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Autologous bone-marrow mesenchymal cell induced chondrogenesis: Single-stage arthroscopic cartilage repair

  • Original Article
  • Regenerative Medicine & Clinical Application
  • Published:
Tissue Engineering and Regenerative Medicine Aims and scope

An Erratum to this article was published on 27 July 2017

This article has been updated

Abstract

We describe a single stage arthroscopic procedure for the treatment of articular cartilage defects in the knee. The novel procedure involves microfracture and application of bone marrow aspirate concentrate cells (BMAC) with hyaluronic acid and fibrin gel. The aim of the study was to evaluate the clinical and radiological outcomes at 2 years. A prospective study of 30 patients with symptomatic ICRS grade III/IV chondral defects, ranging from 2–9 cm2, who were assessed clinically and radiologically. The surgical procedure involved debridement of the lesion, microfracture and application of concentrated BMAC with HA and fibrin gel under CO2 insufflation. Patients underwent morphological MRI, quantitative T2*-mapping and d-GEMRIC scan. Clinical assessment used the Lysholm, IKDC and KOOS scores. Radiological assessment used the MOCART score. At 2 year follow-up, Lysholm score was 80.1, as compared to 50.8 pre-operatively (p < 0.05). KOOS (symptomatic) was 92.1, as compared to 65.7 pre-operatively. IKDC (subjective) was 83, up from 39 preoperatively. The mean T2* relaxation-times for the repair tissue and native cartilage were 29.1 and 29.9 respectively. Average MOCART score for all lesions was 72. Our technique shows encouraging clinical results at 2 year follow-up. Clinical outcome scores show significant benefit. The morphological MRI shows good cartilage defect filling and the biochemical MRI (T2*-mapping) suggests hyaline like repair tissue.

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Change history

  • 27 July 2017

    An erratum to this article has been published.

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Authors and Affiliations

  1. Faculty of Health and Social Sciences, Canterbury Christ Church University, 30 Pembroke Court, Chatham Maritime, Kent, ME4 4UF, UK

    Asode Ananthram Shetty, Vishvas Shetty & Neha Shetty

  2. Kent Knee Unit, Spire Alexandra Hospital, Impton lane, Chatham, Kent, ME5 9PG, UK

    Asode Ananthram Shetty, Seok Jung Kim, Vishvas Shetty, Neha Shetty & Praveen Bilagi

  3. Department of Orthopedic Surgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea

    Seok Jung Kim & Hyun-Jin Lee

  4. Medway Maritime Hospital, Windmill Road, Gillingham, Kent, ME7 5NY, UK

    Praveen Bilagi

  5. Department of Orthopaedics, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    David Stelzeneder

Authors
  1. Asode Ananthram Shetty
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  2. Seok Jung Kim
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  3. Vishvas Shetty
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  5. Neha Shetty
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  7. Hyun-Jin Lee
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Correspondence to Seok Jung Kim.

Additional information

An erratum to this article is available at https://doi.org/10.1007/s13770-017-0073-y.

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Shetty, A.A., Kim, S.J., Shetty, V. et al. Autologous bone-marrow mesenchymal cell induced chondrogenesis: Single-stage arthroscopic cartilage repair. Tissue Eng Regen Med 11, 247–253 (2014). https://doi.org/10.1007/s13770-014-0061-4

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  • DOI: https://doi.org/10.1007/s13770-014-0061-4

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