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Comparative analysis of autologous chondrocyte implantation and other treatment modalities: a systematic review

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this systematic review was to analyze and determine the effectiveness of autologous chondrocyte implantation (ACI) when compared with other treatment modalities, which includes microfracture, mosaicplasty, abrasionplasty, bone marrow–derived mesenchymal stem cell (BMSC), and matrix-assisted autologous chondrocyte implantation (MACI).

Methods

Literature search using online databases PubMed, Scopus, National Institute for Clinical Excellence and Cochrane controlled trial register regarding all cell-based therapies and other interventions for chondral lesions was explored. Data on clinical outcome and repair quality were analyzed. Duplicates and irrelevant articles were omitted.

Result

Seventeen (n = 17) studies were included in this review. Among the four trials on ACI versus mosaicplasty, two studies showed no differences in clinical scores, one suggested similar performance while the other suggested better results in tissue quality for ACI. A systematically performed assessment comparing ACI with microfracture shows better clinical outcomes and higher tissue quality after ACI. Studies comparing ACI with MACI or BMSC demonstrated similar results. Although many of these studies had substantial flaws, on the overall, the evidence comparing ACI with other treatment modalities shows better clinical outcomes and higher tissue quality.

Conclusion

Despite significant differences between the methodologies employed by different researchers, we can conclude that all except two studies demonstrated ACI being the better treatment for cartilage defects. However, final conclusions regarding long-term effects are still difficult, and therefore, future studies are needed to answer the long-term effects of ACI.

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Acknowledgments

The authors would like to thank Hazel Sarah for her assistance with data collection.

Conflict of interest

No funds were received in support of this study. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

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Authors and Affiliations

  1. Tissue Engineering Group (TEG), National Orthopaedic Centre of Excellence in Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, LembahPantai, 50603, Kuala Lumpur, Malaysia

    Sangeetha Naveen, Noorzurani Robson & Tunku Kamarul

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  1. Sangeetha Naveen
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  2. Noorzurani Robson
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  3. Tunku Kamarul
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Correspondence to Sangeetha Naveen.

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Naveen, S., Robson, N. & Kamarul, T. Comparative analysis of autologous chondrocyte implantation and other treatment modalities: a systematic review. Eur J Orthop Surg Traumatol 22, 89–96 (2012). https://doi.org/10.1007/s00590-011-0798-6

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  • DOI: https://doi.org/10.1007/s00590-011-0798-6

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