Barbaret Arthur, Wein Frank, Jacquet Christophe, Ollivier Matthieu
Department of Orthopedic Surgery and Traumatology, St Marguerite Hospital Institute of Movement and Locomotion Marseille France.
Clinique Louis Pasteur Essey-lès-Nancy France.
J Exp Orthop. 2025 Feb 10;12(1):e70162. doi: 10.1002/jeo2.70162. eCollection 2025 Jan.
Knee cartilage defects are a therapeutic challenge, often requiring multiple costly procedures with modest improvements. This study evaluates whether a one-stage minced cartilage autograft with platelet-rich plasma (PRP) improves clinical and radiological outcomes after at least 1 year.
A multicentric, non-randomized, retrospective analysis was conducted using data from two sports medicine centres. Sixty-six patients aged 18-50 years with symptomatic International Cartilage Repair Society Grade III/IV chondral defects underwent the minced cartilage autograft and PRP procedure between January 2021 and April 2023. The minimum follow-up was 1 year. Clinical scores for Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) Score and Self Knee Value (SKV) were collected from medical records and by an independent examiner at the latest follow-up. Magnetic resonance imaging (MRI) assessments using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 scoring system were performed at the latest follow-up in 46 patients (70%).
The mean follow-up was 20.5 ± 7.5 months. The study demonstrated significant improvements in knee function and pain relief following the minced cartilage autograft with the PRP procedure. The mean KOOS total score started from 45.3 to 71.5 points, mean KOOS pain started from 51.9 to 80.4 points, mean KOOS activities of daily living started from 62.1 to 85.3 points, mean KOOS symptoms started from 53.1 to 79 points, mean KOOS sports started from 38.7 to 74.8 points, mean KOOS quality of life started from 43.3 to 73.7 points. The mean IKDC score improved by 27.7 ± 15.7 points. All these scores have been significantly improved ( < 0.05). MRI assessments confirmed the successful integration of repair tissue with a mean MOCART 2.0 score of 80.5 ± 12.5 points.
The minced autograft cartilage technique with PRP provides favourable early clinical and radiological outcomes for limited chondral defects in the knee. This method offers a single-procedure approach with minimal grafting requirements and does not necessitate a laboratory or specialized personnel, unlike other techniques.
Level III retrospective multicentric study.
膝关节软骨缺损是一项治疗挑战，通常需要多次成本高昂的手术，且改善效果有限。本研究评估了采用富含血小板血浆（PRP）的一期切碎软骨自体移植术在至少1年后是否能改善临床和影像学结果。
利用来自两个运动医学中心的数据进行了一项多中心、非随机、回顾性分析。2021年1月至2023年4月期间，66例年龄在18至50岁、有症状的国际软骨修复协会III/IV级软骨缺损患者接受了切碎软骨自体移植和PRP手术。最短随访时间为1年。在最新随访时，从病历中收集并由一名独立检查者记录膝关节损伤和骨关节炎疗效评分（KOOS）、国际膝关节文献委员会（IKDC）评分和自我膝关节评分（SKV）的临床评分。46例患者（70%）在最新随访时采用磁共振观察软骨修复组织（MOCART）2.0评分系统进行磁共振成像（MRI）评估。
平均随访时间为20.5±7.5个月。该研究表明，采用PRP的切碎软骨自体移植术后膝关节功能和疼痛缓解有显著改善。KOOS总分平均从45.3分提高到71.5分，KOOS疼痛评分平均从51.9分提高到80.4分，KOOS日常生活活动评分平均从62.1分提高到85.3分，KOOS症状评分平均从53.1分提高到79分，KOOS运动评分平均从38.7分提高到74.8分，KOOS生活质量评分平均从43.3分提高到73.7分。IKDC评分平均提高了27.7±15.7分。所有这些评分均有显著改善（P<0.05）。MRI评估证实修复组织成功整合，MOCART 2.0评分平均为80.5±12.5分。
采用PRP的切碎自体移植软骨技术为膝关节有限的软骨缺损提供了良好的早期临床和影像学结果。与其他技术不同，该方法提供了一种单步骤方法，移植需求最小，且不需要实验室或专业人员。
III级回顾性多中心研究。
