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CaReS® (MACT) versus microfracture in treating symptomatic patellofemoral cartilage defects: a retrospective matched-pair analysis

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

Treating patellofemoral articular cartilage lesions remains a challenging task in orthopedic surgery. Whereas microfracture and autologous chondrocyte implantation yield good results on femoral condyles, the therapeutic state of the art for treating patellofemoral lesions is yet to be determined. In this study, we compared the CaReS® technique, which is a matrix-associated autologous chondrocyte implantation technique, to microfracture for treating patellofemoral articular cartilage lesions.

Methods

Between May 2003 and December 2005, 17 patients with an isolated patellofemoral cartilage defect (International Cartilage Repair Society III/IV) were treated with the CaReS® technique at our department. After adjusting for inclusion and exclusion criteria, ten of these patients could be included in this study; ten patients treated with microfracture were chosen as a matched-pair group. Clinical outcome was evaluated 3 years after surgery by the 36-item Short Form Health Survey Questionnaire (SF-36), International Knee Documentation Committee (IKDC) subjective evaluation of the knee, Lysholm Score, and Cincinnati Modified Rating Scale scores.

Results

Patients treated with CaReS® had statistically significantly improved IKDC, Lysholm, and Cincinnati scores 36 months after surgery compared with preoperatively. When comparing outcome between groups 36 months after surgery, there was no statistically difference in IKDC, Lysholm, and Cincinnati scores.

Conclusions

This is the first trial comparing the CaReS® technique and microfracture for treating patellofemoral articular cartilage lesions, and results show that CaReS® yields comparable results to microfracture. The small number of patients is a limiting factor of the study, leading to results without statistical significance. A multicentric prospective randomized study comparing the two procedures is desirable.

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Acknowledgments

No financial support was received by any of the authors. The company ArsArthro (Esslingen, Germany) provided logistics related to transport of the chondrocytes/CaReS® from our hospital to the company and back. The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany

    Maximilian Petri, Maximilian Broese, Emmanouil Liodakis, Daniel Guenther, Christian Krettek, Michael Jagodzinski & Carl Haasper

  2. Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Annika Simon

  3. Orthopaedic Surgery Department, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany

    Max Ettinger

  4. Trauma Department, Johannes-Wesling-Hospital, Hans-Nolte-Str. 1, 32429, Minden, Germany

    Johannes Zeichen

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  1. Maximilian Petri
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Correspondence to Maximilian Petri.

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Petri, M., Broese, M., Simon, A. et al. CaReS® (MACT) versus microfracture in treating symptomatic patellofemoral cartilage defects: a retrospective matched-pair analysis. J Orthop Sci 18, 38–44 (2013). https://doi.org/10.1007/s00776-012-0305-x

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  • DOI: https://doi.org/10.1007/s00776-012-0305-x

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