Ron Gilat, Alexander C Weissman, Andrew R Phillips, Allen A Yazdi, Sarah A Muth, Brian J Cole
{"title":"骨髓浓缩物增强无细胞文石支架修复膝关节骨软骨缺损。","authors":"Ron Gilat, Alexander C Weissman, Andrew R Phillips, Allen A Yazdi, Sarah A Muth, Brian J Cole","doi":"10.1177/26350254241303767","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Damage to the joint surface, which affects articular cartilage and the underlying subchondral bone, is a common cause for significant knee pain and disfunction. The use of CartiHeal Agili-C, a cell-free aragonite-based implant, is an emerging option for patients who may otherwise be a poor candidate for allograft transplantation or within geographic areas where there is a limited availability of donor tissue.</p><p><strong>Indications: </strong>The CartiHeal Agili-C implant is indicated for patients with an International Cartilage Repair Society grade III or IV lesion with a total treatable area of 1 to 7 cm<sup>2</sup> and without severe osteoarthritis.</p><p><strong>Technique description: </strong>Standard parapatellar arthrotomy is performed to reveal an osteochondral defect of the femoral condyle. The cell-free aragonite-based scaffold is then transplanted in 7 steps according to numbered instrumentation in the Agili-C toolset. Surgical pearls of placement include proper alignment of the perpendicular aligner tool with circumferential viewing, assistant confirmation, and arthroscopic verification; avoiding wobbling during the shaping phase of the procedure as this may cause an oblong socket with inadequate fixation; and handling the implant with care and only using a thumb or index finger to insert with light tapping.</p><p><strong>Results: </strong>A multicenter randomized control trial followed 251 patients and found 88.5% of the implant group had at least 75% lesion fill as seen on postoperative magnetic resonance imaging at a 2-year follow-up. Additionally, patient-reported outcome measures were statistically superior when compared to controls at 24 months.</p><p><strong>Conclusion: </strong>Transplantation of a cell-free aragonite-based scaffold (Aglili-C; CartiHeal Ltd), augmented with bone marrow aspirate concentrate, provides an efficient, reproducible surgical strategy in the management of osteochondral defects of the femoral condyles.</p><p><strong>Patient consent disclosure statement: </strong>The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.</p>","PeriodicalId":520531,"journal":{"name":"Video journal of sports medicine","volume":"5 3","pages":"26350254241303767"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210379/pdf/","citationCount":"0","resultStr":"{\"title\":\"Cell-Free Aragonite-Based Scaffold With Bone Marrow Aspirate Concentrate Augmentation for Osteochondral Defects of the Knee.\",\"authors\":\"Ron Gilat, Alexander C Weissman, Andrew R Phillips, Allen A Yazdi, Sarah A Muth, Brian J Cole\",\"doi\":\"10.1177/26350254241303767\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Damage to the joint surface, which affects articular cartilage and the underlying subchondral bone, is a common cause for significant knee pain and disfunction. The use of CartiHeal Agili-C, a cell-free aragonite-based implant, is an emerging option for patients who may otherwise be a poor candidate for allograft transplantation or within geographic areas where there is a limited availability of donor tissue.</p><p><strong>Indications: </strong>The CartiHeal Agili-C implant is indicated for patients with an International Cartilage Repair Society grade III or IV lesion with a total treatable area of 1 to 7 cm<sup>2</sup> and without severe osteoarthritis.</p><p><strong>Technique description: </strong>Standard parapatellar arthrotomy is performed to reveal an osteochondral defect of the femoral condyle. The cell-free aragonite-based scaffold is then transplanted in 7 steps according to numbered instrumentation in the Agili-C toolset. Surgical pearls of placement include proper alignment of the perpendicular aligner tool with circumferential viewing, assistant confirmation, and arthroscopic verification; avoiding wobbling during the shaping phase of the procedure as this may cause an oblong socket with inadequate fixation; and handling the implant with care and only using a thumb or index finger to insert with light tapping.</p><p><strong>Results: </strong>A multicenter randomized control trial followed 251 patients and found 88.5% of the implant group had at least 75% lesion fill as seen on postoperative magnetic resonance imaging at a 2-year follow-up. Additionally, patient-reported outcome measures were statistically superior when compared to controls at 24 months.</p><p><strong>Conclusion: </strong>Transplantation of a cell-free aragonite-based scaffold (Aglili-C; CartiHeal Ltd), augmented with bone marrow aspirate concentrate, provides an efficient, reproducible surgical strategy in the management of osteochondral defects of the femoral condyles.</p><p><strong>Patient consent disclosure statement: </strong>The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. 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Cell-Free Aragonite-Based Scaffold With Bone Marrow Aspirate Concentrate Augmentation for Osteochondral Defects of the Knee.
Background: Damage to the joint surface, which affects articular cartilage and the underlying subchondral bone, is a common cause for significant knee pain and disfunction. The use of CartiHeal Agili-C, a cell-free aragonite-based implant, is an emerging option for patients who may otherwise be a poor candidate for allograft transplantation or within geographic areas where there is a limited availability of donor tissue.
Indications: The CartiHeal Agili-C implant is indicated for patients with an International Cartilage Repair Society grade III or IV lesion with a total treatable area of 1 to 7 cm2 and without severe osteoarthritis.
Technique description: Standard parapatellar arthrotomy is performed to reveal an osteochondral defect of the femoral condyle. The cell-free aragonite-based scaffold is then transplanted in 7 steps according to numbered instrumentation in the Agili-C toolset. Surgical pearls of placement include proper alignment of the perpendicular aligner tool with circumferential viewing, assistant confirmation, and arthroscopic verification; avoiding wobbling during the shaping phase of the procedure as this may cause an oblong socket with inadequate fixation; and handling the implant with care and only using a thumb or index finger to insert with light tapping.
Results: A multicenter randomized control trial followed 251 patients and found 88.5% of the implant group had at least 75% lesion fill as seen on postoperative magnetic resonance imaging at a 2-year follow-up. Additionally, patient-reported outcome measures were statistically superior when compared to controls at 24 months.
Conclusion: Transplantation of a cell-free aragonite-based scaffold (Aglili-C; CartiHeal Ltd), augmented with bone marrow aspirate concentrate, provides an efficient, reproducible surgical strategy in the management of osteochondral defects of the femoral condyles.
Patient consent disclosure statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.