Arthroscopic Matrix-Encapsulated Autologous Chondrocyte Implantation: A Pilot Multicenter Investigation in Latin America

Villalobos, Enrique; Madrazo-Ibarra, Antonio; Martínez, Valentín Alejandro; Olivos-Meza, Anell; Velasquillo, Cristina; González, Socorro Cortés; Izaguirre, Aldo; Ortega-Sánchez, Carmina; González, Ricardo; Parra-Cid, Carmen; Pérez-Jiménez, Francisco; Ibarra, Clemente

doi:10.1177/1947603520918630

Cited by 3 publications

(6 citation statements)

References 39 publications

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“…Since its introduction, a handful of studies have employed the MOCART 2.0. knee score for the assessment of radiological outcome after all arthroscopic matrix-encapsulated autologous chondrocyte implantation [27] or MACI [28] in the knee and AMIC in the treatment of osteochondral lesions of the talus [29]. However, none of these studies assessed intraor interrater reliability.…”

Section: Discussionmentioning

confidence: 99%

Reliability of the MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) 2.0 knee score for different cartilage repair techniques—a retrospective observational study

et al. 2021

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Objectives To evaluate the reliability of the MOCART 2.0 knee score in the radiological assessment of repair tissue after different cartilage repair procedures. Methods A total of 114 patients (34 females) who underwent cartilage repair of a femoral cartilage lesion with at least one postoperative MRI examination were selected, and one random postoperative MRI examination was retrospectively included. Mean age was 32.5 ± 9.6 years at time of surgery. Overall, 66 chondral and 48 osteochondral lesions were included in the study. Forty-eight patients were treated with autologous chondrocyte implantation (ACI), 27 via osteochondral autologous transplantation, five using an osteochondral scaffold, and 34 underwent microfracture (MFX). The original MOCART and MOCART 2.0 knee scores were assessed by two independent readers. After a minimum 4-week interval, both readers performed a second reading of both scores. Inter- and intrarater reliabilities were assessed using intraclass correlation coefficients (ICCs). Results The MOCART 2.0 knee score showed higher interrater reliability than the original MOCART score with an ICC of 0.875 versus 0.759, ranging from 0.863 in the MFX group to 0.878 in the ACI group. Intrarater reliability was good with an overall ICC of 0.860 and 0.866, respectively. Overall, interrater reliability was higher for osteochondral lesions than for chondral lesions, with ICCs of 0.906 versus 0.786. Conclusions The MOCART 2.0 knee score enables the assessment of cartilage repair tissue after different cartilage repair techniques (ACI, osteochondral repair techniques, MFX), as well as for different lesion types with good intra- and interrater reliability. Key Points • The MOCART 2.0 knee score provides improved intra- and interrater reliability when compared to the original MOCART score. • The MOCART 2.0 knee score enables the assessment of cartilage repair tissue after different cartilage repair techniques (ACI, osteochondral repair techniques, MFX) with similarly good intra- and interrater reliability. • The assessment of osteochondral lesions demonstrated better intra- and interrater reliability than the assessment of chondral lesions in this study.

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Section: Discussionmentioning

confidence: 99%

Reliability of the MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) 2.0 knee score for different cartilage repair techniques—a retrospective observational study

et al. 2021

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“…The biopsy specimen was sent to a Good Manufacturing Practice laboratory following the minimum biosecurity parameters previously described for transportation, chondrocyte isolation, expansion, and construct formation. 34 An 8 mmdiameter polyglycolic acid scaffold (Neoveil sheet) was seeded and enveloped with cultured autologous chondrocytes.…”

Section: Surgical Technique and Rehabilitationmentioning

confidence: 99%

“…A more detailed explanation has been provided in previous studies. 15,25,34,35 Rehabilitation. All patients underwent rehabilitation following the same protocol.…”

Section: Surgical Technique and Rehabilitationmentioning

confidence: 99%

“…All patients underwent rehabilitation following the same protocol. 34 During the first 6 to 8 weeks, patients underwent the following: (1) weightbearing protection, (2) continuous passive motion for 4 to 6 hours daily, (3) physical therapy focused on reducing pain and swelling, (4) range of motion progression (10°per week), and (5) muscle strengthening. Isometric strengthening of the quadriceps and knee flexors was introduced early in the rehabilitation program and was progressively advanced to exercises against resistance.…”

Section: Surgical Technique and Rehabilitationmentioning

confidence: 99%

“…This technique has shown hyaline-like tissue formation in preclinical studies, 18 as well as promising structural and clinical outcomes, with an adequate safety profile. 15,24,34 The current RCT was performed based on the hypothesis that MACT leads to better structural outcomes and favorable clinical results at midterm follow-up compared with MFx as a treatment method for symptomatic cartilage lesions in the knee. Results of this study have not been previously published.…”

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confidence: 99%

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Arthroscopic Matrix-Assisted Autologous Chondrocyte Transplantation Versus Microfracture: A 6-Year Follow-up of a Prospective Randomized Trial

et al. 2021

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Background: Few randomized controlled trials with a midterm follow-up have compared matrix-assisted autologous chondrocyte transplantation (MACT) with microfracture (MFx) for knee cartilage lesions. Purpose: To compare the structural, clinical, and safety outcomes at midterm follow-up of MACT versus MFx for treating symptomatic knee cartilage lesions. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 48 patients aged between 18 and 50 years, with 1- to 4-cm2 International Cartilage Repair Society (ICRS) grade III to IV knee chondral lesions, were randomized in a 1:1 ratio to the MACT and MFx treatment groups. A sequential prospective evaluation was performed using magnetic resonance imaging (MRI) T2 mapping, the MOCART (magnetic resonance observation of cartilage repair tissue) score, second-look arthroscopic surgery, patient-reported outcome measures, the responder rate (based on achieving the minimal clinically important difference for the Knee injury and Osteoarthritis Outcome Score [KOOS] pain and KOOS Sport/Recreation), adverse events, and treatment failure (defined as a reoperation because of symptoms caused by the primary defect and the detachment or absence of >50% of the repaired tissue during revision surgery). Results: Overall, 35 patients (18 MACT and 17 MFx) with a mean chondral lesion size of 1.8 ± 0.8 cm2 (range, 1-4 cm2) were followed up to a mean of 6 years postoperatively (range, 4-9 years). MACT demonstrated significantly better structural outcomes than MFx at 1 to 6 years postoperatively. At final follow-up, the MRI T2 mapping values of the repaired tissue were 37.7 ± 8.5 ms for MACT versus 46.4 ± 8.5 ms for MFx ( P = .003), while the MOCART scores were 59.4 ± 17.3 and 42.4 ± 16.3, respectively ( P = .006). More than 50% defect filling was seen in 95% of patients at 2 years and 82% at 6 years in the MACT group and in 67% at 2 years and 53% at 6 years in the MFx group. The second-look ICRS scores at 1 year were 10.7 ± 1.3 for MACT and 9.0 ± 1.8 for MFx ( P = .001). Both groups showed significant clinical improvements at 6 years postoperatively compared with their preoperative status. Significant differences favoring the MACT group were observed at 2 years on the KOOS Activities of Daily Living ( P = .043), at 4 years on all KOOS subscales (except Symptoms; P < .05) and the Tegner scale ( P = .008), and at 6 years on the Tegner scale ( P = .010). The responder rates at 6 years were 53% and 77% for MFx and MACT, respectively. There were no reported treatment failures after MACT; the failure rate was 8.3% in the MFx group. Neither group had serious adverse events related to treatment. Conclusion: Patients who underwent MACT had better structural outcomes than those who underwent MFx at 1 to 6 years postoperatively. Both groups of patients showed significant clinical improvements at final follow-up compared with their preoperative status. MACT showed superiority at 4 years for the majority of the KOOS subscales and for the Tegner scale at 4 to 6 years. The MACT group also had a higher responder rate and lower failure rate at final follow-up. Registration: NCT01947374 ( ClinicalTrials.gov identifier).

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Stem cells and tissue engineering: an alternative treatment for craniofacial congenital malformations and articular degenerative diseases

Velasquillo¹,

Madrazo-Ibarra²,

Gómez³

et al. 2020

Plast Aesthet Res

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The life quality of patients with craniofacial malformations is severely affected by the physical disabilities caused by the malformation itself, but also by being subjected to bullying, which leads to a series of relevant psychological and societal effects that have an economic impact on the health sector. Orofacial clefts, notably cleft lip (CL), cleft palate, and microtia, are the most common craniofacial birth defects in humans and represent a substantial burden, both personal and societal. On the other hand, osteoarthritis is a widespread degenerative disease that is becoming more common due to the extension of the human lifespan and to an increase in injuries in young people as a result of their lifestyle. Advances in tissue engineering as a part of regenerative medicine offer new hope to patients that can benefit from new tissue engineering therapies based on the supportive action of tailored 3D biomaterials and the synergic action of stem cells that can be driven to the process of bone and cartilage regeneration. This review provides an update on recent considerations for stem cells and studies on the use of advanced biomaterials and cell therapies for the regeneration of craniofacial congenital malformations and articular degenerative diseases.

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Arthroscopic Matrix-Encapsulated Autologous Chondrocyte Implantation: A Pilot Multicenter Investigation in Latin America

Cited by 3 publications

References 39 publications

Reliability of the MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) 2.0 knee score for different cartilage repair techniques—a retrospective observational study

Reliability of the MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) 2.0 knee score for different cartilage repair techniques—a retrospective observational study

Arthroscopic Matrix-Assisted Autologous Chondrocyte Transplantation Versus Microfracture: A 6-Year Follow-up of a Prospective Randomized Trial

Stem cells and tissue engineering: an alternative treatment for craniofacial congenital malformations and articular degenerative diseases

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