Arthroscopic Matrix-Assisted Autologous Chondrocyte Transplantation Versus Microfracture: A 6-Year Follow-up of a Prospective Randomized Trial

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AudienciaPúblico en generales_ES
CoberturaMéxicoes_ES
Fecha de ingreso2026-09-15T00:30:36Z
Fecha de publicación2021-05-28
ResumenBackground: Few randomized controlled trials with a midterm follow-up have compared matrix-assisted autologous chondrocyte transplantation (MACT) with microfracture (MFx) for knee cartilage lesions. Purpose: To compare the structural, clinical, and safety outcomes at midterm follow-up of MACT versus MFx for treating symptomatic knee cartilage lesions. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 48 patients aged between 18 and 50 years, with 1- to 4-cm 2 International Cartilage Repair Society (ICRS) grade III to IV knee chondral lesions, were randomized in a 1:1 ratio to the MACT and MFx treatment groups. A sequential prospective evaluation was performed using magnetic resonance imaging (MRI) T2 mapping, the MOCART (magnetic resonance observation of cartilage repair tissue) score, second-look arthroscopic surgery, patient-reported outcome measures, the responder rate (based on achieving the minimal clinically important difference for the Knee injury and Osteoarthritis Outcome Score [KOOS] pain and KOOS Sport/Recreation), adverse events, and treatment failure (defined as a reoperation because of symptoms caused by the primary defect and the detachment or absence of >50% of the repaired tissue during revision surgery). Results: Overall, 35 patients (18 MACT and 17 MFx) with a mean chondral lesion size of 1.8 ± 0.8 cm 2 (range, 1-4 cm 2 ) were followed up to a mean of 6 years postoperatively (range, 4-9 years). MACT demonstrated significantly better structural outcomes than MFx at 1 to 6 years postoperatively. At final follow-up, the MRI T2 mapping values of the repaired tissue were 37.7 ± 8.5 ms for MACT versus 46.4 ± 8.5 ms for MFx ( P = .003), while the MOCART scores were 59.4 ± 17.3 and 42.4 ± 16.3, respectively ( P = .006). More than 50% defect filling was seen in 95% of patients at 2 years and 82% at 6 years in the MACT group and in 67% at 2 years and 53% at 6 years in the MFx group. The second-look ICRS scores at 1 year were 10.7 ± 1.3 for MACT and 9.0 ± 1.8 for MFx ( P = .001). Both groups showed significant clinical improvements at 6 years postoperatively compared with their preoperative status. Significant differences favoring the MACT group were observed at 2 years on the KOOS Activities of Daily Living ( P = .043), at 4 years on all KOOS subscales (except Symptoms; P < .05) and the Tegner scale ( P = .008), and at 6 years on the Tegner scale ( P = .010). The responder rates at 6 years were 53% and 77% for MFx and MACT, respectively. There were no reported treatment failures after MACT; the failure rate was 8.3% in the MFx group. Neither group had serious adverse events related to treatment. Conclusion: Patients who underwent MACT had better structural outcomes than those who underwent MFx at 1 to 6 years postoperatively. Both groups of patients showed significant clinical improvements at final follow-up compared with their preoperative status. MACT showed superiority at 4 years for the majority of the KOOS subscales and for the Tegner scale at 4 to 6 years. The MACT group also had a higher responder rate and lower failure rate at final follow-up. Registration: NCT01947374 ( ClinicalTrials.gov identifier).es_ES
Doihttps://doi.org/10.1177/03635465211010487es_ES
URIhttps://riuat.uat.edu.mx/handle/123456789/2549
Idiomaenes_ES
EditorialSAGE Publishinges_ES
RelaciónThe American Journal of Sports Medicinees_ES
URL relacionadohttps://doi.org/10.1177/03635465211010487es_ES
DerechosAcceso restringido / Suscripción (Metadatos de producción científica)es_ES
Licenciahttp://purl.org/coar/access_right/c_16eces_ES
FuenteThe American Journal of Sports Medicine
Palabra claveMedicinees_ES
Palabra claveRandomized controlled triales_ES
Palabra claveSurgeryes_ES
Palabra claveTransplantationes_ES
Palabra claveCartilagees_ES
Palabra claveMagnetic resonance imaginges_ES
Palabra claveOsteoarthritises_ES
Palabra claveArthroscopyes_ES
Palabra claveChondrocytees_ES
Palabra claveKnee paines_ES
Palabra claveProspective cohort studyes_ES
Palabra claveArticular cartilage repaires_ES
ClasificaciónOsteoarthritis Treatment and Mechanismses_ES
TítuloArthroscopic Matrix-Assisted Autologous Chondrocyte Transplantation Versus Microfracture: A 6-Year Follow-up of a Prospective Randomized Triales_ES
TipoArtículoes_ES
ArbitradoHa sido Arbitradoes_ES
AutorIbarra, Clemente
AutorVillalobos, Enrique
AutorMadrazo-Ibarra, Antonio
AutorVelasquillo, Cristina
AutorMartínez-López, Valentín
AutorIzaguirre, Aldo
AutorOlivos‐Meza, Anell
AutorCortés‐González, Socorro
AutorPérez-Jiménez, Francisco Javier
AutorVargas-Ramirez, Alberto
AutorFranco-Sanchez, Gilberto
AutorIbarra-Ibarra, Luis Guillermo
AutorSierra-Suárez, L
AutorAlmazán, Arturo
AutorOrtega-Sánchez, Carmina
AutorTrueba, Cesáreo
AutorMartin, Fernando Barbosa
AutorArredondo-Valdes, Reynaldo
AutorArias, Daniel Chavez-
AutorIbarra, Clementees_ES
AutorVillalobos, Enriquees_ES
AutorMadrazo-Ibarra, Antonioes_ES
AutorVelasquillo, Cristinaes_ES
AutorMartínez-López, Valentínes_ES
AutorIzaguirre, Aldoes_ES
AutorOlivos‐Meza, Anelles_ES
AutorCortés‐González, Socorroes_ES
AutorPérez-Jiménez, Francisco Javieres_ES
AutorVargas-Ramirez, Albertoes_ES
AutorFranco-Sanchez, Gilbertoes_ES
AutorIbarra-Ibarra, Luis Guillermoes_ES
AutorSierra-Suárez, Les_ES
AutorAlmazán, Arturoes_ES
AutorOrtega-Sánchez, Carminaes_ES
AutorTrueba, Cesáreoes_ES
AutorMartin, Fernando Barbosaes_ES
AutorArredondo-Valdes, Reynaldoes_ES
AutorArias, Daniel Chavez-es_ES
InstituciónUniversidad Autónoma de Tamaulipas
InstituciónUniversidad Autónoma de Tamaulipases_ES
Número8es_ES
Rango de páginas2165-2176es_ES
URL relacionadahttps://doi.org/10.1177/03635465211010487
Tipo de artículoIndexado
Tipo de artículoIndexadoes_ES
Volumen49es_ES

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