Third‐generation autologous chondrocyte implantation versus mosaicplasty for knee cartilage injury: 2‐year randomized trial

Journal of Orthopaedic Research - Tập 34 Số 4 - Trang 658-665 - 2016
Arnaud Clavé1,2,3, J.-F. Potel4, Elvire Servıen5, Philippe Neyret5, F. Dubrana2,3, Éric Stindel1,2,3
1LaTIM INSERM UMR 1101, 2 av Foch 29609 Brest Cedex France
2Service de Chirurgie Orthopédique et Traumatologique de la Cavale Blanche CHRU Brest, bd Tanguy Prigent 29200 Brest France
3Université de Bretagne Occidentale Faculté de Médecine, 22 avenue Camille Desmoulins 29200 Brest France
4Clinique Médipôle Garonne, 45, rue Gironis, 31036 Toulouse cedex 1, France
5Centre Albert Trillat, service de chirurgie orthopédique, Hôpital de la Croix‐Rousse Hospices civils de Lyon, 103 grande rue de la Croix‐Rousse 69004 Lyon France

Tóm tắt

ABSTRACTNumerous surgical techniques have been developed to treat osteochondral defects of the knee. A study reported encouraging outcomes of third‐generation autologous chondrocyte implantation achieved using the solid agarose‐alginate scaffold Cartipatch®. Whether this scaffold is better than conventional techniques remains unclear. This multicenter randomized controlled trial compared 2‐year functional outcomes (IKDC score) after Cartipatch® versus mosaicplasty in patients with isolated symptomatic femoral chondral defects (ICRS III and IV) measuring 2.5–7.5 cm2. In addition, a histological evaluation based on the O'Driscoll score was performed after 2 years. We needed 76 patients to demonstrate an at least 10‐point subjective IKDC score difference with α = 5% and 90% power. During the enrolment period, we were able to include 55 patients, 30 of them were allocated at random to Cartipatch® and 25 to mosaicplasty. After 2 years, eight patients had been lost to follow‐up, six in the Cartipatch® group, and two in the mosaicplasty group. The baseline characteristics of the two groups were not significantly different. The mean IKDC score and score improvement after 2 years were respectively 73.7 ± 20.1 and 31.8 ± 20.8 with Cartipatch® and 81.5 ± 16.4 and 44.4 ± 15.2 with mosaicplasty. The 12.6‐point absolute difference in favor of mosaicplasty is statistically significant. Twelve adverse events were recorded in the Cartipatch® group against six in the mosaicplasty group. After 2 years, functional outcomes were significantly worse after Cartipatch® treatment compared to mosaicplasty for isolated focal osteochondral defects of the femur. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:658–665, 2016.

Từ khóa


Tài liệu tham khảo

10.1016/j.otsr.2011.09.007

10.1007/s00167-009-0955-1

Rodriguez‐Merchan EC, 2012, The treatment of cartilage defects in the knee joint: microfracture, mosaicplasty, and autologous chondrocyte implantation, Am J Orthop, 41, 236

10.1302/0301-620X.85B2.13543

10.1016/S0278-5919(05)70128-9

10.1053/joca.1997.0092

10.1302/0301-620X.90B5.20360

10.1016/j.otsr.2011.08.005

10.1016/j.arthro.2014.11.018

10.1016/j.jbspin.2007.01.036

10.1089/10763270152044170

10.1007/s00167-013-2614-9

10.1007/s00776-013-0449-3

10.1155/2014/272481

10.1016/j.knee.2014.10.001

10.1007/s00264-014-2368-0

10.1016/j.joca.2013.10.004

Matricali GA, 2010, Donor site morbidity after articular cartilage repair procedures: a review, Acta Orthop Belg, 76, 669

10.2106/00004623-200403000-00001

10.1053/jars.2002.25967

10.1177/0363546507306465

10.1016/S0749-8063(04)00607-3

10.1007/s00167-014-2843-6

10.2165/11584920-000000000-00000

10.1055/s-2007-989435

Thông tin
Thông tin xuất bản

Journal of Orthopaedic Research

Tập 34 Số 4

658-665

Thông tin tác giả