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Microfracture with adiposederived stem cells linked with improved radiologic outcomes
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Use of microfracture and adipose-derived stem cells with fibrin glue showed improved radiologic and KOOS pain and symptom subscores in the treatment of symptomatic knee cartilage defects compared with the use of microfracture alone, according to results.
Researchers randomly assigned 80 patients aged 18 years to 50 years who had a single International Cartilage Repair Society grade III/IV symptomatic cartilage defect on the femoral condyle to receive either adipose-derived stem cells with fibrin glue combined with microfracture treatment (group 1) or microfracture treatment alone (group 2). Researchers used the Lysholm score, the KOOS and a 10-point VAS for pain to evaluate clinical scores preoperatively and postoperatively at 3 months, 12 months and at last follow-up visit.
Compared with 72.5% of patients in group 2, results showed 80% of patients in group 1 experienced normal or nearly normal signal intensity. At a mean clinical follow-up period of 27.4 months, researchers found significantly greater improvements in the mean KOOS pain and symptom subscores in group 1 vs. group 2, but no significant differences between the groups in improvements in other KOOS subscores.
Researchers performed second-look arthroscopies in 57 knees, during which biopsy procedures were performed for 18 patients in group 1 and 16 patients in group 2. Results showed good repair tissue quality, although researchers did not observe any significant intergroup differences.
Group 1 had a mean total histologic score of 1,054 vs. 967 in group 2, according to results. Researchers also found patient age, lesion size, duration of symptoms before surgery, mechanism of injury and combined procedures were not correlated with clinical results, Magnetic Resonance Observation of Cartilage Repair Tissue scores and histologic outcomes at short-term follow-up. –by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.
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