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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

21-10-2022 | KNEE

Sustained superiority in KOOS subscores after matrix-associated chondrocyte implantation using spheroids compared to microfracture

Authors: Arnd Hoburg, Philipp Niemeyer, Volker Laute, Wolfgang Zinser, Christoph Becher, Thomas Kolombe, Jakob Fay, Stefan Pietsch, Tomasz Kuźma, Wojciech Widuchowski, Stefan Fickert

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 6/2023

Abstract

Purpose

To evaluate the safety and efficacy of matrix-associated autologous chondrocyte implantation (ACI) using spheroids in comparison to arthroscopic microfracture for the treatment of symptomatic cartilage defects of the knee.

Methods

In a prospective multicenter-controlled trial, patients aged between 18 and 50 years, with single symptomatic focal cartilage defects between 1 and 4 cm² (mean 2.6 ± 0.8, median 2.75, range 1.44–5.00) in the knee were randomized to treatment with ACI with spheroids (n = 52) or microfracture (n = 50). Primary clinical outcome was assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS). Analyses were performed in a defined hierarchical manner where outcomes of ACI were first compared to baseline values followed by a comparison to the microfracture group with repeated-measures ANCOVA with a non-inferiority approach. Subgroup analyses were performed to investigate the influence of age and defect size on the overall KOOS. Secondary clinical outcomes were the magnetic resonance observation of cartilage repair tissue (MOCART), modified Lysholm score and International Knee Documentation Committee (IKDC) examination form. Safety data focused on adverse events. Here the 5 years results are presented at which there were 33 observed cases in the ACI group and 30 in the microfracture group.

Results

The overall KOOS and its five subscores were significantly improved compared to baseline for both the ACI and microfracture group. Non-inferiority of ACI to microfracture was confirmed for the overall KOOS and the subscores, while for the subscores activities of daily living, quality of life and sports and recreation of the threshold for superiority was passed. In the ACI group, a notably more rapid initial improvement of the KOOS was found at three months for the older age group compared to the younger age group and the microfracture group. No other differences were found based on age or defect size. In addition, clinical improvement was found for the MOCART, modified Lysholm and IKDC examination form both the ACI and microfracture group. No safety concern related to either treatment was observed.

Conclusion

This study confirms the safety and efficacy of matrix-associated ACI with spheroids at a mid to long-term follow-up. Non-inferiority of ACI to microfracture was confirmed for the overall KOOS and all subscores, while superiority was reached for the subscores activities of daily living, quality of life and sports and recreation in the ACI group. This underlines the importance of ACI for the young and active patients.

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Title: Sustained superiority in KOOS subscores after matrix-associated chondrocyte implantation using spheroids compared to microfracture
Authors: Arnd Hoburg
Philipp Niemeyer
Volker Laute
Wolfgang Zinser
Christoph Becher
Thomas Kolombe
Jakob Fay
Stefan Pietsch
Tomasz Kuźma
Wojciech Widuchowski
Stefan Fickert
Publication date: 21-10-2022
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 6/2023
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-022-07194-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Sustained superiority in KOOS subscores after matrix-associated chondrocyte implantation using spheroids compared to microfracture

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence.

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence.

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