Third‐generation autologous chondrocyte implantation versus mosaicplasty for knee cartilage injury: 2‐year randomized trial |
| |
| Authors: | Arnaud Clavé Jean‐François Potel Elvire Servien Philippe Neyret Frédéric Dubrana Eric Stindel |
| |
| Affiliation: | 1. Université de Bretagne Occidentale, Faculté de Médecine, 22 avenue Camille Desmoulins, Brest, France;2. Service de Chirurgie Orthopédique et Traumatologique de la Cavale Blanche, CHRU Brest, bd Tanguy Prigent, Brest, France;3. LaTIM, INSERM UMR 1101, 2 av Foch, Brest Cedex, France;4. Clinique Médip?le Garonne, 45 rue Gironis, Toulouse Cedex 1, France;5. Centre Albert Trillat, service de chirurgie orthopédique, H?pital de la Croix‐Rousse, Hospices civils de Lyon, 103 grande rue de la Croix‐Rousse, Lyon, France |
| |
| Abstract: | Numerous surgical techniques have been developed to treat osteochondral defects of the knee. A study reported encouraging outcomes of third‐generation autologous chondrocyte implantation achieved using the solid agarose‐alginate scaffold Cartipatch®. Whether this scaffold is better than conventional techniques remains unclear. This multicenter randomized controlled trial compared 2‐year functional outcomes (IKDC score) after Cartipatch® versus mosaicplasty in patients with isolated symptomatic femoral chondral defects (ICRS III and IV) measuring 2.5–7.5 cm2. In addition, a histological evaluation based on the O'Driscoll score was performed after 2 years. We needed 76 patients to demonstrate an at least 10‐point subjective IKDC score difference with α = 5% and 90% power. During the enrolment period, we were able to include 55 patients, 30 of them were allocated at random to Cartipatch® and 25 to mosaicplasty. After 2 years, eight patients had been lost to follow‐up, six in the Cartipatch® group, and two in the mosaicplasty group. The baseline characteristics of the two groups were not significantly different. The mean IKDC score and score improvement after 2 years were respectively 73.7 ± 20.1 and 31.8 ± 20.8 with Cartipatch® and 81.5 ± 16.4 and 44.4 ± 15.2 with mosaicplasty. The 12.6‐point absolute difference in favor of mosaicplasty is statistically significant. Twelve adverse events were recorded in the Cartipatch® group against six in the mosaicplasty group. After 2 years, functional outcomes were significantly worse after Cartipatch® treatment compared to mosaicplasty for isolated focal osteochondral defects of the femur. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:658–665, 2016. |
| |
| Keywords: | cartilage knee autologous chondrocyte implantation mosaicplasty scaffold |
|
|
