Summary

Minced cartilage procedure for medium to large chondral- or osteochondral lesions of the knee show good patient-reported mid-term results with low complications and reoperation rates and are a viable, single-stage alternative to more conventional techniques

Abstract

Background

Cartilage injuries in the knee are frequent but their treatment remains challenging. Minced cartilage is a one-step, autologous procedure with promising short-term results.

Purpose

The aim of the present study was to evaluate mid-term results in a patient cohort treated with the minced cartilage procedure due to chondral- and osteochondral lesions of the knee.

Study design: Prospective Case Series

Methods

From February 2015 through June 2016, a total of 34 consecutive patients were treated with a single-step, autologous minced cartilage procedure for treatment of chondral and osteochondral lesions across the knee joint. Magnetic resonance imaging (MRI) was obtained pre- and postoperatively. The primary outcome measures were the numeric analogue scale (NAS) for pain and knee function, which were obtained prior to surgery and at 12, 24 and 60 months postoperatively. Additionally at final follow up the Lysholm score, Tegner activity score and the International Knee Documentation Committee (IKDC) score were obtained.

Results

A total of 28 patients (44.1% females, mean age at surgery: 29.5±11.5 years) were available at a mean follow up of 65.5 ± 4.1 months. Mean defect size was 3.5±1.8 cm2 and preoperative AMADEUS score (Area Measurement and Depth and Underlying Structures) was 55.2±21.5. NAS for pain decreased from a median of 7 (range: 2 -10) preoperatively to 2 (0 - 7), 1 (0 - 5) and 2 (0 - 8) after one, two and five years respectively. Knee function improved from a median of 7 (range: 2 -10) to 3 (0 - 7), 2 (0 - 7) and 3 (0 - 7) after one, two and five years respectively. Lysholm-, Tegner activity- and IKDC score were 76.5±12.5, 4 (min – max: 3-9) and 71.6±14.8 at final FU, respectively. The average overall MOCART score for all examined patients and anatomical sites (patellar, femoral condyle, trochlea) was 62.6 ± 15.8 Four surgery related adverse events with necessary revision operation occurred during the five-year period.

Conclusion

Minced cartilage procedure for medium to large chondral- and osteochondral lesions of the knee show good patient-reported mid-term results with low complications and reoperation rates and are a viable, single-stage alternative to more conventional techniques