Microfractures Versus a Porcine-Derived Collagen-Augmented Chondrogenesis Technique for Treating Knee Cartilage Defects: A Multicenter Randomized Controlled Trial
- 주제(기타) Orthopedics
- 주제(기타) Sport Sciences
- 주제(기타) Surgery
- 설명문(일반) [Kim, Man Soo; In, Yong] Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Dept Orthopaed Surg, 222 Banpo Daero, Seoul 06591, South Korea; [Chun, Churl Hong] Wonkwang Univ, Wonkwang Univ Hosp, Coll Med, Dept Orthopaed Surg, Iksan, South Korea; [Wang, Joon Ho] Sungkyunkwan Univ, Coll Med, Samsung Med Ctr, Dept Orthopaed Surg,Sch Med, Seoul, South Korea; [Kim, Jin Goo; Ha, Jeong Ku] Inje Univ, Seoul Paik Hosp, Coll Med, Dept Orthoped Surg, Seoul, South Korea; [Kang, Seung-Baik; Chang, Chong Bum] Seoul Natl Univ, SMG SNU Boramae Med Ctr, Dept Orthopaed Surg, Coll Med, Seoul, South Korea; [Yoo, Jae Doo] Ewha Womans Univ, Mokdong Hosp, Coll Med, Dept Orthopaed Surg, Seoul, South Korea; [Chon, Je-Gyun; Song, In Soo] Daejeon Sun Hosp, Dept Orthopaed Surg, Daejeon, South Korea; [Kim, Myung Ku] Inha Univ, Inha Univ Hosp, Coll Med, Dept Orthopaed Surg, Incheon, South Korea; [Moon, Chan Woong] Catholic Univ Korea, Bucheon St Marys Hosp, Coll Med, Dept Orthopaed Surg, Bucheon, South Korea; [Choi, Nam Yong] Catholic Univ Korea, St Pauls Hosp, Coll Med, Dept Orthopaed Surg, Seoul, South Korea
- 등재 SCIE, SCOPUS
- 발행기관 W B SAUNDERS CO-ELSEVIER INC
- 발행년도 2020
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000169172
- 본문언어 영어
- Published As https://dx.doi.org/10.1016/j.arthro.2019.11.110
- PubMed https://pubmed.ncbi.nlm.nih.gov/31785390
초록/요약
Purpose: The purpose of this study was to evaluate the clinical efficacy and safety of treating patients with a cartilage defect of the knee with microfractures and porcine-derived collagen-augmented chondrogenesis technique (C-ACT). Methods: One hundred participants were randomly assigned to the control group (n = 48, microfracture) or the investigational group (n = 52, C-ACT). Clinical and magnetic resonance imaging (MRI) outcomes were assessed 12 and 24 months postoperatively for efficacy and adverse events. Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) assessment was used to analyze cartilage tissue repair. MRI outcomes for 50% defect filling and repaired tissue/reference cartilage (RT/RC) ratio were quantified using T2 mapping. Clinical outcomes were assessed using the visual analogue scale (VAS) for pain and 20% improvement, minimal clinically important difference (MCID), and patient acceptable symptom state for Knee Injury and Osteoarthritis Outcome Score (KOOS) and the International Knee Documentation Committee score. Results: MOCART scores in the investigation group showed improved defect repair and filling (P = .0201), integration with the border zone (P = .0062), and effusion (P = .0079). MRI outcomes showed that the odds ratio (OR) for >= 50% defect filling at 12 months was statistically higher in the investigation group (OR 3.984, P = .0377). Moreover, the likelihood of the RT/RC OR becoming >= 1 was significantly higher (OR 11.37, P = .0126) in the investigation group. At 24 months postoperatively, the OR for the VAS 20% improvement rate was significantly higher in the investigational group (OR 2.808, P = .047). Twenty-three patients (52.3%) in the control group and 35 (77.8%) in the investigation group demonstrated more than the MCID of KOOS pain from baseline to 1 year postoperatively, with a significant difference between groups (P = .0116). Conclusion: In this multicenter randomized trial, the addition of C-ACT resulted in better filling of cartilage defect of the knee joint.
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