Long-term Results After Hyaluronan-based MACT for the Treatment of Cartilage Lesions of the Patellofemoral Joint

Kon, Elizaveta; Filardo, Giuseppe; Gobbi, Alberto; Berruto, Massimo; Andriolo, Luca; Ferrua, Paolo; Crespiatico, Ilaria; Marcacci, Maurilio

doi:10.1177/0363546515620194

Cited by 52 publications

(62 citation statements)

References 28 publications

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“…Ten studies 5 , 11 – 15 , 19 , 23 , 28 , 29 met inclusion and exclusion criteria ( Figure 1 ) (two with level 1 evidence, 12 , 28 one level 2, 14 one level 3, 13 and six level 4 5 , 11 , 15 , 19 , 23 , 29 ). Of these, 3 studies 14 , 19 , 23 reported outcomes specific to the PF joint, 4 studies 11 – 13 , 28 reported outcomes specific to the TF joint, and 3 studies 5 , 15 , 29 reported outcomes specific to both PF and TF joints. Nine studies 11 – 15 , 19 , 23 , 28 , 29 excluded patients with diffuse or inflammatory/metabolic arthritis.…”

Section: Resultsmentioning

confidence: 99%

“…Of these, 3 studies 14 , 19 , 23 reported outcomes specific to the PF joint, 4 studies 11 – 13 , 28 reported outcomes specific to the TF joint, and 3 studies 5 , 15 , 29 reported outcomes specific to both PF and TF joints. Nine studies 11 – 15 , 19 , 23 , 28 , 29 excluded patients with diffuse or inflammatory/metabolic arthritis. One study 5 included patients with early osteoarthritis and kissing lesions.…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies 5 , 12 , 14 , 15 , 19 , 23 , 29 performed concomitant procedures ( Table 3 ). Additionally, 2 studies 11 , 23 reported postoperative complications, including 1 patient with a deep venous thrombosis 23 and 10 patients with graft hypertrophy.…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies 5 , 11 , 12 , 14 , 15 , 19 , 23 reported treatment failures. Two studies 5 , 23 did not provide a specific definition of treatment failure, 2 studies 11 , 12 did not provide a clear definition of treatment failure beyond graft failure, and 3 studies 14 , 15 , 19 defined treatment failure as the need for reoperation due to symptoms caused by the primary defect. Overall, 9.7% of patients failed treatment, including 12.4% in the TF group and 4.7% in the PF group ( P = .037) ( Table 5 ).…”

Section: Resultsmentioning

confidence: 99%

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Matrix-Assisted Autologous Chondrocyte Transplantation in the Knee: A Systematic Review of Mid- to Long-Term Clinical Outcomes

Schuette

Kraeutler

McCarty

2017

Orthopaedic Journal of Sports Medicine

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Background:Matrix-assisted autologous chondrocyte transplantation (MACT) is a surgical treatment option for articular cartilage lesions of the knee joint.Purpose:To investigate mid- to long-term clinical outcomes of MACT in the patellofemoral (PF) and tibiofemoral (TF) joints.Study Design:Systematic review; Level of evidence, 4.Methods:A systematic review was performed by searching PubMed, Embase, and the Cochrane Library to find studies evaluating minimum 5-year clinical outcomes of patients undergoing MACT in the knee joint. Search terms used were knee, matrix, and autologous chondrocyte. Patients were evaluated based on treatment failure rates, magnetic resonance imaging, and subjective outcome scores. Study methodology was assessed using the Modified Coleman Methodology Score (MCMS).Results:Ten studies (two level 1, one level 2, one level 3, and six level 4 evidence) were identified that met inclusion and exclusion criteria, for a total of 442 TF patients and 136 PF patients. Treatment failure occurred in 9.7% of all patients, including 4.7% of PF patients and 12.4% of TF patients (P = .037). Weighted averages of subjective outcome scores, including Knee injury and Osteoarthritis Outcome Score, Short Form–36 Health Survey, and Tegner scores, improved from baseline to latest follow-up in both TF and PF patients. The mean MCMS was found to be 57.4, with a standard deviation of 18.5.Conclusion:Patients undergoing MACT in the knee show favorable mid- to long-term clinical outcomes. A significantly higher treatment failure rate was found in patients undergoing MACT in the TF joint compared with the PF joint.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Matrix-Assisted Autologous Chondrocyte Transplantation in the Knee: A Systematic Review of Mid- to Long-Term Clinical Outcomes

Schuette

Kraeutler

McCarty

2017

Orthopaedic Journal of Sports Medicine

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“…Autologous chondrocyte implantation (ACI) is so far the treatment that has most evolved, although some studies showed failure in a considerable percentage of patients . Currently, the matrix‐assisted chondrocyte transplantation (MACT) is being studied with promising results, but further long‐term clinical trials are needed …”

Section: Introductionmentioning

confidence: 99%

Autologous bioscaffolds based on different concentrations of platelet rich plasma and synovial fluid as a vehicle for mesenchymal stem cells

Garate¹,

Sánchez

Delgado³

et al. 2017

J Biomedical Materials Res

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In the field of tissue engineering, diverse types of bioscaffolds are being developed currently for osteochondral defect applications. In this work, a novel scaffold based on platelet rich plasma (PRP) and hyaluronic acid with mesenchymal stem cells (MSCs) has been evaluated to observe its effect on immobilized cells. The bioscaffolds were prepared by mixing different volumes of synovial fluid (SF) with PRP from patients obtaining three formulations at PRP-SF ratios of 3:1, 1:1 and 1:3 (v/v). The live/dead staining revealed that although the cell number of each type of bioscaffold was different, these this constructs provide cells with a suitable environment for their viability and proliferation. Moreover, immobilized MSCs showed their ability to secrete fibrinolytic enzymes, which vary depending on the fibrin amount of the scaffold. Immunohistochemical analysis revealed the positive staining for collagen type II in all cases, proving the biologic action of SF derived MSCs together with the suitable characteristics of the bioscaffold for chondrogenic differentiation. Considering all these aspects, this study demonstrates that these cells-based constructs represent an attractive method for cell immobilization, achieving completely autologous and biocompatible scaffolds. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 377-385, 2018.

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Sex does not influence the long‐term outcome of matrix‐assisted autologous chondrocyte transplantation

Salerno,

Andriolo,

Angelelli

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeRegenerative techniques for articular cartilage lesions demonstrated heterogeneous clinical results. Several factors may influence the outcome, with sex being one of the most debated. This study aimed at quantifying the long‐term influence of sex on the clinical outcome obtained with a regenerative procedure for knee chondral lesions.MethodsMatrix‐assisted autologous chondrocyte transplantation (MACT) was used to treat 235 knees which were prospectively evaluated with the International Knee Documentation Committee (IKDC), EuroQol visual analogue scale, and Tegner scores at 14‐year mean follow‐up. A multilevel analysis was performed with the IKDC subjective scores standardised according to the age/sex category of each patient and/or the selection of a match‐paired subgroup to compare homogeneous men and women patients.ResultsAt 14 years, men and women showed a failure rate of 10.7% and 28.8%, respectively (p < 0.0005). An overall improvement was observed in both sexes. Women had more patellar lesions and men more condylar lesions (p = 0.001), and the latter also presented a higher preinjury activity level (p < 0.0005). Men had significantly higher IKDC subjective scores at all follow‐ups (at 14 years: 77.2 ± 18.9 vs. 62.8 ± 23.1; p < 0.0005). However, the analysis of homogeneous match‐paired populations of men and women, with standardised IKDC subjective scores, showed no differences between men and women (at 14 years: −1.6 ± 1.7 vs. −1.9 ± 1.6).ConclusionMen and women treated with MACT for knee chondral lesions presented a significant improvement and stable long‐term results. When both sexes are compared with homogeneous match‐paired groups, they have similar results over time. However, women present more often unfavourable lesion patterns, which proved more challenging in terms of long‐term outcome after MACT.Level of EvidenceLevel II.

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Long-term Results After Hyaluronan-based MACT for the Treatment of Cartilage Lesions of the Patellofemoral Joint

Abstract: The clinical results of hyaluronan-based MACT treatment of chondral lesions of the patellofemoral joint do not worsen over time but remain stable and show a low rate of failure at long-term follow-up.

Cited by 52 publications

References 28 publications

Matrix-Assisted Autologous Chondrocyte Transplantation in the Knee: A Systematic Review of Mid- to Long-Term Clinical Outcomes

Matrix-Assisted Autologous Chondrocyte Transplantation in the Knee: A Systematic Review of Mid- to Long-Term Clinical Outcomes

Autologous bioscaffolds based on different concentrations of platelet rich plasma and synovial fluid as a vehicle for mesenchymal stem cells

Sex does not influence the long‐term outcome of matrix‐assisted autologous chondrocyte transplantation

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