Biphasic Scaffold Loaded With Autologous Cartilage Yields Better Clinical Outcome and Magnetic Resonance Imaging Filling Compared With Marrow Stimulation for Focal Osteochondral Lesions in the Knee.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2025;13(11):34 Arthroscopy . 2025 Mar;41(3):688-699.What this means for my practice?
Clinicians should remember that a biphasic scaffold loaded with autologous cartilage provided superior KOOS subscale scores and MRI-based cartilage refill compared to marrow stimulation at 2 years. This suggests that using the scaffold can enhance long-term cartilage repair and function. However, the short follow-up period and limited assessment of bony incorporation are important limitations to consider.
Study Summary
Fifty-four patients with focal osteochondral knee lesions were randomized to receive either a biphasic scaffold loaded with autologous cartilage (n=27) or marrow stimulation (n=27). The primary outcome was the International Knee Documentation Committee (IKDC) subjective score at 2 years. Secondary outcomes included the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales and MRI-based cartilage filling. Outcomes were assessed at baseline, 1 year, and 2 years post-treatment. Overall, the scaffold group achieved greater improvements in the KOOS Symptoms/Stiffness and Sports/Recreation subscales compared to the marrow stimulation group. MRI showed superior cartilage refill and more isointense signal intensity in the scaffold group. The findings suggest that biphasic scaffold treatment leads to better clinical outcomes and cartilage regeneration than marrow stimulation at 2 years.
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