Purpose
The aim of this pilot prospective case series study was to evaluate the results of this matrix-induced cell-based technique for the treatment of knee focal chondral.
Methods
20 ICRS grade 3 and 4 cartilage defects with a mean size of 4.3 cm2 (range 1.7 - 6.1 cm2) in 19 patients (11 male and 8 female) with an average age of 31.36 years (range 16-45 years) were treated with matrix-induced autologous transplantation of adipose-derived mesenchymal stem cells. This single-staged procedure involved filling of each defect with autologous culture-expanded mesenchymal stem cells embedded in a trimmed-to-fit commercially available biodegradable matrix. The patients were followed for at 1st, 3rd, 6th,12th and 24th p.o. month (mean follow-up 22.7 months) and their outcome analysis was based on the Knee injury and Osteoarthritis Outcome Score (KOOS) and the International Knee Documentation Committee (IKDC) forms, whereas the non-parametric Wilcox Signed Ramk test was used (p<0.05). In addition the patients underwent MRI (3 Tesla) at the 12th and 24th p.o. month using the Magnetic Resonance Obsrevation of Cartilage Repair (MOCART) scoring system.
Results
No complications and/or adverse events had been reported; analysis of the results showed a significant increase in the mean values of the IKDC total score (from 46.1 to 70.4, p=0.15) and all KOOS subscales (Symptoms and Stiffness from 52.8 to 75.7- p=0.06, Pain from 54.0 to 86.0- p=0.02, Activities of Daily Living from 51.6 to 90.8- p=0.02, Sports and Recreation from 27.2 to 60.7 p=0.02, and Knee-related Quality of Life from 25.0 to 62.7 p=0.013). The MOCART score revealed significant development of tissue resembling the healthy cartilage.
Conclusions
This study has shown promising preliminary results for the treatment of focal knee chondral lesions with a single-staged cell-based technique almost 2 years postoperatively.