Cartilage Defect Treatments: With or without Cells? Mesenchymal Stem Cells or Chondrocytes? Traditional or Matrix-Assisted? A Systematic Review and Meta-Analyses
Table 1
Short description of major treatments for cartilage defects.
Technique
Stage
Scaffold
Procedure
Major disadvantages
Pridie drilling
1 stage
None
Open procedure
(a) 2 to 2.5 mm drill holes to access bone marrow; (b) inconsistent results; (c) long recovery; (d) high complication rate.
Microfracture
1 stage
None
Arthroscopic procedure
(a) 0.5 to 1 mm drill holes to access bone marrow; (b) same major disadvantages as Pridie drilling and less impact than Pridie drilling on biomechanics of underlying subchondral.
Abrasion chondroplasty
1 stage
None
Arthroscopic procedure
(a) Irreproducible, unreliable; (b) loss of underlying subchondral mechanical support.
Mosaicplasty
1 stage
None
Arthroscopic procedure
(a) Morbidity at harvest site; (b) osteochondral plugs 15–20 mm deep; (c) blood clot in interspace.
Traditional ACI
2 stages
None
Open/arthroscopic procedure
(a) Periosteal patch or collagen membrane; (b) secured by sutures and/or fibrin glue; (c) greatest clinical experience.
MACT
1 stage or 2 stages
Hydrogel, fibrous scaffold, decellularized ECM, or composite
