Hydrogel‐based and spheroid‐based autologous chondrocyte implantation of the knee show similar 2‐year functional outcomes: An analysis based on the German Cartilage Registry (KnorpelRegister DGOU)

Bumberger, Alexander; Niemeyer, Philipp; Angele, Peter; Wright, Emily K.; Faber, Svea O.

doi:10.1002/ksa.12248

Knee surg. sports traumatol. arthrosc.

2024

DOI: 10.1002/ksa.12248

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Hydrogel‐based and spheroid‐based autologous chondrocyte implantation of the knee show similar 2‐year functional outcomes: An analysis based on the German Cartilage Registry (KnorpelRegister DGOU)

Alexander Bumberger,

Philipp Niemeyer,

Peter Angele

et al.

Abstract: PurposeTo compare short‐term patient‐reported outcomes (PRO) of two contemporary matrix‐associated autologous chondrocyte implantation (M‐ACI) products for the treatment of large articular cartilage defects of the knee.MethodsA retrospective, registry‐based, matched‐pair analysis was performed, comparing PRO of patients undergoing isolated M‐ACI with either Spherox™, a spheroid‐based ACI (Sb‐ACI), or NOVOCART™ Inject, a hydrogel‐based ACI product (Hb‐ACI), for a focal full‐thickness cartilage defect of the kne… Show more

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Autologous platelet‐rich plasma and fibrin‐augmented minced cartilage implantation in chondral lesions of the knee leads to good clinical and radiological outcomes after more than 12 months: A retrospective cohort study of 71 patients

Blanke,

Warth,

Oehler

et al. 2024

J. exp. orthop.

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PurposeThe treatment of cartilage lesions remains a challenge. Matrix‐associated autologous chondrocyte implantation has evolved to become the gold standard procedure. However, this two‐step procedure has crucial disadvantages, and the one‐step minced cartilage procedure has gained attention. This retrospective study aimed to evaluate the clinical and radiological outcome of an all‐autologous minced cartilage technique in cartilage lesions at the knee joint.MethodsIn this retrospective cohort study, 71 patients (38.6 years ± 12.0, 39,4% female) with a magnetic resonance imaging (MRI) confirmed grade III–IV cartilage defect at the medial femur condyle (n = 20), lateral femur condyle (n = 2), lateral tibia plateau (n = 1), retropatellar (n = 28) and at the trochlea (n = 20) were included. All patients were treated with an all‐autologous minced cartilage procedure (AutoCart™). Clinical knee function was evaluated by the Tegner score, visual analogue scale, the subjective and objective evaluation form of the International Knee Documentation Committee and the Knee Injury and Osteoarthritis Outcome Score (KOOS). MRI analyses were performed by magnetic resonance observation of cartilage repair tissue (MOCART) 2.0 knee score. Follow‐up examination was 13.7 ± 4.2 (12–24) months postoperative.ResultsAll clinical scores significantly improved after surgical intervention (p < 0.0001), especially the subgroup sports and recreation of KOOS showed clear changes from baseline in the follow‐up examination. In the postoperative MRI evaluation, 39 of 71 patients showed a complete fill of the cartilage defect without subchondral changes in 78% of the patients in the MOCART 2.0 score in the follow‐up analysis. None of the patients showed adverse effects, which are linked to the minced cartilage procedure during the time of follow‐up.ConclusionAn all‐autologous minced cartilage technique for chondral lesions at the knee joint seems to be an effective and safe treatment method with good clinical and radiological short‐term results.Level of EvidenceLevel IV.

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Autologous platelet‐rich plasma and fibrin‐augmented minced cartilage implantation in chondral lesions of the knee leads to good clinical and radiological outcomes after more than 12 months: A retrospective cohort study of 71 patients

Blanke,

Warth,

Oehler

et al. 2024

J. exp. orthop.

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Secondary matrix‐associated autologous chondrocyte implantation after failed cartilage repair shows superior results when combined with autologous bone grafting: Findings from the German Cartilage Registry (KnorpelRegister DGOU)

Weishorn,

Niemeyer,

Angele

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe aim of this study was to evaluate whether additive autologous bone grafting (ABG) improves clinical outcome and survival in revision matrix‐associated autologous chondrocyte implantation (M‐ACI) after failed cartilage repair (CR).MethodsA retrospective, registry‐based, matched‐pair analysis was performed to compare patient‐reported outcomes and survival in secondary M‐ACI with or without additional bone grafting for focal full‐thickness cartilage defects of the knee and to compare it with those in primary M‐ACI. Patients were matched for age, sex, body mass index, defect size and localization, and number of previous CRs. The Knee Injury and Osteoarthritis Outcome Score (KOOS) was assessed over a follow‐up period of 36 months. The patient acceptable symptomatic state, the clinical response rate and the survival of the subgroups were determined.ResultsA total of 818 patients were matched. Revision M‐ACI (n = 238) with concomitant bone grafting was associated with significantly higher PRO as measured by KOOS (80.8 ± 16.8 vs. 72.0 ± 17.5, p = 0.032) and higher CRR (81.4% vs. 52.0%, p = 0.018) at 36 months compared to patients with revision M‐ACI alone. KOOS and KOOS improvement in these patients did not differ from those who underwent primary M‐ACI (p = n.s.). The combination of M‐ACI and ABG resulted in a significantly higher KOOS at 36 months than M‐ACI alone, regardless of whether bone marrow stimulation (89.6 ± 12.5 vs. 68.1 ± 17.9, p = 0.003) or ACI (82.6 ± 17.0 vs. 72.8 ± 16.0, p = 0.021) was performed before. Additional bone grafting results in equivalent survival rates at 7 years in secondary compared to primary M‐ACI (83% vs. 84%, p = n.s.).ConclusionsRegardless of the type of previous CR, additional bone grafting in secondary M‐ACI improves the clinical outcome, response rate and survival at 36 months compared to M‐ACI alone. Secondary M‐ACI with ABG had comparable clinical response and survival rates to primary M‐ACI. Therefore, subchondral bone should be treated even in cases of mild bone involvement in revision M‐ACI.Level of evidenceLevel III.

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Hydrogel‐based and spheroid‐based autologous chondrocyte implantation of the knee show similar 2‐year functional outcomes: An analysis based on the German Cartilage Registry (KnorpelRegister DGOU)

Cited by 2 publications

References 45 publications

Autologous platelet‐rich plasma and fibrin‐augmented minced cartilage implantation in chondral lesions of the knee leads to good clinical and radiological outcomes after more than 12 months: A retrospective cohort study of 71 patients

Autologous platelet‐rich plasma and fibrin‐augmented minced cartilage implantation in chondral lesions of the knee leads to good clinical and radiological outcomes after more than 12 months: A retrospective cohort study of 71 patients

Secondary matrix‐associated autologous chondrocyte implantation after failed cartilage repair shows superior results when combined with autologous bone grafting: Findings from the German Cartilage Registry (KnorpelRegister DGOU)

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