scholarly journals Correlation between histological outcome and surgical cartilage repair technique in the knee: A meta-analysis

The Knee ◽  
2016 ◽  
Vol 23 (3) ◽  
pp. 344-349 ◽  
Author(s):  
Alex C. DiBartola ◽  
Joshua S. Everhart ◽  
Robert A. Magnussen ◽  
James L. Carey ◽  
Robert H. Brophy ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Meta Analysis ◽  
Repair Technique ◽  
Surgical Cartilage Repair

scholarly journals Whole joint MRI assessment of surgical cartilage repair of the knee: Cartilage Repair OsteoArthritis Knee Score (CROAKS)

2014 ◽  
Vol 22 (6) ◽  
pp. 779-799 ◽  
Author(s):  
F.W. Roemer ◽  
A. Guermazi ◽  
S. Trattnig ◽  
S. Apprich ◽  
S. Marlovits ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Knee Score ◽  
Knee Cartilage ◽  
Osteoarthritis Knee ◽  
Surgical Cartilage Repair

scholarly journals Meta-Analysis and Evidence Base for the Efficacy of Autologous Bone Marrow Mesenchymal Stem Cells in Knee Cartilage Repair: Methodological Guidelines and Quality Assessment

2019 ◽  
Vol 2019 ◽  
pp. 1-15 ◽  
Author(s):  
Mohamed E. Awad ◽  
Khaled A. Hussein ◽  
Inas Helwa ◽  
Mohamed F. Abdelsamid ◽  
Alexandra Aguilar-Perez ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Mesenchymal Stem Cells ◽  
Cartilage Repair ◽  
Meta Analysis ◽  
Autologous Bone Marrow ◽  
Knee Cartilage ◽  
Marrow Mesenchymal Stem Cells ◽  
Autologous Bone ◽  
Coleman Methodology Score

The aim of this study is to review all the published clinical trials on autologous bone marrow mesenchymal stem cells (BM-MSCs) in the repair of cartilage lesions of the knee. We performed a comprehensive search in three electronic databases: PubMed, Medline via Ovid, and Web of Science. A systematic review was conducted according to the guidelines of PRISMA protocol and the Cochrane Handbook for Systematic Reviews of Interventions. The modified Coleman methodology score was used to assess the quality of the included studies. Meta-analysis was conducted to estimate the effect size for Pain and function change after receiving BM-MSCs. Thirty-three studies—including 724 patients of mean age 44.2 years—were eligible. 50.7% of the included patients received cultured BM-MSCs for knee cartilage repair. There was improvement in the MINORS quality score over time with a positive correlation with the publication year. Meta-analysis indicated better improvement and statistical significance in the Visual Analog Scale for Pain, IKDC Function, Tegner Activity Scale, and Lysholm Knee Score after administration of noncultured BM-MSCs when compared to evaluation before the treatment. Meanwhile, there was a clear methodological defect in most studies with an average modified Coleman methodology score (MCMS) of 55. BM-MSCs revealed a clinically relevant improvement in pain, function, and histological regeneration.

Intra-articular Injection of Culture-Expanded Mesenchymal Stem Cells Without Adjuvant Surgery in Knee Osteoarthritis: A Systematic Review and Meta-analysis

2019 ◽  
Vol 48 (11) ◽  
pp. 2839-2849 ◽  
Author(s):  
Seong Hwan Kim ◽  
Yoshi Pratama Djaja ◽  
Yong-Beom Park ◽  
Jung-Gwan Park ◽  
Young-Bong Ko ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Cartilage Repair ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Mean Difference ◽  
Resonance Imaging ◽  
Adjuvant Surgery ◽  
Significant Difference ◽  
Standardized Mean Difference ◽  
And Cartilage

Background: Although many clinical studies have assessed the efficacy of mesenchymal stem cells (MSCs) in knee osteoarthritis, evidence on their efficacy remains unclear owing to heterogeneity of cell entity and concomitant procedures. Purpose: To determine the efficacy of culture-expanded MSCs in knee osteoarthritis in terms of clinical outcome and cartilage repair via meta-analysis of randomized controlled trials (RCTs) without adjuvant surgery. Study Design: Meta-analysis. Methods: PubMed, Embase, the Cochrane Library, CINAHL, and Scopus were searched from inception to December 31, 2018. RCTs with culture-expanded MSCs for treating knee osteoarthritis were included. Studies with adjuvant surgery or cell concentrate were excluded. Quality was assessed by the Cochrane Collaboration risk-of-bias tool. For meta-analysis, data on clinical outcomes were measured using a visual analog scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and data on cartilage repair were measured using the Whole-Organ Magnetic Resonance Imaging Score (WORMS); categorization related to improvement was extracted. Results: Six RCTs (203 patients) were included. Two studies were deemed to have a low risk of bias. In pooled analysis, the only significant difference was in the VAS score (mean difference, –13.55; 95% CI, –22.19 to −4.9). In cumulative pain analysis with VAS and WOMAC pain scores, there was significant improvement after treatment (standardized mean difference, –0.54; 95% CI, –0.85 to −0.23). There was no significant difference in cartilage repair assessed by magnetic resonance imaging (standardized mean difference, 0.11; 95% CI, –0.51 to 0.73), WORMS (standardized mean difference, 1.68; 95% CI −14.84 to 18.21), or categorical results (odds ratio, 1.56; 95% CI, 0.32-7.59). Conclusion: Intra-articular injection of culture-expanded MSCs without adjuvant surgery can improve pain for patients experiencing knee osteoarthritis at short-term follow-up (6-12 months). However, evidence regarding function and cartilage repair remains limited.

Comparative Effectiveness of Cartilage Repair With Respect to the Minimal Clinically Important Difference

2019 ◽  
Vol 47 (13) ◽  
pp. 3284-3293 ◽  
Author(s):  
Kristofer J. Jones ◽  
Benjamin V. Kelley ◽  
Armin Arshi ◽  
David R. McAllister ◽  
Peter D. Fabricant
Keyword(s):  
Clinical Outcomes ◽  
Cartilage Repair ◽  
Meta Analysis ◽  
Osteochondral Allograft ◽  
Time Points ◽  
Outcome Scores ◽  
Chondrocyte Implantation ◽  
Autologous Chondrocyte

Background: Recent studies demonstrated a 5% increase in cartilage repair procedures annually in the United States. There is currently no consensus regarding a superior technique, nor has there been a comprehensive evaluation of postoperative clinical outcomes with respect to a minimal clinically important difference (MCID). Purpose: To determine the proportion of available cartilage repair studies that meet or exceed MCID values for clinical outcomes improvement over short-, mid-, and long-term follow-up. Study Design: Systematic review and meta-analysis. Methods: A systematic review was performed via the Medline, Scopus, and Cochrane Library databases. Available studies were included that investigated clinical outcomes for microfracture (MFX), osteoarticular transfer system (OATS), osteochondral allograft transplantation, and autologous chondrocyte implantation/matrix-induced autologous chondrocyte implantation (ACI/MACI) for the treatment of symptomatic knee chondral defects. Cohorts were combined on the basis of surgical intervention by performing a meta-analysis that utilized inverse-variance weighting in a DerSimonian-Laird random effects model. Weighted mean improvements in International Knee Documentation Committee (IKDC), Lysholm, and visual analog scale for pain (VAS pain) scores were calculated from preoperative to short- (1-4 years), mid- (5-9 years), and long-term (≥10 years) postoperative follow-up. Mean values were compared with established MCID values per 2-tailed 1-sample Student t tests. Results: A total of 89 studies with 3894 unique patients were analyzed after full-text review. MFX met MCID values for all outcome scores at short- and midterm follow-up with the exception of VAS pain in the midterm. OATS met MCID values for all outcome scores at all available time points; however, long-term data were not available for VAS pain. Osteochondral allograft transplantation met MCID values for IKDC at short- and midterm follow-up and for Lysholm at short-term follow-up, although data were not available for other time points or for VAS pain. ACI/MACI met MCID values for all outcome scores (IKDC, Lysholm, and VAS pain) at all time points. Conclusion: In the age of informed consent, it is important to critically evaluate the clinical outcomes and durability of cartilage surgery with respect to well-established standards of clinical improvement. MFX failed to maintain VAS pain improvements above MCID thresholds with follow-up from 5 to 9 years. All cartilage repair procedures met MCID values at short- and midterm follow-up for IKDC and Lysholm scores; ACI/MACI and OATS additionally met MCID values in the long term, demonstrating extended maintenance of clinical benefits for patients undergoing these surgical interventions as compared with MFX.

scholarly journals Handheld Co-Axial Bioprinting: Application to in situ surgical cartilage repair

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Serena Duchi ◽  
Carmine Onofrillo ◽  
Cathal D. O’Connell ◽  
Romane Blanchard ◽  
Cheryl Augustine ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Surgical Cartilage Repair

Gel ACI (GACI): Articular Cartilage Repair Technique

2014 ◽  
pp. 175-186 ◽  
Author(s):  
Seok-Jung Kim ◽  
Asode Ananthram Shetty ◽  
Vishvas A. Shetty
Keyword(s):  
Articular Cartilage ◽  
Cartilage Repair ◽  
Articular Cartilage Repair ◽  
Repair Technique

Microfracture versus Enhanced Microfracture Techniques in Knee Cartilage Restoration: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Hong-Jie Wen ◽  
Li-Bo Yuan ◽  
Hong-Bo Tan ◽  
Yong-Qing Xu
Keyword(s):  
Cartilage Repair ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Visual Analog Scale Score ◽  
International Knee Documentation Committee ◽  
Mean Difference ◽  
Cartilage Defects ◽  
Continuous Variables ◽  
Significant Difference ◽  
Registration Number

AbstractThis study aimed to compare the efficacy and safety of the microfracture (MFx) and microfracture augmented (MFx + ) techniques for the treatment of cartilage defects of the knee. The PubMed and EMBASE databases were searched from 1 January, 1950 to 1 May, 2019. RevMan5.3 was used to perform statistical analysis. Relative risk was calculated for binary variables, and weighted mean difference and standardized mean difference (SMD) were measured for continuous variables. The 95% confidence interval (CI) of each variable was assessed. Thirteen trials with 635 patients were included. There was a significant difference in the Lysholm's score (SMD = 0.26, 95% CI: 0.01–0.50, p = 0.04) and magnetic resonance observation of cartilage repair tissue score (SMD = 14.01, 95% CI: 8.01–20.02, p < 0.01) between the MFx and MFx+ groups. There was no significant difference in the Western Ontario and McMaster Universities Osteoarthritis Index score (SMD =  − 12.40, 95% CI: −27.50 to 32.71, p = 0.11), International Knee Documentation Committee score (SMD = 8.67, 95% CI: −0.92 to 18.27, p = 0.08), visual analog scale score (SMD =  − 0.20, 95% CI: −2.45 to 0.96, p = 0.57), Tegner's score (SMD = 0.26, 95% CI: −0.67 to 1.18, p = 0.59), modified Cincinnati's score (SMD =  − 4.58, 95% CI: −14.31 to 5.14, p = 0.36) and modified International Cartilage Repair Society pain score (SMD = 0.09, 95% CI: −0.37 to 0.55, p = 0.70) between the groups. Results of the pooled analyses of the MFx+ and MFx groups suggested that the MFx+ technique is slightly superior to the MFx technique for the treatment of articular cartilage defects of the knee. Further research is required and future studies should include assessments of the outcomes at long-term follow-ups. Trial registration number is PROSPERO CRD42019135803

Effectiveness of High Tibial Osteotomy with or without Other Procedures for Medial Compartment Osteoarthritis of Knee: An Update Meta-Analysis

2020 ◽  
Author(s):  
Ru-Zhan Yao ◽  
Wei-Qiang Liu ◽  
Liang-Zhi Sun ◽  
Ming-Dong Yu ◽  
Guang-Lin Wang
Keyword(s):  
Pain Relief ◽  
Clinical Outcomes ◽  
High Tibial Osteotomy ◽  
Cartilage Repair ◽  
Meta Analysis ◽  
Mean Difference ◽  
Control Group ◽  
Tibial Osteotomy ◽  
Beneficial Effects ◽  
Magnetic Resonance Imaging Mri

AbstractTo improve the long-term outcomes of high tibial osteotomy (HTO) for gonarthritis, many cartilage repair procedures appeared, but their effects were controversial. To evaluate the efficacy of cartilage repair procedures during HTO for gonarthritis, we performed this update meta-analysis. We performed the system retrieval for clinical trials using various databases and then pooled the outcomes of the included studies. Fifteen studies were involved. The pooled results indicated that there were no significant differences in Kellgren and Lawrence (KL) scale (mean difference [MD] = 0.02, 95% confidence interval [CI] = −0.01 to 0.06, p = 0.24), the femorotibial angle (MD = 0.06, 95% CI = −0.04 to 0.16, p = 0.22), and magnetic resonance imaging (MRI) outcomes (MD = 12.53, 95% CI = −2.26 to 27.32, p = 0.10) of patients in experimental group than control. The subgroup analysis showed that the clinical outcomes of abrasion arthroplasty (AA) were worse than control group (standardized mean difference [SMD] −2.65, 95% CI = −3.67 to −1.63, p < 0.001), while mesenchymal stem cells (MSCs) injection improved the clinical outcomes (SMD = 2.37, 95% CI = 1.25–3.50, p < 0.001). There were significant differences between the two groups in arthroscopic (SMD = 1.38, 95% CI = 0.82–1.94, p < 0.001) and histologic results (relative risk [RR] = 1.77, 95% CI = 1.36–2.29, p < 0.001). The pain relief (MD = 0.17, 95% CI = −3.26 to 3.61, p = 0.92) and operative complications (RR = 1.42, 95% CI = 0.83–2.42; p = 0.19) of the two groups had no significant differences. Our analysis supports that concurrent cartilage repair procedures might improve arthroscopic and histologic outcomes, but they have no beneficial effect on clinical outcomes, radiograph, MRI, and pain relief. The concurrent procedures do not increase the risk of operative complication. Furthermore, MSC has some beneficial effects on clinical outcomes, while AA might play an opposite role.

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