Surgical treatment of chondral knee defects using a collagen membrane – autologus matrix-induced chondrogenesis

Abstract

ObjectivesTo evaluate the clinical and functional results of patients diagnosed with full-thickness chondral defects on symptomatic knees who underwent a biological repair technique using autologous matrix-induced chondrogenesis.MethodsSeven patients who underwent surgical treatment due to chondral lesions in the knee by autologous matrix-induced chondrogenesis were evaluated. The Lysholm, Kujala and visual analog scale of pain questionnaires were applied before and 12 months after the surgery. Nuclear magnetic resonance images were evaluated 12 months after surgery according to MOCART (magnetic resonance observation of cartilage repair tissue) cartilage repair tissue score.ResultsOf the seven patients evaluated, three presented defects classified as grade III and four as grade IV according to the International Cartilage Repair Society classification. Chondral defects were located in the medial femoral condyle (n = 2), patella (n = 2), and trochlea (n = 3). The mean age of the patients (six men and one woman) was 37.2 years (24–54 years). The mean chondral defect size was 2.11 cm2 (1.0–4.6 cm2). After 12 months, post-operative nuclear magnetic resonance showed resurfacing of the lesion site with scar tissue less thick than normal cartilage in all patients. The mean MOCART score was 66.42 points. A significant decrease in pain and an improvement in the Lysholm and Kujala scores were observed.ConclusionThe use of the collagen I/III porcine membrane was favorable for the treatment of chondral and osteochondral lesions of the knee when assessing the results using the VAS, Lysholm, and Kujala scores 1 year after surgery, as well as when assessing the magnetic resonance image of the lesion 6 months after surgery.

Lesões condrais maiores tratadas com uso de membrana de colágeno – Condrogênese autóloga induzida por matriz - Apresentam maior aumento nos escores clínicos

“…These results show agreement with the previous study published by our group. 24 There was no significant impact of age and BMI on the results found in the present study.…”

“…Esses resultados mostram concordância com o estudo anterior publicado pelo grupo. 24 Não houve impacto significante da idade e IMC nos resultados encontrados neste estudo.…”

A novel autologous-made matrix using hyaline cartilage chips and platelet-rich growth factors for the treatment of full-thickness cartilage or osteochondral defects: Preliminary results

“…6 Previous surgical techniques have demonstrated a variety of MRI-based cartilage repair characteristics. The present surgical technique has demonstrated higher MOCART scores compared to microfracture and collagen membrane matrix, 14 microfracture and a chitosan-based polymer scaffolding biomaterial, 15 mesenchymal stem cells, 16 and cell-free scaffold with collagen and hydroxiapatite. 17 Interestingly, Christensen et al reported the outcomes of a dual-tissue transplantation technique for osteochondritis dissecans in which autologous bone and cartilage tissue were used.…”

Particulated Autologous Chondral−Platelet-Rich Plasma Matrix Implantation (PACI) for Treatment of Full-Thickness Cartilage Osteochondral Defects

“…19,20 Cugat et al 2 reported a mean MOCART score of 70 (a score of 100 represents completely healthy cartilage) at 12 months using PACI technique , which was greater when compared with microfracture and collagen membrane matrix, microfracture, and chitosanbased polymer scaffolding biomaterial, mesenchymal stem cells, and cell-free scaffold with collagen and hydroxyapatite. [21][22][23] Massen et al 9 reported a mean MOCART score of 40.6 AE 21.1 at 6 months, and similar results were reported by Christensen et al 24 observed a MOCART score of 52.5 at 1 year after a particulate cartilage procedure, and Niemeyer et al 25 observed a long-term (follow-up of 10.9 years) MOCART score of 44.9 AE 23.6 after first-generation ACI.…”