Stephan Oehme, Benjamin Bartek, Janne Callsen, Jessica Schallock, Tobias Winkler, Thorsten Diekhoff, Tobias Jung, Danko Dan Milinkovic
{"title":"基于球体基质诱导的自体软骨细胞植入联合自体骨移植可恢复骨软骨膝关节缺损的软骨和软骨下骨的生理特性——一项基于mri的分析。","authors":"Stephan Oehme, Benjamin Bartek, Janne Callsen, Jessica Schallock, Tobias Winkler, Thorsten Diekhoff, Tobias Jung, Danko Dan Milinkovic","doi":"10.1002/ksa.70091","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the radiological and patient-reported outcome measures (PROMs) following spheroid-based matrix-induced autologous chondrocyte implantation combined with autologous bone grafting (MABCI) for the treatment of osteochondral defects of the knee.</p><p><strong>Methods: </strong>In this retrospective cohort analysis of prospectively collected data, 28 consecutive patients with 29 defects of the femoral condyle (male: 15, female: 13, mean age 27.3 ± 9.8 years, mean defect size 3.7 ± 1.6 cm²) treated with MABCI were included. Radiological assessments were performed using 3T magnetic resonance imaging (MRI) to evaluate cartilage thickness, T2 relaxation times and Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 scores. Clinical outcomes were assessed using validated PROMs, including the International Knee Documentation Committee (IKDC) score, the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Lysholm scale and the Patient-Reported Outcomes Measurement Information System 29-Item Profile (PROMIS-29). Correlation analyses were conducted to evaluate associations between radiological parameters and PROMs.</p><p><strong>Results: </strong>The analysis was conducted at a mean follow-up of 44.4 ± 21.6 months. Cartilage thickness in the repair tissue exceeded that of the reference cartilage (3.4 ± 0.9 mm vs. 3.0 ± 0.5 mm; p = 0.036), while T2 relaxation times in the repair tissue were within physiological range (50.5 ± 40.0 ms vs. 41.3 ± 5.4 ms; n.s.). The mean MOCART 2.0 score was 61.3 ± 13.0 (volume fill: 16.1 ± 3.7, integration with adjacent cartilage: 12.9 ± 3.3), reflecting satisfactory repair quality. All clinical scores showed significant improvement compared to the preoperative condition (IKDC: 70.6 ± 13.2 vs. 54.8 ± 17.5, p < 0.001; KOOS: pain 78.7 ± 16.9 vs. 66.1 ± 18.6, p = 0.002, symptoms 75.6 ± 16.0 vs. 65.8 ± 19.1, p = 0.006, ADL 86.8 ± 14.0 vs. 77.6 ± 16.8, p = 0.003, sport 63.0 ± 24.2 vs. 47.3 ± 26.9, p = 0.009, quality of life (QoL) 51.0 ± 22.7 vs. 39.6 ± 17.5, p = 0.014; numeric pain rating scale: 3.0 ± 2.2 vs. 5.2 ± 2.4, p < 0.001). A greater cartilage thickness was associated with reduced pain intensity (r = -0.457, p = 0.013) and improved QoL (r = 0.429, p = 0.020), indicating that better structural repair is associated with improved patient satisfaction.</p><p><strong>Conclusions: </strong>MABCI results in satisfactory cartilage regeneration and subchondral remodelling in addition to significant improvements in patient satisfaction and overall QoL.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":5.0000,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Spheroid-based matrix-induced autologous chondrocyte implantation combined with autologous bone grafting restores physiological cartilage and subchondral bone properties in osteochondral knee defects - An MRI-based analysis.\",\"authors\":\"Stephan Oehme, Benjamin Bartek, Janne Callsen, Jessica Schallock, Tobias Winkler, Thorsten Diekhoff, Tobias Jung, Danko Dan Milinkovic\",\"doi\":\"10.1002/ksa.70091\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This study aimed to evaluate the radiological and patient-reported outcome measures (PROMs) following spheroid-based matrix-induced autologous chondrocyte implantation combined with autologous bone grafting (MABCI) for the treatment of osteochondral defects of the knee.</p><p><strong>Methods: </strong>In this retrospective cohort analysis of prospectively collected data, 28 consecutive patients with 29 defects of the femoral condyle (male: 15, female: 13, mean age 27.3 ± 9.8 years, mean defect size 3.7 ± 1.6 cm²) treated with MABCI were included. Radiological assessments were performed using 3T magnetic resonance imaging (MRI) to evaluate cartilage thickness, T2 relaxation times and Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 scores. Clinical outcomes were assessed using validated PROMs, including the International Knee Documentation Committee (IKDC) score, the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Lysholm scale and the Patient-Reported Outcomes Measurement Information System 29-Item Profile (PROMIS-29). Correlation analyses were conducted to evaluate associations between radiological parameters and PROMs.</p><p><strong>Results: </strong>The analysis was conducted at a mean follow-up of 44.4 ± 21.6 months. Cartilage thickness in the repair tissue exceeded that of the reference cartilage (3.4 ± 0.9 mm vs. 3.0 ± 0.5 mm; p = 0.036), while T2 relaxation times in the repair tissue were within physiological range (50.5 ± 40.0 ms vs. 41.3 ± 5.4 ms; n.s.). The mean MOCART 2.0 score was 61.3 ± 13.0 (volume fill: 16.1 ± 3.7, integration with adjacent cartilage: 12.9 ± 3.3), reflecting satisfactory repair quality. All clinical scores showed significant improvement compared to the preoperative condition (IKDC: 70.6 ± 13.2 vs. 54.8 ± 17.5, p < 0.001; KOOS: pain 78.7 ± 16.9 vs. 66.1 ± 18.6, p = 0.002, symptoms 75.6 ± 16.0 vs. 65.8 ± 19.1, p = 0.006, ADL 86.8 ± 14.0 vs. 77.6 ± 16.8, p = 0.003, sport 63.0 ± 24.2 vs. 47.3 ± 26.9, p = 0.009, quality of life (QoL) 51.0 ± 22.7 vs. 39.6 ± 17.5, p = 0.014; numeric pain rating scale: 3.0 ± 2.2 vs. 5.2 ± 2.4, p < 0.001). A greater cartilage thickness was associated with reduced pain intensity (r = -0.457, p = 0.013) and improved QoL (r = 0.429, p = 0.020), indicating that better structural repair is associated with improved patient satisfaction.</p><p><strong>Conclusions: </strong>MABCI results in satisfactory cartilage regeneration and subchondral remodelling in addition to significant improvements in patient satisfaction and overall QoL.</p><p><strong>Level of evidence: </strong>Level III.</p>\",\"PeriodicalId\":520702,\"journal\":{\"name\":\"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.0000,\"publicationDate\":\"2025-10-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1002/ksa.70091\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/ksa.70091","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的：本研究旨在评估球体基质诱导的自体软骨细胞植入联合自体骨移植（MABCI）治疗膝关节骨软骨缺损的放射学和患者报告的预后指标（PROMs）。方法：回顾性队列分析前瞻性资料，纳入28例经MABCI治疗的29例股骨髁缺损患者（男15例，女13例，平均年龄27.3±9.8岁，平均缺损面积3.7±1.6 cm²）。影像学评估采用3T磁共振成像（MRI）评估软骨厚度、T2松弛时间及软骨修复组织磁共振观察（MOCART） 2.0评分。临床结果采用经过验证的PROMs进行评估，包括国际膝关节文献委员会（IKDC）评分、膝关节损伤和骨关节炎结局评分（oos）、Lysholm量表和患者报告的结果测量信息系统29项概况（promiso -29）。进行相关分析以评估放射学参数与PROMs之间的关系。结果：平均随访时间为44.4±21.6个月。修复组织的软骨厚度大于对照软骨（3.4±0.9 mm vs. 3.0±0.5 mm, p = 0.036），修复组织的T2松弛时间在生理范围内（50.5±40.0 ms vs. 41.3±5.4 ms; n.s）。MOCART 2.0平均评分为61.3±13.0（体积填充：16.1±3.7，与邻近软骨融合：12.9±3.3），修复质量满意。与术前相比，所有临床评分均有显著改善（IKDC: 70.6±13.2 vs. 54.8±17.5,p）。结论：MABCI除了显著改善患者满意度和总体生活质量外，还能获得令人满意的软骨再生和软骨下重构。证据等级：三级。
Spheroid-based matrix-induced autologous chondrocyte implantation combined with autologous bone grafting restores physiological cartilage and subchondral bone properties in osteochondral knee defects - An MRI-based analysis.
Purpose: This study aimed to evaluate the radiological and patient-reported outcome measures (PROMs) following spheroid-based matrix-induced autologous chondrocyte implantation combined with autologous bone grafting (MABCI) for the treatment of osteochondral defects of the knee.
Methods: In this retrospective cohort analysis of prospectively collected data, 28 consecutive patients with 29 defects of the femoral condyle (male: 15, female: 13, mean age 27.3 ± 9.8 years, mean defect size 3.7 ± 1.6 cm²) treated with MABCI were included. Radiological assessments were performed using 3T magnetic resonance imaging (MRI) to evaluate cartilage thickness, T2 relaxation times and Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 scores. Clinical outcomes were assessed using validated PROMs, including the International Knee Documentation Committee (IKDC) score, the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Lysholm scale and the Patient-Reported Outcomes Measurement Information System 29-Item Profile (PROMIS-29). Correlation analyses were conducted to evaluate associations between radiological parameters and PROMs.
Results: The analysis was conducted at a mean follow-up of 44.4 ± 21.6 months. Cartilage thickness in the repair tissue exceeded that of the reference cartilage (3.4 ± 0.9 mm vs. 3.0 ± 0.5 mm; p = 0.036), while T2 relaxation times in the repair tissue were within physiological range (50.5 ± 40.0 ms vs. 41.3 ± 5.4 ms; n.s.). The mean MOCART 2.0 score was 61.3 ± 13.0 (volume fill: 16.1 ± 3.7, integration with adjacent cartilage: 12.9 ± 3.3), reflecting satisfactory repair quality. All clinical scores showed significant improvement compared to the preoperative condition (IKDC: 70.6 ± 13.2 vs. 54.8 ± 17.5, p < 0.001; KOOS: pain 78.7 ± 16.9 vs. 66.1 ± 18.6, p = 0.002, symptoms 75.6 ± 16.0 vs. 65.8 ± 19.1, p = 0.006, ADL 86.8 ± 14.0 vs. 77.6 ± 16.8, p = 0.003, sport 63.0 ± 24.2 vs. 47.3 ± 26.9, p = 0.009, quality of life (QoL) 51.0 ± 22.7 vs. 39.6 ± 17.5, p = 0.014; numeric pain rating scale: 3.0 ± 2.2 vs. 5.2 ± 2.4, p < 0.001). A greater cartilage thickness was associated with reduced pain intensity (r = -0.457, p = 0.013) and improved QoL (r = 0.429, p = 0.020), indicating that better structural repair is associated with improved patient satisfaction.
Conclusions: MABCI results in satisfactory cartilage regeneration and subchondral remodelling in addition to significant improvements in patient satisfaction and overall QoL.
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