Minced cartilage for focal cartilage defects-A comprehensive systematic review of surgical techniques in clinical studies, animal studies and basic research studies.
Lukas B Moser, Stefan Fickert, Sophie Pitzek, Christoph Bauer, Markus Neubauer, Dietmar Dammerer, Thore Zantop, Stefan Landgraeber, Stefan Nehrer
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Abstract
Purpose: This study aimed to determine whether the minced cartilage procedure for treating focal cartilage defects is already a standardized technique.
Methods: A systematic literature review was conducted in MEDLINE (PubMed), EMBASE and Google Scholar to include all relevant studies (clinical studies, animal studies and basic research) investigating minced cartilage for treating focal cartilage defects.
Results: A total of 8 clinical studies, 14 animal studies and 17 basic research studies met the inclusion criteria. Among the eight clinical studies, one was a randomized controlled trial (minced cartilage vs. microfracture), one was a matched-cohort study (minced cartilage vs. autologous matrix-induced chondrogenesis), while the other six studies were case series with a small number of patients (maximum 28). Defect localization varied among the studies: most frequently femoral condyle defects were treated, followed by trochlea/patella. In three studies, cartilage was harvested and minced with a scalpel; in two studies, cartilage was harvested and minced with a shaver. The other clinical studies used a mixture of a curette, a scalpel or a shaver. Six studies used fibrin glue to seal the implanted cartilage. In three studies, a matrix was used for defect coverage. In two studies, cartilage was additionally augmented with autologous blood products. All animal and basic research studies observed similar differences regarding each surgical step.
Conclusion: A standardized minced cartilage procedure has not yet emerged. There are differences in the methods of cartilage mincing, cartilage fixation, cartilage coverage using matrices and augmentation with autologous blood products.
期刊介绍：
Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication.
The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance.
Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards.
Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
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