Scaffold-associated procedures are superior to microfracture in managing focal cartilage defects in the knee: A systematic review &amp; meta-analysis

Seewoonarain, Sheena; Ganesh, Divolka; Perera, Edward; Popat, Ravi; Jones, Julian R.; Sugand, Kapil; Gupte, Chinmay

doi:10.1016/j.knee.2023.04.001

Cited by 5 publications

(2 citation statements)

References 45 publications

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“…Several surgical techniques have been proposed to try to improve the regeneration of the articular cartilage. They can be broadly divided into bone marrow stimulation with microfractures (MF), cartilage replacement, and cartilage regeneration [8].…”

Section: Introductionmentioning

confidence: 99%

“…Despite these benefits, there is still an ongoing debate on whether surgical treatment with MF is superior to scaffold-associated procedures for the treatment of large chondral defects, primarily due to a lack of standardization in techniques, differences in study designs, and poor outcome definitions, rendering the use of this new approach limited [8]. Additionally, there is a wide array of scaffold designs, and therefore there is a need to elucidate the optimal scaffold option for future human trials to advocate for homogeneity in terms of exposures.…”

Section: Introductionmentioning

confidence: 99%

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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: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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Organoids of Musculoskeletal System for Disease Modeling, Drug Screening, and Regeneration

Chen,

Liu,

et al. 2024

Adv Healthcare Materials

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Musculoskeletal diseases have emerged as the leading cause of disability worldwide, with their prevalence increasing annually. In light of this escalating health challenge, organoids, an emerging technology in tissue engineering, offer promising solutions for disease modeling, drug screening, regeneration, and repair processes. The successful development of musculoskeletal organoids represents a significant breakthrough, providing a novel platform for studying musculoskeletal diseases and facilitating the discovery of new treatments. Moreover, organoids serve as valuable complements to traditional 2D culture methods and animal models, offering rich insights into musculoskeletal biology. This review provides an overview of organoid technology, outlining the construction processes of various musculoskeletal organoids and highlighting their similarities and differences. Furthermore, the challenges associated with organoid technology in musculoskeletal systems are discussed and insights into future perspectives are offered.

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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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Scaffold-associated procedures are superior to microfracture in managing focal cartilage defects in the knee: A systematic review & meta-analysis

Cited by 5 publications

References 45 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

Organoids of Musculoskeletal System for Disease Modeling, Drug Screening, and Regeneration

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

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