title: CaReS (MACT) versus microfracture in treating symptomatic patellofemoral cartilage defects: a retrospective matched-pair analysis.
abstract: BACKGROUND
  Treating patellofemoral articular cartilage lesions remains a challenging task in orthopedic surgery. Whereas microfracture and autologous chondrocyte implantation yield good results on femoral condyles, the therapeutic state of the art for treating patellofemoral lesions is yet to be determined. In this study, we compared the CaReS technique, which is a matrix-associated autologous chondrocyte implantation technique, to microfracture for treating patellofemoral articular cartilage lesions.
  
  
  METHODS
  Between May 2003 and December 2005, 17 patients with an isolated patellofemoral cartilage defect (International Cartilage Repair Society III/IV) were treated with the CaReS technique at our department. After adjusting for inclusion and exclusion criteria, ten of these patients could be included in this study; ten patients treated with microfracture were chosen as a matched-pair group. Clinical outcome was evaluated 3 years after surgery by the 36-item Short Form Health Survey Questionnaire (SF-36), International Knee Documentation Committee (IKDC) subjective evaluation of the knee, Lysholm Score, and Cincinnati Modified Rating Scale scores.
  
  
  RESULTS
  Patients treated with CaReS had statistically significantly improved IKDC, Lysholm, and Cincinnati scores 36 months after surgery compared with preoperatively. When comparing outcome between groups 36 months after surgery, there was no statistically difference in IKDC, Lysholm, and Cincinnati scores.
  
  
  CONCLUSIONS
  This is the first trial comparing the CaReS technique and microfracture for treating patellofemoral articular cartilage lesions, and results show that CaReS(®) yields comparable results to microfracture. The small number of patients is a limiting factor of the study, leading to results without statistical significance. A multicentric prospective randomized study comparing the two procedures is desirable.
authors.affiliation: Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany. petri.maximilian@mh-hannover.de
authors.forename: Maximilian
authors.initials: M
authors.lastname: Petri
authors.forename: Maximilian
authors.initials: M
authors.lastname: Broese
authors.forename: Annika
authors.initials: A
authors.lastname: Simon
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Liodakis
authors.forename: Max
authors.initials: M
authors.lastname: Ettinger
authors.forename: Daniel
authors.initials: D
authors.lastname: Guenther
authors.forename: Johannes
authors.initials: J
authors.lastname: Zeichen
authors.forename: Christian
authors.initials: C
authors.lastname: Krettek
authors.forename: Michael
authors.initials: M
authors.lastname: Jagodzinski
authors.forename: Carl
authors.initials: C
authors.lastname: Haasper
mesh_terms: D000328:Adult; D054544:Arthroplasty, Subchondral / Q000379:methods*; D001182:Arthroscopy; D001706:Biopsy; D002357:Cartilage Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D002358:Cartilage, Articular / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D019902:Chondrocytes / Q000637:transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D057071:Patellofemoral Joint / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D012189:Retrospective Studies; D014182:Transplantation, Autologous