title: Scaffold-based repair for cartilage healing: a systematic review and technical note.
abstract: OBJECTIVE
  The aim of this systematic review was to address the treatment of chondral and osteochondral knee lesions through the use of scaffolds, by showing surgical options and results of this scaffold-based repair approach for the healing of the articular surface.
  
  
  METHODS
  All studies published in English addressing cartilage scaffold-based treatment were identified, including those that fulfilled the following criteria: (1) Levels I to IV evidence addressing the outlined areas of interest, (2) measures of functional or clinical outcome, (3) knee cartilage lesions, and (4) minimum of 2 years of follow-up.
  
  
  RESULTS
  The analysis showed a progressively increasing number of articles per year from 1995 to February 2012. The number of selected articles was 51, with 40 focusing on 2-step procedures and 11 focusing on 1-step procedures. The evaluation of evidence level showed 3 randomized studies, 10 comparative studies, 33 case series, and 5 case reports.
  
  
  CONCLUSIONS
  Regenerative scaffold-based procedures are emerging as a therapeutic option for the treatment of chondral lesions, but well-designed studies are lacking. Systematic long-term evaluation of these techniques and randomized studies are necessary to confirm the potential of this treatment approach, especially compared with the available traditional treatments. Different 1-step scaffold-based strategies are emerging to simplify the procedure and reduce costs.
  
  
  METHODS
  Level IV, systematic review of Level I to IV studies.
authors.affiliation: Biomechanics Lab, Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Filardo
authors.forename: Elizaveta
authors.initials: E
authors.lastname: Kon
authors.forename: Alice
authors.initials: A
authors.lastname: Roffi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Di Martino
authors.forename: Maurilio
authors.initials: M
authors.lastname: Marcacci
mesh_terms: D020341:Absorbable Implants; D000818:Animals; D001182:Arthroscopy / Q000379:methods; D015706:Bibliometrics; D001672:Biocompatible Materials; D002358:Cartilage, Articular / Q000601:surgery*; D019902:Chondrocytes / Q000502:physiology / Q000637:transplantation*; D003094:Collagen; D017886:Durapatite; D005337:Fibrin; D006801:Humans; D006820:Hyaluronic Acid; D020100:Hydrogels; D020007:Implants, Experimental; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D049329:Nanostructures; D019637:Orthopedic Procedures / Q000706:statistics & numerical data; D011108:Polymers; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012038:Regeneration; D012189:Retrospective Studies; D054457:Tissue Scaffolds; D014945:Wound Healing / Q000502:physiology
chemical_list: D001672:Biocompatible Materials; D020100:Hydrogels; D011108:Polymers; D005337:Fibrin; D006820:Hyaluronic Acid; D003094:Collagen; D017886:Durapatite