A Randomized Trial Comparing Autologous Chondrocyte Implantation with Microfracture

122

114

Section: Discussionsupporting

confidence: 71%

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

Siclari

Mascaro

Gentili

et al. 2012

122

114

“…In six studies comparing autologous chondrocyte transplantation with microfracture that described three distinct groups of patients, early studies showed no difference in patient-reported outcome measures between the two methods [17,18,42]; however, two studies at 3 and 5 years postoperatively in the same study group found improved patient-reported outcomes with autologous chondrocyte transplantation compared with microfracture when controlling for patient duration of symptoms before surgery. Patients with less than 3 years of symptoms before undergoing autologous chondrocyte transplantation had 10-point higher overall Knee Injury and Osteoarthritis Outcome Scores (KOOS) compared with microfracture at 5 years postoperatively (p = 0.026 for overall KOOS) [33,43].…”

Section: Studies Comparing Microfracture Chondrocyte Transplantationmentioning

confidence: 99%

What Is the Effect of Matrices on Cartilage Repair? A Systematic Review

Wylie

Hartley

Kapron

et al. 2015

Background Articular cartilage has minimal endogenous ability to undergo repair. Multiple chondral restoration strategies have been attempted with varied results. Questions/purposes The purpose of our review was to determine: (1) Does articular chondrocyte transplantation or matrix-assisted articular chondrocyte transplantation provide better patient-reported outcomes scores, MRI morphologic measurements, or histologic quality of repair tissue compared with microfracture in prospective comparative studies of articular cartilage repair; and (2) which available matrices for matrix-assisted articular chondrocyte transplantation show the best patient-reported outcomes scores, MRI morphologic measurements, or histologic quality of repair tissue? Methods We conducted a systematic review of PubMed, CINAHL, and MEDLINE from March 2004 to February 2014 using keywords determined to be important for articular cartilage repair, including ''cartilage'', ''chondral'', ''cell source'', ''chondrocyte'', ''matrix'', ''augment'', ''articular'', ''joint'', ''repair'', ''treatment'', ''regeneration'', and ''restoration'' to find articles related to cell-based articular cartilage repair of the knee. The articles were reviewed by two authors (JDW, MKH), our study exclusion criteria were applied, and articles were determined to be relevant (or not) to the research questions. The Methodological Index for Nonrandomized Studies (MIN-ORS) scale was used to judge the quality of nonrandomized manuscripts used in this review and the Jadad score was used to judge the quality of randomized trials. Seventeen articles were reviewed for the first research question and 83 articles were reviewed in the second research question from 301 articles identified in the original systematic search. The average MINORS score was 9.9 (62%) for noncomparative studies and 16

“…Although clinical studies of autologous chondrocyte transplantation generally have reported significant improvements in pain, swelling, and function after surgery [9,60], one controlled prospective trial showed no benefit of autologous chondrocyte implantation as compared with the standard treatment of microfracture of the subchondral bone, as based on indices of joint function, pain, or characteristics of the cartilage defect [47]. Furthermore, an animal study suggested the harvest procedure may induce donor-site morbidity and iatrogenic damage that may initiate osteoarthritic degeneration in the joint [50].…”

Section: Background: Articular Cartilage Injury and Repairmentioning

confidence: 99%

2010 Nicolas Andry Award: Multipotent Adult Stem Cells from Adipose Tissue for Musculoskeletal Tissue Engineering

Guilak

Estes

Diekman

et al. 2010

141

Background Cell-based therapies such as tissue engineering provide promising therapeutic possibilities to enhance the repair or regeneration of damaged or diseased tissues but are dependent on the availability and controlled manipulation of appropriate cell sources. Questions/purposes The goal of this study was to test the hypothesis that adult subcutaneous fat contains stem cells with multilineage potential and to determine the influence of specific soluble mediators and biomaterial scaffolds on their differentiation into musculoskeletal phenotypes. Methods We reviewed recent studies showing the stemlike characteristics and multipotency of adipose-derived stem cells (ASCs), and their potential application in cellbased therapies in orthopaedics.