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Archives of Orthopaedic and Trauma Surgery

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01.02.2015 | Arthroscopy and Sports Medicine

Matrix-induced autologous mesenchymal stem cell implantation versus matrix-induced autologous chondrocyte implantation in the treatment of chondral defects of the knee: a 2-year randomized study

verfasst von: Isık Akgun, Mehmet C. Unlu, Ozan A. Erdal, Tahir Ogut, Murat Erturk, Ercument Ovali, Fatih Kantarci, Gurkan Caliskan, Yamac Akgun

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 2/2015

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Abstract

Background

Cell-based strategies that combine in vitro- expanded autologous chondrocytes with matrix scaffolds are currently preferred for full-thickness cartilage lesions of the knee ≥2 cm². Although this approach is reasonable, continuing advances in the field of cartilage repair will further expand the options available to improve outcomes.

Hypothesis/purpose

In the present clinical study, we compared the outcomes of matrix-induced autologous mesenchymal stem cell implantation (m-AMI) with matrix-induced autologous chondrocyte implantation (m-ACI) for the treatment of isolated chondral defects of the knee.

Study design

Prospective, single-site, randomized, single-blind pilot study.

Methods

Fourteen patients with isolated full-thickness chondral lesions of the knee >2 cm² were randomized into two treatment groups: m-AMI and m-ACI. Outcomes were assessed pre-operatively and 3, 6, 12 and 24 months post-operatively.

Results

Clinical evaluations revealed that improvement from pre-operation to 24 months post-operation occurred in both groups (p < 0.05). At all follow-up intervals, m-AMI demonstrated significantly better functional outcomes (motion deficit and straight leg raise strength) than did m-ACI (p < 0.05). At all follow-up intervals, m-AMI demonstrated significantly better subjective sub-scale scores for pain, symptoms, activities of daily living and sport and recreation of the knee injury and osteoarthritis outcome score (KOOS) than did m-ACI (p < 0.05). Additionally, m-AMI demonstrated significantly better (p < 0.05) scores than m-ACI for the quality of life sub-scale of the KOOS and visual analog scale (VAS) severity at the 6-month follow-up. The Tegner activity score and VAS frequency were not significantly different between the two groups. Graft failure was not observed on magnetic resonance imaging at the 24-month follow-up. m-AMI and m-ACI demonstrated very good-to-excellent and good-to-very good infill, respectively, with no adverse effects from the implant, regardless of the treatment.

Conclusion

For the treatment of isolated full-thickness chondral lesion of the knee, m-AMI can be used effectively and may potentially accelerate recovery. A larger patient cohort and follow-up supported by histological analyses are necessary to determine long-term outcomes.

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Titel: Matrix-induced autologous mesenchymal stem cell implantation versus matrix-induced autologous chondrocyte implantation in the treatment of chondral defects of the knee: a 2-year randomized study
verfasst von: Isık Akgun
Mehmet C. Unlu
Ozan A. Erdal
Tahir Ogut
Murat Erturk
Ercument Ovali
Fatih Kantarci
Gurkan Caliskan
Yamac Akgun
Publikationsdatum: 01.02.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 2/2015
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-014-2136-z

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