Particulated Costal Allocartilage With Microfracture Versus Microfracture Alone for Knee Cartilage Defects: A Multicenter, Prospective, Randomized, Participant- and Rater-Blinded Study.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2023;11(23):5 Orthop J Sports Med . 2023 Jul 12;11(7):23259671231185570.What this means for my practice?
Overall, the particulated costal allocartilage with microfracture showed superiority over microfracture alone in patients with knee cartilage defects however, did not show any differences in patient-reported outcomes (IKDC; VAS pain with the exception of 24 weeks; and KOOS sports, symptoms, pain, ADL, and QoL at all time points with the exception of pain at 24 weeks and sports, symptoms, pain, and ADL at 12 weeks). The results of this trial were limited by a short follow-up period, the lack of multiple assessments of the quality of cartilage repair, and small sample size. More trials are needed to confirm the results of this study.
Study Summary
90 patients with knee cartilage defects were randomized to receive either particulated costal allocartilage with microfracture (n=44) or microfracture alone (n=46). The primary outcome of interest included Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) scores. Secondary outcomes included International Knee Documentation Committee (IKDC) scores, pain on a Visual Analog Scale (VAS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and the incidence of adverse events. The particulated costal allocartilage group showed significantly better MOCART total scores. Similarly, the particulated costal allocartilage group showed significantly better VAS pain and KOOS pain scores at 24 weeks, with significantly better KOOS sports, symptoms, pain, and activities of daily living at 12 weeks. No differences were apparent in IKDC and all outcomes at 48 weeks.
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