Document Detail


Matrix-induced autologous chondrocyte implantation versus microfracture in the treatment of cartilage defects of the knee: a 2-year randomised study.
MedLine Citation:
PMID:  20062969     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cartilage defects occur in approximately 12% of the population and can result in significant function impairment and reduction in quality of life. Evidence for the variety of surgical treatments available is inconclusive. This study aimed to compare the clinical outcomes of patients with symptomatic cartilage defects treated with matrix-induced autologous chondrocyte implantation (MACI or microfracture (MF). Included patients were >or= 18 and <or= 50 years of age with symptomatic, post-traumatic, single, isolated chondral defects (4-10 cm2) and were randomised to receive MACI or MF. Patients were followed up 8-12, 22-26 and 50-54 weeks post-operatively for efficacy and safety evaluation. Outcome measures were the Tegner, Lysholm and ICRS scores. Sixty patients were included in a randomised study (40 MACI, 20 MF). The difference between baseline and 24 months post-operatively for both treatment groups was significant for the Lysholm, Tegner, patient ICRS and surgeon ICRS scores (all P < 0.0001). However, MACI was significantly more effective over time (24 months versus baseline) than MF according to the Lysholm (P = 0.005), Tegner (P = 0.04), ICRS patient (P = 0.03) and ICRS surgeon (P = 0.02) scores. There were no safety issues related to MACI or MF during the study. MACI is superior to MF in the treatment of articular defects over 2 years. MACI and MF are complementary procedures, depending on the size of the defect and symptom recurrence. The MACI technique represents a significant advance over both first and second generation chondrocyte-based cartilage repair techniques for surgeons, patients, health care institutions and payers in terms of reproducibility, safety, intraoperative time, surgical simplicity and reduced invasiveness.
Authors:
Erhan Basad; Bernd Ishaque; Georg Bachmann; Henning Stürz; Jürgen Steinmeyer
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA     Volume:  18     ISSN:  1433-7347     ISO Abbreviation:  Knee Surg Sports Traumatol Arthrosc     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-23     Completed Date:  2010-12-14     Revised Date:  2012-10-10    
Medline Journal Info:
Nlm Unique ID:  9314730     Medline TA:  Knee Surg Sports Traumatol Arthrosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  519-27     Citation Subset:  IM    
Affiliation:
Clinic and Polyclinic for Orthopaedic Surgery, University Hospital Giessen-Marburg GmbH, Giessen, Germany.erhan.basad@ortho.med.uni-giessen.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Arthroplasty, Subchondral*
Arthroscopy
Cartilage, Articular / injuries,  pathology*,  surgery*
Chondrocytes / transplantation*
Female
Follow-Up Studies
Humans
Knee Injuries / pathology,  surgery*
Magnetic Resonance Imaging
Male
Middle Aged
Prospective Studies
Transplantation, Autologous
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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