Satisfactory clinical outcomes with autologous matrix-induced chondrogenesis in the treatment of grade IV chondral injuries of the knee

Quiceno, Germán Alejandro Jaramillo; Riveros, Paula Andrea Sarmiento; Perea, German Alberto Ochoa; Vergara, Mauricio Gutierrez; Muñoz, Luis Fernando Rodriguez; Pérez, Ruben Darío Arias; Piovesan, Nicolas Ochoa; Salamanca, Jaime Alonso Muñoz

doi:10.1016/j.jisako.2022.11.004

Cited by 6 publications

(3 citation statements)

References 43 publications

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“…According to our findings, the usage of HA 3-D scaffold for the treatment of cartilage defects is effective and superior to MF, with evidence related to less time for total recovery of functional status (MCKRS) and faster improvement in MRI findings (Henderson score). Recently, similar findings about satisfactory clinical outcomes with the use of HA 3-D scaffolds were reported [22,23]. However, there is still a need to clarify its superiority when compared to MF, convey the type of scaffold with the best performance, and apply similar clinical outcomes.…”

Section: Discussionmentioning

confidence: 73%

Rapid Recovery after Reparation of Full-Thickness Chondral Defects of the Knee with the Use of Hyaluronan (HA)-Based 3-D Scaffold

Valladares,

Cabrero Montes,

Jacobo-Jimenez

et al. 2023

JFB

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Articular cartilage injuries are found in up to 60% of patients who undergo an arthroscopic knee procedure, and those that totally affect articular cartilage (grade IV) have limited regenerative capacity and extended time for recovery. 3-D scaffolds represent a novel solution to address this type of injury. Our purpose was to analyze the MRI findings and functional status of patients that underwent repair of chondral defects either by microfractures or Hyaluronan (HA) 3-D scaffolding. We conducted a retrospective study of patients with chondral defects. The outcomes analyzed in this study included anatomical changes evaluated by the Henderson score (based on MRI findings) at baseline, 6, and 12 months after surgery, and improvement in functionality evaluated by the Modified Cincinnati Knee Rating System (MCKRS) at baseline and 6 months after surgery. Clinical and demographic characteristics were similar for both groups. There was a statistically significant improvement in Henderson score for the 3-D scaffold-treated group at 6 months versus the microfracture group (p < 0.0001). Improvement in functionality, measured by the MCKRS, was more frequently found in the 3-D scaffold-treated group. In conclusion, the use of HA 3-D scaffolding was superior, with faster recovery evident 6 months after the surgery that progressed to full recovery in all patients a year after surgery. Future studies with a randomized design might help to support our findings. This study provides level III evidence.

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Section: Discussionmentioning

confidence: 73%

Rapid Recovery after Reparation of Full-Thickness Chondral Defects of the Knee with the Use of Hyaluronan (HA)-Based 3-D Scaffold

Valladares,

Cabrero Montes,

Jacobo-Jimenez

et al. 2023

JFB

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“…Repairing cartilage defects with Hyalofast TM scaffold (fibrin membrane stimulating cartilage growth) has emerged as a compelling alternative for patients experiencing intense joint pain [25][26][27][28]. Hyalofast is composed only of semisynthetic hyaluronic acid derivatives, which are natural components of the extracellular matrix and fundamental constituents of human cartilage.…”

Section: Introductionmentioning

confidence: 99%

“…This substrate enables the differentiation of mesenchymal stem cells into chondrocytes, which are capable of producing physiological cartilage. Hyalofast, upon application, creates a chondroprotective layer that extends the survival of mesenchymal stem cells at the site of the cartilage defect following mobilization through the microfracture technique [25][26][27]29]. However, despite significant advances in the treatment of knee injuries, recovery time can be prolonged, which significantly delays the return of athletes to active sports.…”

Section: Introductionmentioning

confidence: 99%

Rehabilitation of Soccer Players’ Knee Injuries: Cartilage Reconstruction, Anterior Cruciate Ligament Surgery, and Intensive Recovery—A Pilot Study

Kacprzak,

Rosińska

2023

JCM

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Knee injuries, particularly anterior cruciate ligament (ACL) damage and cartilage defects, are highly prevalent among athletes and affect their sports performance and long-term joint function. The purpose of this research was to evaluate the effectiveness of a comprehensive combination therapy approach for individuals with ACL and cartilage injuries. Twelve professional soccer players aged 18 to 30 years underwent bone–tendon–bone ACL reconstruction, microfracture cartilage repair surgery, and hyaluronic acid scaffold treatment. Early postoperative rehabilitation included immediate supervised physiotherapy and complete weight bearing. Follow-up assessments involved clinical evaluations, functional joint assessments, and magnetic resonance imaging (MRI) scans to measure cartilage defect repair and symptom alleviation. The results showed that patients resumed pain-free activities within 3–4 weeks and returned to their pre-injury level within 4.5 months. MRI demonstrated the absence of inflammatory reactions, repair of marrow edema, and the emergence of new cartilage. Six months and one year after surgery, the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Short Form (36) Health Survey (SF-36) questionnaire results demonstrated considerable improvement in patients’ health condition and quality of life. Overall, the study suggests that the combination of Hyalofast membranes, microfracture surgery, tissue adhesive, and intensive postoperative physical therapy may be a potential alternative to commonly used treatments for patients with ACL rupture, allowing them to recover efficiently and return to sports activities.

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Drop in survivorship 13 years after AMIC procedures in aligned knees: A long‐term follow‐up

Barrera Uso,

Boillat,

Blümel

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeAutologous matrix‐induced chondrogenesis (AMIC) showed promising short‐term results comparable to microfracture. This study aims to assess the 19‐year outcomes of AMIC, addressing the lack of long‐term data.MethodsRetrospective cohort of 34 knees treated with AMIC underwent a 19‐year follow‐up. The primary outcome was AMIC survival, considering total knee arthroplasty as a failure event. Survival analysis for factors that were associated with longer survival of the AMIC was also performed. Clinical and radiological outcome scores were analysed for the AMIC group.ResultsTwenty‐three knees were available for follow‐up analysis. Of these, 14 (61%) underwent revision surgery for total knee arthroplasty (TKA). The mean time was 13.3 ± 2.5 years (range: 9–17 years). Secondary outcomes showed that increased age at surgery (hazard ratio [HR]: 1.05; p = 0.021) and larger defect size (HR: 1.95; p = 0.018) were risk factors for failure. Concomitant proximal tibial osteotomy (HR: 0.22; p = 0.019) was associated with longer survival. The remaining nine knees (39%) were analysed as a single group. The mean clinical score at follow‐up of 18.6 ± 0.9 SD years was 79.5 ± 19.7 SD for the Lysholm score, 1.8 ± 1.5 SD for the visual analog scale score, 74.2 ± 22.4 SD for the KOOS score and a median of 3 (range: 3–4) for the Tegner activity scale.ConclusionsThe mean survival time of 13.3 years indicates the durability of AMIC in properly aligned knees. Nonetheless, despite a 61% conversion to TKA, the knees that persisted until the 19‐year follow‐up remained stable, underscoring the procedure's longevity and consistent clinical outcomes.Level of EvidenceLevel IV.

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Satisfactory clinical outcomes with autologous matrix-induced chondrogenesis in the treatment of grade IV chondral injuries of the knee

Cited by 6 publications

References 43 publications

Rapid Recovery after Reparation of Full-Thickness Chondral Defects of the Knee with the Use of Hyaluronan (HA)-Based 3-D Scaffold

Rapid Recovery after Reparation of Full-Thickness Chondral Defects of the Knee with the Use of Hyaluronan (HA)-Based 3-D Scaffold

Rehabilitation of Soccer Players’ Knee Injuries: Cartilage Reconstruction, Anterior Cruciate Ligament Surgery, and Intensive Recovery—A Pilot Study

Drop in survivorship 13 years after AMIC procedures in aligned knees: A long‐term follow‐up

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