A novel, minimally-invasive technique of cartilage repair in the human knee using arthroscopic microfracture and injections of mesenchymal stem cells and hyaluronic acid--a prospective comparative study on safety and short-term efficacy
Annals of the Academy of Medicine, Singapore
;
: 511-517, 2012.
Article
in English
| WPRIM
| ID: wpr-299595
ABSTRACT
<p><b>INTRODUCTION</b>Most current cell-based cartilage repair techniques require some form of scaffolds and 2 separate surgical procedures. We propose a novel, scaffold-less technique of cartilage repair in the human knee that combines arthroscopic microfracture and outpatient intra-articular injections of autologous bone marrow-derived mesenchymal stem cells (MSCs) and hyaluronic acid (HA).</p><p><b>MATERIALS AND METHODS</b>Seventy matched (age, sex, lesion size) knees with symptomatic cartilage defects underwent cartilage repair with the proposed technique (n = 35) or an open technique (n = 35) in which the MSCs were implanted beneath a sutured periosteal patch over the defect. Prospective evaluation of both groups were performed using the International Cartilage Repair Society (ICRS) Cartilage Injury Evaluation Package, which included questions from the Short-Form (SF-36) Health Survey, International Knee Documentation Committee (IKDC) subjective knee evaluation form, Lysholm knee scale, and Tegner activity level scale. Postoperative magnetic resonance imaging (MRI) evaluation was also performed at 1 year for most patients.</p><p><b>RESULTS</b>There were no clinically significant adverse events reported through the course of our study. At the fi nal follow-up (mean = 24.5 months), there was significant improvement in mean IKDC, Lysholm, SF-36 physical component score and visual analogue pain scores in both treatment groups.</p><p><b>CONCLUSION</b>In the short term, the results of this novel technique are comparable to the open procedure with the added advantages of being minimally invasive and requiring only a single operation under general anaesthesia. Its safety has been validated and its efficacy is currently being evaluated in an ongoing randomised controlled trial.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Arthroscopy
/
Singapore
/
Therapeutics
/
Wounds and Injuries
/
Magnetic Resonance Imaging
/
Cartilage, Articular
/
Prospective Studies
/
Outcome Assessment, Health Care
/
Combined Modality Therapy
/
Therapeutic Uses
Type of study:
Controlled clinical trial
/
Observational study
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
English
Journal:
Annals of the Academy of Medicine, Singapore
Year:
2012
Type:
Article
Similar
MEDLINE
...
LILACS
LIS