engleski

Microfractures Versus Autologus Chondrocyte Implantation

Objectives : Characterized chondrocyte implantation was compared with single grade III to IV symptomatic cartilage defects of the femoral condyles in a multicenter trial. Patients (materials) & methods : Patients aged 18 to 50 years were randomized to aharacterized chondrocyte implantation (n=57) or microfracure (n=61). Structural repair was blindly assessed in biopsy specimens taken at 1 year using computerized histomorphometry and evaluation of overall histological components of structural repair. Clinical outcome was measures using the self administered Knee injury and Osteoarthritis Outcome Score. Results : Characterized chondrocyte implantation resulted in better structural repair. As assessed by histomorphometry (P=.003) and overall histology evaluation (P=.012). Aspects of structural repair relating to chondrocyte phenotype and tissue structure were superior with characterised chondrocyte implantation. Clinical outcome as measured by Knee injury and Osteoarthritis Outcome Score at 12 to 18 month after characterised chondrocyte implantation was comparable with microfracture at this stage. Both treatment groups had similar means baseline overall Knee injury and Osteoarthritis Outcome Score (56.30&plusmn ; ; 13.61 and 59.53&plusmn ; ; 14.95 for microfracture and characterised chondrocyte implantation, respectively) which increased in both groups to 70.56&plusmn ; ; 12.39 and 72.63&plusmn ; ; 15.55 at 6 months, 73.26&plusmn ; ; 14.66 and 73.10&plusmn ; ; 16.01 at 12 months, and 74.73&plusmn ; ; 17.01 and 75.04&plusmn ; ; 14.50 at 18 months. Both techniques were generally well tolerated ; the incidence of adverse events after characterised chondrocyte implantation was not markedly increased compared with that for microfracure.

cartilage repair; autologous chondrocyte implantation; microfracture

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