|
| Patient number | Defect
location(s) | Defect type | Defect
size | Additional treatment | Nature of biomaterials | Source of bone marrow | Concentration performed? | Method of concentration | Aspirate amount/defect | Study group(s) | Follow-up | Evaluation
methods | Major findings | Ref. |
|
| 11 | Femoral condyle, patella | 1 or 2 chondral defects, Outerbridge types III or IV | 2–8 cm2 | Microfracture | Type I/III porcine
collagen matrix | (1) Iliac crest | Yes | BMA (24 ml) centrifuged (15 min) to obtain a concentrated phase containing mononuclear cells. | n.a. | (1) Microfracture
+ collagen
membrane
+ BMAC | 6
months | (1) FACS
analysis | (1) More cells with
MSC phenotype
obtained from
iliac crest than
microfracture
site. | [71] |
(2) Microfracture
site | (2) Culture of
bone marrow
samples from
iliac crest and
microfracture
site | (2) Only MSCs
from bone
marrow could
be long-term
propagated
and efficiently
differentiated
in vitro. |
(3) Clinical
evaluations:
pain, adverse
events | (3) No pain. No
adverse events. |
|
| 50 | Patella, medial femoral condyle | Chondral defects, ICRS grade IV | Median lesion sizes of 4.5 or 6.5 cm2 | Microfracture | Hyaluronic acid-based scaffold | Iliac crest | Yes | BMA (60 ml) centrifuged. Yield: cellular concentration ~6× baseline value. | n.a. | (1) Hyaluronic
acid-based
scaffold + BMAC
(HA-BMAC) | 2 and 5
years | (1) MRI | (1) 100% normal or
nearly normal
IKDC objective
score at 2 years
in HA-BMAC
(microfracture
64%). | [72] |
| Batroxobin enzyme used to activate the BMAC. | (2) Microfracture | (2) IKDC
objective and
subjective
score | (2) HA-BMAC
group maintained improved
knee function
at 5 years
according to
Lysholm, Tegner, IKDC
objective and
subjective scores. |
| (4) KOOS | (3) Higher score
for HA-BMAC
group according
to Tegner, IKDC
objective, and
KOOS scores. |
| (5) Lysholm |
| (6) Tegner |
| 34 | Talus | Osteochondral defects | 0.5–2.2 cm2 | Microfracture | n.a. | Iliac crest | Yes | n.a. | 3 ml | (1) Microfracture | 2.8–8.3 years | (1) FAOS pain subscale | (1) FAOS and SF-12
PCS score
significantly
improved in
microfracture
group after a
mean of 6.4
years and in the
microfracture
+ BMAC group
after a mean of
4 years. | [73] |
(2) Microfracture
+ BMAC | (2) SF-12 PCS | (2) MOCART score
in microfracture
+ BMAC group
significantly
higher than in
microfracture
group after 2
years. |
| (3) MRI | (3) Per MRI less fissuring and fibrillation in the microfracture + BMAC group after 2 years. |
|
| 12 | Talus | Full-thickness chondral | 1.0–3.9 cm2 | Particulated juvenile articular cartilage (PJAC); subchondral drilling | Bovine type I collagen and glycos-amino-glycan | Iliac crest | Yes | BMA (60 ml) centrifuged. Yield: 6 ml of BMAC | 6 ml | (1) Subchondral
drilling + BMAC +
collagen
scaffold | 2.1 years (range: 1.0–3.5 years) | (1) AOFAS
score | Better clinical
outcome for the
subchondral
drilling + PJAC
group according
to higher AOFAS
and FAAM scores
after 2 years. | [74] |
(2) Subchondral
drilling +
PJAC | (2) FAAM
score |
(3) SF-12
score |
|
