New York University Grossman School of Medicine, NYU Langone Orthopedic Hospital, New York, New York, USA.
Cornell University, Weill Medical College, New York, New York, USA.
Am J Sports Med. 2024 Dec;52(14):3561-3568. doi: 10.1177/03635465241287524. Epub 2024 Nov 3.
One-step cell-based techniques of cartilage repair that lead to restoration of durable chondral tissue and long-term maintenance of joint function are cost-effective and ideal for routine use.
To examine the long-term clinical outcomes, after a mean follow-up duration of 14 years, of cartilage repair in the knee using a hyaluronic acid-based scaffold in association with bone marrow aspirate concentrate (HA-BMAC) and to evaluate the effect of age, lesion characteristics, and associated treatments on the outcome of this cartilage repair method.
Case series; Level of evidence, 4.
Patients were followed prospectively for a mean duration of 14.0 years after undergoing treatment of knee full-thickness articular cartilage injury using HA-BMAC. Clinical evaluation consisted of the patient-reported scoring tools of the visual analog scale and the Knee injury and Osteoarthritis Outcome Score, which were completed preoperatively and at the time of final follow-up.
A total of 26 patients with a mean age of 48.3 years (17 male, 9 female) and median chondral lesion size of 6.6 cm (range, 1-27 cm) were followed prospectively. There were 3 treatment failures, and 1 patient who underwent medial compartment unicompartmental arthroplasty 12 years after HA-BMAC treatment of patellar chondral injury. Of the 22 remaining patients, after a mean final follow-up duration of 14.0 years (range, 12-16 years), the median visual analog scale score of 0.6 was significantly decreased from the preoperative median score of 5.0 ( < .001). The median Knee injury and Osteoarthritis Outcome Score Pain (92), Symptoms (86), Activities of Daily Living (96), Sports (85), and Quality of Life (88) subscale values were all increased compared with the preoperative scores (≤ .001). There was no correlation of clinical outcome score and body mass index.
One-step cartilage repair of full-thickness chondral defects in the knee using an HA-BMAC led to successful long-term clinical outcomes and maintenance of joint junction after a mean follow-up duration of 14 years. Long-term clinical success in active, nonobese patients has been uniformly demonstrated across a wide range of patient ages and lesion types, including cases of multicompartment involvement, treatment of associated conditions, and large or bipolar chondral lesions.
一步法细胞软骨修复技术可恢复持久的软骨组织，并长期维持关节功能，具有成本效益，非常适合常规使用。
在平均 14 年的随访后，检查使用透明质酸为基础的支架联合骨髓抽吸浓缩物（HA-BMAC）修复膝关节软骨的长期临床结果，并评估年龄、病变特征和相关治疗对这种软骨修复方法结果的影响。
病例系列；证据水平，4 级。
对接受 HA-BMAC 治疗全层关节软骨损伤的患者进行前瞻性随访，平均随访 14.0 年。临床评估包括患者报告的视觉模拟评分和膝关节损伤和骨关节炎结果评分，这些评分在术前和最终随访时完成。
共 26 例患者，平均年龄 48.3 岁（17 例男性，9 例女性），中位软骨损伤大小为 6.6cm（范围 1-27cm）。有 3 例治疗失败，1 例患者在 HA-BMAC 治疗髌骨软骨损伤 12 年后接受内侧间室单髁关节置换术。在 22 例其余患者中，平均最终随访 14.0 年（范围 12-16 年）后，中位数视觉模拟评分从术前的 5.0 分（ <.001）显著下降至 0.6。Knee injury and Osteoarthritis Outcome Score 疼痛（92）、症状（86）、日常生活活动（96）、运动（85）和生活质量（88）亚量表的中位数评分均高于术前评分（≤.001）。临床结局评分与体重指数无相关性。
使用 HA-BMAC 对膝关节全层软骨缺损进行一步法软骨修复，在平均 14 年的随访后，可获得成功的长期临床结果，并维持关节连接。在广泛的患者年龄和病变类型范围内，包括多间室受累、相关疾病的治疗以及大或双极软骨损伤，都证明了活跃、非肥胖患者的长期临床成功。
