M. Kim (Seoul, KR)

Seoul St. Mary's Hospital Orthopaedic Surgery

Presenter Of 1 Presentation

Podium Presentation Joint Specific Cartilage Repair

16.1.4 - Microfracture Versus a Collagen-Augmented Chondrogenesis Technique for Treating Knee Cartilage Defects: A Randomized Controlled Trial

Presentation Number
16.1.4
Presentation Topic
Joint Specific Cartilage Repair
Lecture Time
11:42 - 11:51
Session Name
Session Type
Free Paper Session
Corresponding Author
Disclosure
All of authors reported receiving the sponsorship including provision of material (CartifillTM), MRI scans from Sewon Cellontech Seoul, Korea. Sewon Cellontech is a company manufacturing the products of cartilage regeneration and researching their applica

Abstract

Purpose

Augmentation techniques have been suggested to remedy the imperfection of microfracture to repair cartilage defects, but the efficacy of the proposed methods is unclear. Collagen-augmented chondrogenesis techniques (C-ACTs) intended to repair cartilage defects is thought to as safe and efficacious than microfracture. The purpose of this study was to examine the quality of articular cartilage repair by C-ACT and its clinical outcomes compared to those achieved by microfracture.

Methods and Materials

Altogether, 100 participants with knee cartilage defects were randomly assigned to the control group (n = 48, microfracture alone) or the investigational group (n = 52, modified microfracture using C-ACT). Clinical and magnetic resonance imaging (MRI) outcomes were assessed 12 and 24 months postoperatively for efficacy and adverse events. Clinical outcomes were assessed using the visual analogue scale (VAS)–pain, VAS–20% improvement based on minimal clinically important improvement (MCII), Knee Injury and Osteoarthritis Outcome Score (KOOS), and International Knee Documentation Committee (IKDC) score. The Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) assessment analyzed cartilage tissue repair. MRI outcomes for 50% filling of the defect and the Repair Tissue/Reference Cartilage (RT/RC) ratio were quantified by T2 mapping.

Results

At 24 months postoperatively, the odds ratio (OR) for the VAS–20% improvement rate was significantly higher in the investigational group (OR=2.808, P=0.047). The MOCART score in the investigational group showed improved defect repair and filling (P=0.0201), integration with the border zone (P=0.0062), and effusion (P=0.0079). MRI outcomes showed that the OR for ≥50% defect filling at 12 months was statistically higher in the investigational group (OR=3.984, P=0.0377). The likelihood of the RT/RC OR becoming ≥1 was significantly higher (OR=11.37, P=0.0126) in the investigational group.

Conclusion

This multicenter, randomized trial, both clinically and by imaging, indicated that C-ACT is as effective and safe as microfracture for treating cartilage defects.

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