Clinically Significant Outcomes Following the Treatment of Focal Cartilage Defects of the Knee With Microfracture Augmentation Using Cartilage Allograft Extracellular Matrix: A Multicenter Prospective Study

Current Advances in the Regeneration of Degenerated Articular Cartilage: A Literature Review on Tissue Engineering and Its Recent Clinical Translation

“…In parallel to the clinical evaluation of cell-based tissue engineering for articular cartilage regeneration, cell-free tissue engineering was also evaluated by a number of clinical studies, but mainly as an augmentation to microfracture. In a recent prospective cohort study, Cole et al (2021) augmented microfracture by a cell-free matrix that is a commercial cartilage allograft ECM to act as a scaffold supporting cells released following microfracture. A total of 48 patients with symptomatic focal cartilage defects in the knees were included in this study, and the results evidenced desirable clinical outcomes following the augmented microfracture at 2-year follow-up [87].…”

Articular Cartilage Restoration Requires Cells, Scaffolds, Growth Factors, and Mechanical Stimulation

“…Yet, wedas orthopaedic surgeonsdcontinue to strive to restore destroyed cartilage, and unlike the wall, we may rely on the benefit of biologics. 17,18 Cole et al 10 report excellent early results that must not be minimized despite some limitations of the study. Long-term outcomes and a larger number of study subjects remain to be reported.…”

“…In searching for a reproducible, single-stage treatment for cartilage defects, Cole et al 10 enhance microfracture (autologous, mesenchymal stem cells) with dehydrated micronized allograft extracellular matrix (scaffold), platelet-rich plasma (containing anabolic, anticatabolic, and anti-inflammatory growth factors), a fibrin glue sealant, and careful rehabilitation providing mechanical stimulation. The platelet-rich plasma and micronized allogeneic cartilage powder is mixed into a paste and evenly applied over a meticulously microfractured surface.…”

“…Fibrin glue is used as a final, stabilizing sealant, and after a minimum of 10 minutes, the wound is closed. 10,11 The potpourri of ingredients combines prior methods with the addition of an allogeneic cartilage powder in a single-stage approach. Cole et al 10 appropriately acknowledge those previous studies on which their method was based, as well as newer studies using the same method.…”

“…10,11 The potpourri of ingredients combines prior methods with the addition of an allogeneic cartilage powder in a single-stage approach. Cole et al 10 appropriately acknowledge those previous studies on which their method was based, as well as newer studies using the same method. [12][13][14][15] Outcomes of cartilage repair procedures result in appropriate scrutiny and necessary skepticism in consideration of the doctrine published by Hunter in 1743 16 that "from Hippocrates to the present age, it is universally allowed that ulcerated cartilage is a troublesome thing and that when destroyed, it is not recovered."…”