Outcomes of microfracture for traumatic chondral defects of the knee: Average 11-year follow-up

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

“…Bone marrow-stimulating techniques in cartilage repair such as drilling and microfracture are limited by the formation of fibrous to hyaline-like repair tissue [33]. To enhance these techniques several authors have suggested covering defects with absorbable scaffolds [22,38].…”

“…Access to the subchondral bone is established by multiple drill holes although these typically are deeper than the defects created by microfracturing [5]. Limitations of these techniques are poor repair tissue quality, ranging from hyaline to fibrous cartilage [33], and a decrease of clinical scores in patients who are 40 years old or younger at 18 to 36 months [18]. To overcome these limitations, advanced minimally invasive one-step techniques are needed that would enhance the patient-reported outcome scores and matrix components of the cartilage repair tissue [10].…”

Articular cartilage repair by genetically modified bone marrow aspirate in sheep

“…In human patients, proper rehabilitation protocols are crucial to optimize the results of bone marrow stimulating as well as cell-based techniques, including postoperative continuous passive motion exercises along with crutchassisted restrictions of weight-bearing up to 6-8 weeks. 38,39 Practical limitations prevented postoperative ambulation restrictions, possibly allowing detrimental shear forces on the construct and leading to a reduced quality of produced matrix. These limitations might be reflected in the fact that TGF-treated groups had good concentrations of GAGs and collagen II, but very high content of collagen I and low content of water.…”

Oligo[poly(ethylene glycol)fumarate] Hydrogel Enhances Osteochondral Repair in Porcine Femoral Condyle Defects

“…Operative treatment of OCD includes transplantation of osteochondral autografts [9,39,64], microfracture [34,51,62], and autologous chondrocyte implantation [36,47] combined with subchondral bone restoration [40,52]. Osteochondral autograft offers the benefits of mature hyaline cartilage transplantation, primary bone healing, and quick recovery and is recommended for high-demand athletes but is limited by donor graft morbidity [10,11].…”

“…Osteochondral autograft offers the benefits of mature hyaline cartilage transplantation, primary bone healing, and quick recovery and is recommended for high-demand athletes but is limited by donor graft morbidity [10,11]. Microfracture produces fibrocartilage and has inferior biomechanical properties [7,15,32,38], while autologous chondrocyte implantation produces a better hybrid of fibrocartilage and hyaline cartilage [7,32,38,51] but requires prolonged and complicated rehabilitation [34]. The use of scaffold alone offers a new strategy in the treatment of osteochondral injuries and diseases.…”