Review Article

Cartilage Defect Treatments: With or without Cells? Mesenchymal Stem Cells or Chondrocytes? Traditional or Matrix-Assisted? A Systematic Review and Meta-Analyses

Table 3

Characteristics of studies that compared ACI with MACT.

StudyYearStudy designRegionsNumber of patientsFUAge
Mean, range (yr)
Gender
Male/female
LocationsMajor assessments of efficacyExcellentGoodFairPoorGraft hypertrophyFrequency of reoperationOther assessments

Bartlett et al. [21]2005RCTEnglandACI-C: 44
MACT: 47
1 yr33.7, 15–49
33.4, 17–47
54/37KneeMCS10
15
16
19
10
7
8
6
4/44
3/47
4/44
4/47
ICRS, biopsy

Manfredini et al. [34]2007CCSItalyACI-C: 17
MACT: 15
Mean, 48.5 mo.32.3, 17–51
35.2, 20–55
15/2
13/2
KneeHSS9
6
6
3
2
1
0
0
NR
NR
NR
NR
ICRS, MRI, and biopsy

Ferruzzi et al. [35]2008CCSItalyACI-P: 48
MACT: 50
5 yr32.3
35.2
30/18
36/14
KneeIKDC7
7
10
23
23
11
8
9
4/48
2/50
6/48
2/50
MRI, biopsy

Zeifang et al. [20] 2010RCTGermanyACI-P: 10
MACT: 11
2 yr29.5
29.1
16/5Femoral condyleIKDCNR
NR
NR
NR
NR
NR
NR
NR
7/9
1/8
1/10
3/11
Lysholm, SF-36, TAS, and MOCART

Macmull et al. [36]2012CCSEnglandACI-C: 25
MACT: 23
Mean, 40.3 mo.34.6, 17–50
35, 21–46
16/9
14/9
PatellaeMCS4
6
6
7
6
8
9
2
NR
NR
NR
NR
VAS, Bentley score

Panagopoulos et al. [37]2012CCSEnglandACI-P: 11
MACT: 8
Mean, 37.5 mo.32.2, 18–438/3
7/1
KneeLysholm0
0
2
1
4
6
5
1
3/11
2/8
NR
NR
IKDC, TAS

FU: follow-up; RCT: randomized controlled trial; CCS: case-control study; ACI-C: autologous chondrocyte implantation with a flap made of collagen; ACI-P: autologous chondrocyte implantation with periosteal flap MACT: matrix-assisted autologous chondrocyte transplantation; MCS: Modified Cincinnati Rating System; ICRS: International Cartilage Repair score; HSS: Hospital for Special Surgery score; IKDC: International Knee Documentation Committee; MRI: magnetic resonance imaging; SF-36: Short-Form-36 Health Survey; MOCART: Magnetic Resonance Observation of Cartilage Repair; VAS: Visual Analogue Scale; TAS: Tegner Activity Score.