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Microfractures Versus a Porcine-Derived Collagen-Augmented Chondrogenesis Technique for Treating Knee Cartilage Defects: A Multicenter Randomized Controlled Trial

Title
Microfractures Versus a Porcine-Derived Collagen-Augmented Chondrogenesis Technique for Treating Knee Cartilage Defects: A Multicenter Randomized Controlled Trial
Authors
Kim, Man SooChun, Churl HongWang, Joon HoKim, Jin GooKang, Seung-BaikYoo, Jae DooChon, Je-GyunKim, Myung KuMoon, Chan WoongChang, Chong BumSong, In SooHa, Jeong KuChoi, Nam YongIn, Yong
Ewha Authors
유재두
SCOPUS Author ID
유재두scopus
Issue Date
2020
Journal Title
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY
ISSN
0749-8063JCR Link

1526-3231JCR Link
Citation
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY vol. 36, no. 6, pp. 1612 - 1624
Publisher
W B SAUNDERS CO-ELSEVIER INC
Indexed
SCIE; SCOPUS WOS
Document Type
Article
Abstract
Purpose: The purpose of this study was to evaluate the clinical efficacy and safety of treating patients with a cartilage defect of the knee with microfractures and porcine-derived collagen-augmented chondrogenesis technique (C-ACT). Methods: One hundred participants were randomly assigned to the control group (n = 48, microfracture) or the investigational group (n = 52, C-ACT). Clinical and magnetic resonance imaging (MRI) outcomes were assessed 12 and 24 months postoperatively for efficacy and adverse events. Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) assessment was used to analyze cartilage tissue repair. MRI outcomes for 50% defect filling and repaired tissue/reference cartilage (RT/RC) ratio were quantified using T2 mapping. Clinical outcomes were assessed using the visual analogue scale (VAS) for pain and 20% improvement, minimal clinically important difference (MCID), and patient acceptable symptom state for Knee Injury and Osteoarthritis Outcome Score (KOOS) and the International Knee Documentation Committee score. Results: MOCART scores in the investigation group showed improved defect repair and filling (P = .0201), integration with the border zone (P = .0062), and effusion (P = .0079). MRI outcomes showed that the odds ratio (OR) for >= 50% defect filling at 12 months was statistically higher in the investigation group (OR 3.984, P = .0377). Moreover, the likelihood of the RT/RC OR becoming >= 1 was significantly higher (OR 11.37, P = .0126) in the investigation group. At 24 months postoperatively, the OR for the VAS 20% improvement rate was significantly higher in the investigational group (OR 2.808, P = .047). Twenty-three patients (52.3%) in the control group and 35 (77.8%) in the investigation group demonstrated more than the MCID of KOOS pain from baseline to 1 year postoperatively, with a significant difference between groups (P = .0116). Conclusion: In this multicenter randomized trial, the addition of C-ACT resulted in better filling of cartilage defect of the knee joint.
DOI
10.1016/j.arthro.2019.11.110
Appears in Collections:
의과대학 > 의학과 > Journal papers
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