Kim Man Soo, Choi Keun Young, Cho Ryu Kyoung, Jang Hyuk Jin, Kwak Dong Ho, Yang Sung Cheol, Oh Seung Taek, In Yong
Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Knee Surg Sports Traumatol Arthrosc. 2025 Jun;33(6):2052-2062. doi: 10.1002/ksa.12500. Epub 2024 Oct 6.
This study investigated whether age affects clinical outcomes and cartilage repair quality in patients who underwent collagen-augmented chondrogenesis.
The study included patients who underwent either the collagen-augmented chondrogenesis technique or microfracture for cartilage defects of the knee joint of International Cartilage Repair Society grade 3 or 4. Patients were categorised according to an age threshold of 50 years and the treatment method, whether collagen-augmented chondrogenesis technique or microfracture. Group 1 comprised 31 patients aged 50 years or older who received the collagen-augmented chondrogenesis technique, Group 2 consisted of 32 patients under the age of 50 years who received the collagen-augmented chondrogenesis technique and Group 3 included 243 patients aged 50 years or older who received microfracture. Clinical outcomes were assessed using the walking visual analogue scale (VAS) for pain and the Western Ontario McMaster University Osteoarthritis Index scale score (WOMAC) two years after surgery. For patients with magnetic resonance imaging results 1 year postoperatively (Group 1: 30 patients; Group 2: 31 patients; and Group 3: 31 patients), Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) assessment was used to evaluate repaired cartilage lesions.
There were no significant differences in the VAS and WOMAC scores between the three groups 2 years after surgery (all n.s.). The MOCART score in patients who underwent MRI at 1 year postoperatively showed significant differences in the degree of defect repair, integration with the border zone, surface of the repaired tissue, adhesion and total score among the three groups (all p < 0.05). Post hoc analysis revealed no difference in the total MOCART scores between Groups 1 and 2. However, Groups 1 and 2 had significantly higher MOCART scores than Group 3 1 year after surgery (all p < 0.05).
The collagen-augmented chondrogenesis technique group showed improved quality of cartilage repair compared to the microfracture group, regardless of patient age. Compared with simple microfracture treatment, there were no differences in clinical outcomes between the patient groups, related to age.
Level Ⅲ.
本研究调查年龄是否会影响接受胶原增强软骨形成术患者的临床结局和软骨修复质量。
该研究纳入了接受国际软骨修复协会3级或4级膝关节软骨缺损的胶原增强软骨形成术或微骨折术的患者。根据50岁的年龄阈值和治疗方法（胶原增强软骨形成术或微骨折术）对患者进行分类。第1组包括31例50岁及以上接受胶原增强软骨形成术的患者，第2组由32例50岁以下接受胶原增强软骨形成术的患者组成，第3组包括243例50岁及以上接受微骨折术的患者。术后两年使用步行视觉模拟量表（VAS）评估疼痛情况，并使用西安大略和麦克马斯特大学骨关节炎指数量表评分（WOMAC）评估临床结局。对于术后1年有磁共振成像结果的患者（第1组：30例；第2组：31例；第3组：31例），采用磁共振软骨修复组织观察（MOCART）评估来评价修复的软骨损伤。
术后2年，三组之间的VAS和WOMAC评分无显著差异（均无统计学意义）。术后1年接受MRI检查的患者的MOCART评分显示，三组在缺损修复程度、与边界区的整合情况、修复组织表面、粘连情况和总分方面存在显著差异（均p < 0.05）。事后分析显示第1组和第2组之间的MOCART总分无差异。然而，术后1年第1组和第2组的MOCART评分显著高于第3组（均p < 0.05）。
无论患者年龄如何，胶原增强软骨形成术组与微骨折术组相比，软骨修复质量有所提高。与单纯微骨折治疗相比，不同年龄患者组之间的临床结局没有差异。
Ⅲ级。
