Spontaneous Minced Cartilage Procedure for Unexpectedly Large Femoral Condyle Surface Defect

Salzmann, Gian M.; Baumann, Günter; Preiß, Stefan

doi:10.1155/2016/1498135

Cited by 7 publications

(5 citation statements)

References 11 publications

(12 reference statements)

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“…In addition, it is a feasible treatment option in incidental findings of larger cartilage defects during other joint-preserving knee procedures, as it can be spontaneously added to the primary procedure. 8,43 Donor cartilage can be taken from the periphery of the existing lesion, where it is necessary to debride into the healthy cartilage. Different publications have clearly described that such chondrocytes are viable and could be used for further transplantation.…”

Section: Discussionmentioning

confidence: 99%

One-Step Autologous Minced Cartilage Procedure for the Treatment of Knee Joint Chondral and Osteochondral Lesions: A Series of 27 Patients With 2-Year Follow-up

Maßen

Inauen

Harder

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background: Chondral and osteochondral lesions are being detected with increasing frequency. For large-diameter lesions, cell-based treatment modalities are speculated to result in the best possible outcome. Purpose: To prospectively evaluate the 2-year clinical and radiological results after the treatment of chondral and osteochondral knee joint lesions by a single-step autologous minced cartilage procedure. Study Design: Case series; Level of evidence, 4. Methods: From February 2015 to June 2016, a total of 27 consecutive patients suffering from chondral or osteochondral lesions of the knee joint were treated using a single-step autologous minced cartilage procedure. All patients underwent preoperative and postoperative magnetic resonance imaging for the collection of AMADEUS (Area Measurement and Depth and Underlying Structures) and MOCART (magnetic resonance observation of cartilage repair tissue) scores. Clinical analysis was conducted by a numeric analog scale (NAS) for pain and knee function before the intervention and at 12 and 24 months postoperatively. Results: A total of 12 female and 15 male patients (mean age, 28.7 years) were evaluated for a mean of 28.2 ± 3.8 months. The mean cartilage defect size encountered intraoperatively was 3.1 ± 1.6 cm 2 . There was a significant decrease in pain from 7.2 ± 1.9 preoperatively to 1.8 ± 1.6 ( P < .001) at 2-year follow-up. Knee function improved from a mean of 7.2 ± 2.0 preoperatively to 2.1 ± 2.3 ( P < .001) at 2 years after surgery. The mean preoperative AMADEUS score was 57.4 ± 21.4. Postoperatively, the mean MOCART score was 40.6 ± 21.1 at 6-month follow-up. No correlation was observed between the clinical data and the MOCART or AMADEUS scores. Conclusion: Overall, the findings of this study demonstrated that patients undergoing a single-step autologous minced cartilage procedure had a satisfactory outcome at 2-year follow-up. As a result, the single-step autologous minced cartilage procedure does represent a possible alternative to standard autologous chondrocyte implantation. Longer follow-up and larger cohorts are required to define the benefits of this procedure.

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Section: Discussionmentioning

confidence: 99%

One-Step Autologous Minced Cartilage Procedure for the Treatment of Knee Joint Chondral and Osteochondral Lesions: A Series of 27 Patients With 2-Year Follow-up

Maßen

Inauen

Harder

et al. 2019

Orthopaedic Journal of Sports Medicine

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“…13 A recent case report provided an excellent clinical and MR outcome after a spontaneous minced cartilage procedure that was combined with subchondral drilling (a large localized bone marrow edema was present) to simultaneously relieve pressure and revitalize the subchondral bone and the particulate cartilage. 14 The defect in that case report had a lesion diameter of 3.75 cm 2 . With calculation by the use of the AMADEUS (Area Measurement And DEpth and Underlying Structures) cartilage defect score 15 it was coded as 3.75cBE with a total score of 40 points and thus grade 3.…”

Section: Discussionmentioning

confidence: 80%

Second-Generation Autologous Minced Cartilage Repair Technique

Salzmann

Calek

Preiß

2017

Arthroscopy Techniques

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Articular cartilage defects at the knee joint are identified and treated with increasing frequency. Autologous chondrocytes may have the strongest potential to generate high-quality repair tissue within the defective region. Autologous chondrocyte implantation is not available in every country. We present a surgical technique where the surgeon can apply autologous chondrocytes in a one-step procedure to treat articular cartilage defects at the knee joint.

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Section: Discussionmentioning

confidence: 99%

“…Preparation of the cartilage defect consists of creating a stable, viable cartilage wall and removal of the calcified layer at the bottom of the defect. The harvested cartilage from the defect edge is vital 25,62 and shows superior redif-ferentiation of chondrocytes compared to non-weight bearing cartilage. 63,64 Also, the shear-off lesions remain viable, as we also have seen with the "modified hedgehog technique," where we press-fitted back the flake, and ingrowth of vital cartilage was seen after 1 year.…”

Section: Discussionmentioning

confidence: 99%

Minced Autologous Chondral Fragments with Fibrin Glue as a Simple Promising One-Step Cartilage Repair Procedure: A Clinical and MRI Study at 12-Month Follow-Up

Wodzig

Peters²,

Emanuel

et al. 2022

CARTILAGE

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Objective The aim of this study was to investigate early radiological and clinical outcome of autologous minced cartilage treatment as a single-step treatment option in patients with a chondral or osteochondral lesion (OCL) in the knee. Design Eighteen patients with an OCL in the knee were included. Cartilage from healthy-appearing loose bodies and/or the periphery of the defect were minced into small chips and sealed in the defect using fibrin glue. Preoperatively, and at 3 ( n = 14) and 12 ( n = 18) months follow-up, magnetic resonance imaging (MRI) was performed. The Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 score was used to assess the cartilage repair tissue on MRI at 12 months. The International Knee Documentation Score, Knee Injury and Osteoarthritis Outcome Score, EuroQoL-5D, and Visual Analogue Scale pain were collected preoperatively and 12 months after surgery. Results Three months postoperative, MRI showed complete defect filling in 11 out of 14 patients. Mean MOCART 2.0 score at 12 months was 65.0 ± 18.9 with higher scores for lateral femoral chondral lesions compared to medial femoral chondral lesions (75.8 ± 14.3, 52.5 ± 15.8 respectively, P = 0.02). Clinical and statistical significant improvements were observed in the patient-reported outcome measures at 12 months postoperatively compared to preoperatively. Conclusion Treatment of OCLs using the autologous minced cartilage procedure resulted in good cartilage repair measured by MOCART 2.0. Clinically relevant improvements were observed in the clinical scores. This study suggests autologous minced cartilage as a promising, single-step treatment for OCLs.

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Spontaneous Minced Cartilage Procedure for Unexpectedly Large Femoral Condyle Surface Defect

Cited by 7 publications

References 11 publications

One-Step Autologous Minced Cartilage Procedure for the Treatment of Knee Joint Chondral and Osteochondral Lesions: A Series of 27 Patients With 2-Year Follow-up

One-Step Autologous Minced Cartilage Procedure for the Treatment of Knee Joint Chondral and Osteochondral Lesions: A Series of 27 Patients With 2-Year Follow-up

Second-Generation Autologous Minced Cartilage Repair Technique

Minced Autologous Chondral Fragments with Fibrin Glue as a Simple Promising One-Step Cartilage Repair Procedure: A Clinical and MRI Study at 12-Month Follow-Up

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