Scaffold Augmentation vs Microfracture for Knee Cartilage Repair: No Short-Term Superiority Found .
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Does scaffold enhancement show significant superiority over microfracture alone for treating knee chondral defects? A systematic review and meta-analysis of randomised clinical trials.
Knee Surg Sports Traumatol Arthrosc . 2025 Jun;33(6):2027-2043.Ten RCTs including 378 patients with focal knee chondral/osteochondral defects were included in this systematic review and meta‑analysis comparing microfracture plus scaffold augmentation versus microfracture alone. Pooled outcomes of interest included IKDC, KOOS, VAS, and MOCART. Across 12–24 months, pooled effects showed no significant superiority of scaffold augmentation over microfracture on IKDC, KOOS, VAS, and MOCART at 1 yr. In individual trials, some longer‑term signals favored scaffolds, but heterogeneity was high. Overall, the main finding is that routine scaffold augmentation did not outperform microfracture at short‑ to mid‑term, suggesting careful patient selection and the need for standardized methods and longer follow‑up.
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