Single-Stage Arthroscopic Cartilage Repair With Injectable Scaffold and BMAC

Abstract

Injectable scaffold augmentation is a promising modality for single-stage cartilage repair. According to published studies, cartilage repair with scaffold augmentation has improved clinical outcomes, radiological fill, and histological repair compared with microfracture alone. Injectable scaffolds have the versatility to be used in large and irregularly shaped lesions. With correct preparation, they can be applied to lesions on the femoral condyle that may be vertical, or even inverted lesions such as those in the patella. They can be combined with bone marrow aspirate concentrate (BMAC) to provide mesenchymal stem cells (MSCs), thereby avoiding the need for microfracture. This protects the subchondral plate, preventing biomechanical alteration and potentially resulting in improved long-term outcomes. In this article, we demonstrate the utility of injectable scaffolds and their combination with BMAC.

Knee Osteochondral Defect Reconstruction With Autologous Bone Grafting and Mesenchymal Cell Transplantation

“…This feature can also be used in cases of lesions small enough to not require bone graft transplantation, resulting in less trauma. [9][10][11] Autologous cancellous bone grafts have an advantage over bone replacement material in bone integration during healing, facilitating faster recovery, and are preferred when performing the reconstruction procedure. Arthroscopy performed before addressing the osteochondral lesion allows treatment of any concomitant injuries in the knee and confirms miniopen access localization.…”

Dry arthroscopy with a simple retraction technique for knee joint cartilage repair using allogenic human umbilical cord blood-derived mesenchymal stem cells

“…e4 other cartilage defect repair methods. [14][15][16][17]22 In this study, we described dry arthroscopic knee cartilage repair using crossed spinal needles, and a suture receiver. Our technique has several advantages over the others.…”

“…To create working space for dry arthroscopy, a simple suture or probe is used for soft tissue retraction. 14 In addition, special equipment such as a retraction plate 15 and CO 2 gas as a substitute for saline solution is used. 16,17 In this study, we introduce an easy and effective technique for dry arthroscopic hUCB-MSC implantation using a conventional arthroscopic device.…”

“…Heng et al recommended the use of a switching stick or probe as a soft tissue retractor and the application of traction sutures to keep wet soft tissue away from the lesion 14. Shetty et al and DeFroda et al used CO 2 gas instead of saline solution to keep the knee joint fluid-free 16,17.…”

Within or Without You? A Perspective Comparing In Situ and Ex Situ Tissue Engineering Strategies for Articular Cartilage Repair

“…[140][141][142][143][144] Various methods can be used to "dry out" the surgical field which may help with improving contact of the implant with the native tissue. [143,145,146]…”