Arthroscopic minced cartilage implantation provides superior clinical and magnetic resonance imaging outcomes compared to microfracture in patellar cartilage defects

IF 5.5 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2026-06-15 Epub Date: 2025-07-21 DOI:10.1002/ksa.12800

Frank Wein, Clément Ferri, Lisa Peduzzi, Arthur Barbaret, Paul Walbron

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引用次数: 0

Abstract

Purpose

To compare clinical and radiological outcomes of arthroscopic minced cartilage implantation (MCI) versus microfracture (MFx) in patients with patellar cartilage defects.

Methods

A retrospective, single-centre cohort study was conducted on 46 patients treated between January 2021 and December 2022. Patients underwent either MCI (n = 26) or MFx (n = 20) with a minimum follow-up of 24 months (mean 35.7 ± 6.2). Magnetic resonance imaging (MRI) outcomes were assessed using the MOCART 2.0 Knee score by an independent blinded radiologist. Clinical outcomes included pain (visual analogue scale), function (self knee value), International Knee Documentation Committee, knee injury and osteoarthritis outcome score (KOOS) and patient acceptable symptom state (PASS)/minimal clinically important difference scores.

Results

The MOCART 2.0 score was significantly higher in the MCI group (mean 86; 95% confidence interval [CI]: 83–92) compared to the MFx group (mean 66; 95% CI: 55–73) (p < 0.001). MCI patients achieved significantly greater improvements across all clinical measures, notably in the KOOS sport subscore (+33.2 vs. +5.3 points). PASS was achieved in 100% of MCI patients versus 35% of MFx patients (p < 0.001). No major complications or reoperations were reported.

Conclusion

Both MCI and MFx improved clinical and MRI outcomes in patellar cartilage defects after 2 years, but MCI demonstrated significantly superior results across all parameters. Arthroscopic MCI appears to be an effective, safe, single-stage alternative to MFx for treating focal patellar cartilage lesions.

Level of Evidence

Level III retrospective cohort study.

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关节镜下碎软骨植入与髌软骨缺损微骨折相比，提供了更好的临床和磁共振成像结果。

目的：比较关节镜下碎软骨植入术（MCI）与微骨折（MFx）治疗髌骨软骨缺损的临床和影像学结果。方法：对2021年1月至2022年12月期间接受治疗的46例患者进行回顾性单中心队列研究。患者接受MCI （n = 26）或MFx (n = 20)，最小随访时间为24个月（平均35.7±6.2）。磁共振成像（MRI）结果由独立的盲法放射科医生使用MOCART 2.0膝关节评分进行评估。临床结果包括疼痛（视觉模拟量表）、功能（自我膝关节价值）、国际膝关节文献委员会、膝关节损伤和骨关节炎结局评分（oos）和患者可接受症状状态(PASS)/最小临床重要差异评分。结果：MCI组MOCART 2.0评分显著高于MCI组(平均86分；95%可信区间[CI]: 83-92)与MFx组相比(平均66；结论：2年后，MCI和MFx均改善了髌骨软骨缺损的临床和MRI结果，但MCI在所有参数上都表现出明显的优势。关节镜下MCI似乎是治疗局灶性髌骨软骨病变的一种有效、安全、单期替代MFx的方法。证据等级：III级，回顾性队列研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

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).