation Results in Better Structural Repair when Treating Symptomatic Cartilage Defects of the Knee in a Randomized Controlled Trial versus Microfracture

Abstract

One year after treatment, characterized chondrocyte implantation was associated with a tissue regenerate that was superior to that after microfracture. Short-term clinical outcome was similar for both treatments. The superior structural outcome may result in improved long-term clinical benefit with characterized chondrocyte implantation. Long-term follow-up is needed to confirm these findings.

A Cell-free Scaffold-based Cartilage Repair Provides Improved Function Hyaline-like Repair at One year

“…In the second study, at 36 months chondrocyte implantation was associated with greater improvement in the KOOS compared with the microfracture group: 21.25 versus 15.83, respectively [31]. We found similar improvements in KOOS (31) at 12 months followup compared with that reported by Saris et al [31,32]. Additional studies using one-step cartilage repair approaches showed improvements in KOOS of 46 (mean) at 24 months followup using a hyaluronan scaffold [4] and 28 at 2 years followup for a collagen type I/III membrane [6].…”

“…Injection of PRP in knees with chronic degenerative symptoms reportedly reduced pain and improved knee function as assessed by VAS pain and IKDC scores in younger patients at 1 year followup [16]. Two randomized controlled studies have investigated whether cartilage regeneration after chondrocyte implantation is superior to microfracture treatment for cartilage defects of the knee [31,32]. In the second study, at 36 months chondrocyte implantation was associated with greater improvement in the KOOS compared with the microfracture group: 21.25 versus 15.83, respectively [31].…”

What Is the Effect of Matrices on Cartilage Repair? A Systematic Review

“…Microfracture outcomes worsened with larger lesions, whereas autologous chondrocyte transplantation outcomes did not [18]. At 1 year postoperatively, autologous chondrocyte transplantation showed better histomorphometry (p = 0.003) and overall histologic evaluation (p = 0.012) scores on biopsy specimens compared with microfracture [34].…”

Articular cartilage repair by genetically modified bone marrow aspirate in sheep

“…Current treatment modalities include microfracture, transplantation of ostechondral grafts and chondrocytes, use of biodegradable scaffolds or combination of these. 1,2 Although these procedures can produce initially good clinical results in terms of pain relief and improvement of joint function, they typically produce a fibrocartilagenouse repair tissue that is inferior to normal cartilage, such that long-term outcomes are less predictable and satisfactory. 3 New biological approaches to cartilage repair that are based on the use of cells and molecules that promote chondrogenesis or/and inhibit cartilage breakdown offer a promising alternative to current treatment options.…”