Treatment of large chondral lesions with an autologous minced cartilage technique and synovial flap leads to superior results compared to matrix associated autologous chondrocyte transplantation technique after 24 months: A controlled clinical trial
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| Format: | Artículo Open Access |
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2025
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| author | Johanna Mayr Franziska Warth Nicola Oehler Martin Majewski Christoph Lutter Fabian Blanke |
| author_facet | Johanna Mayr Franziska Warth Nicola Oehler Martin Majewski Christoph Lutter Fabian Blanke Johanna Mayr Franziska Warth Nicola Oehler Martin Majewski Christoph Lutter Fabian Blanke |
| collection | Wiley Open Access |
| contents | Treatment of large chondral lesions with an autologous minced cartilage technique and synovial flap leads to superior results compared to matrix associated autologous chondrocyte transplantation technique after 24 months: A controlled clinical trial Johanna Mayr Franziska Warth Nicola Oehler Martin Majewski Christoph Lutter Fabian Blanke Knee Surgery, Sports Traumatology, Arthroscopy Abstract Purpose Treating large cartilage lesions in the knee remains a challenge. While matrix‐associated autologous chondrocyte implantation (MACI) is the gold standard for medium to large lesions, the minced cartilage technique has shown promise in smaller defects. Enhancing this technique with biomaterials has been suggested for larger lesions, but its effectiveness remains unclear due to limited data. This study aimed to evaluate the outcomes of the minced cartilage technique with autologous synovial flap coverage in large knee cartilage lesions and compare the results with MACI. Methods Twenty patients with large Grade III–IV cartilage defects (>6 cm²) at the knee were included. Ten patients underwent the autologous minced cartilage procedure (AutoCart™) with synovial flap (Group A), and ten received the MACI procedure (Group B). Clinical outcomes were assessed using the Tegner score, visual analog scale (VAS), the International Knee Documentation Committee (IKDC) forms, and the Knee Injury and Osteoarthritis Outcome Score (KOOS). MRI evaluations were performed using the MOCART 2.0 score before surgery and 24 months postoperatively. Results Clinical scores significantly improved in Group A after surgery, while Group B showed improvement only in the VAS, pain, and sports/recreation levels. Postoperative MRI revealed similar results between groups, with Group A showing significantly better cartilage defect volume fill and fewer subchondral changes compared to Group B ( p < 0.05). The mean MOCART 2.0 score at the final follow‐up was 76.0 ± 15.4 for Group A and 65.6 ± 17.6 for Group B, though without statistical significance. Conclusion The study suggests that the all‐autologous minced cartilage technique with synovial flap is an effective treatment for large chondral lesions, yielding outcomes similar to or better compared to the MACI technique. Level of Evidence Level III. 10.1002/ksa.12708 http://creativecommons.org/licenses/by/4.0/ |
| doi_str_mv | 10.1002/ksa.12708 |
| format | Artículo Open Access |
| id | wiley_oa_10_1002_ksa_12708 |
| institution | Wiley Open Access |
| license_str_mv | http://creativecommons.org/licenses/by/4.0/ |
| publishDate | 2025 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Treatment of large chondral lesions with an autologous minced cartilage technique and synovial flap leads to superior results compared to matrix associated autologous chondrocyte transplantation technique after 24 months: A controlled clinical trial Johanna Mayr Franziska Warth Nicola Oehler Martin Majewski Christoph Lutter Fabian Blanke Knee Surgery, Sports Traumatology, Arthroscopy Treatment of large chondral lesions with an autologous minced cartilage technique and synovial flap leads to superior results compared to matrix associated autologous chondrocyte transplantation technique after 24 months: A controlled clinical trial Johanna Mayr Franziska Warth Nicola Oehler Martin Majewski Christoph Lutter Fabian Blanke Knee Surgery, Sports Traumatology, Arthroscopy Abstract Purpose Treating large cartilage lesions in the knee remains a challenge. While matrix‐associated autologous chondrocyte implantation (MACI) is the gold standard for medium to large lesions, the minced cartilage technique has shown promise in smaller defects. Enhancing this technique with biomaterials has been suggested for larger lesions, but its effectiveness remains unclear due to limited data. This study aimed to evaluate the outcomes of the minced cartilage technique with autologous synovial flap coverage in large knee cartilage lesions and compare the results with MACI. Methods Twenty patients with large Grade III–IV cartilage defects (>6 cm²) at the knee were included. Ten patients underwent the autologous minced cartilage procedure (AutoCart™) with synovial flap (Group A), and ten received the MACI procedure (Group B). Clinical outcomes were assessed using the Tegner score, visual analog scale (VAS), the International Knee Documentation Committee (IKDC) forms, and the Knee Injury and Osteoarthritis Outcome Score (KOOS). MRI evaluations were performed using the MOCART 2.0 score before surgery and 24 months postoperatively. Results Clinical scores significantly improved in Group A after surgery, while Group B showed improvement only in the VAS, pain, and sports/recreation levels. Postoperative MRI revealed similar results between groups, with Group A showing significantly better cartilage defect volume fill and fewer subchondral changes compared to Group B ( p < 0.05). The mean MOCART 2.0 score at the final follow‐up was 76.0 ± 15.4 for Group A and 65.6 ± 17.6 for Group B, though without statistical significance. Conclusion The study suggests that the all‐autologous minced cartilage technique with synovial flap is an effective treatment for large chondral lesions, yielding outcomes similar to or better compared to the MACI technique. Level of Evidence Level III. 10.1002/ksa.12708 http://creativecommons.org/licenses/by/4.0/ |
| title | Treatment of large chondral lesions with an autologous minced cartilage technique and synovial flap leads to superior results compared to matrix associated autologous chondrocyte transplantation technique after 24 months: A controlled clinical trial |
| topic | Knee Surgery, Sports Traumatology, Arthroscopy |
| url | https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/ksa.12708 |