title: Single-stage cartilage repair in the knee with microfracture covered with a resorbable polymer-based matrix and autologous bone marrow concentrate.
abstract: BACKGROUND
  Different single-stage surgical approaches are currently under evaluation to repair focal cartilage lesions. This study aims to analyze the clinical and histological results after treatment of focal condylar articular lesions of the knee with microfracture and subsequent covering with a resorbable polyglycolic acid/hyaluronan (PGA -HA) matrix augmented with autologous bone marrow concentrate (BMC).
  
  
  METHODS
  Nine patients with focal lesions of the condylar articular cartilage were consecutively treated with arthroscopic PGA -HA-covered microfracture and bone marrow concentrate (PGA -HA-CMBMC). Patients were retrospectively assessed using standardized assessment tools and magnetic resonance imaging (MRI). Five patients consented to undergo second look arthroscopy and 2 consented biopsy harvest.
  
  
  RESULTS
  All the patients but one showed improvement in clinical scoring from the pre-operative situation to the latest follow-up (average 22±2months). The mean IKDC subjective score, Lysholm score, VAS and the median Tegner score significantly increased from baseline to the latest follow-up. Cartilage macroscopic assessment at 12months revealed that one repair appeared normal, three almost normal and one appeared abnormal. Histological analysis proofed hyaline-like cartilage repair tissue formation in one case. MRI at 8 to 12months follow-up showed complete defect filling.
  
  
  CONCLUSIONS
  The first clinical experience with single-stage treatment of focal cartilage defects of the knee with microfracture and covering with the PGA -HA matrix augmented with autologous BMC (PGA -HA-CMBMC) suggests that it is safe, it improves knee function and has the potential to regenerate hyaline-like cartilage.
  
  
  METHODS
  IV, case series.
authors: Department of Orthopedics, Polytechnic University of Marche, Via Tronto 10/A, 60020 Ancona, Italy. Electronic address: davidenea@tiscali.it.
authors: D
authors: D
authors: Enea
authors: S
authors: S
authors: Cecconi
authors: S
authors: S
authors: Calcagno
authors: A
authors: A
authors: Busilacchi
authors: S
authors: S
authors: Manzotti
authors: C
authors: C
authors: Kaps
authors: A
authors: A
authors: Gigante
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D054544:Arthroplasty, Subchondral / Q000379:methods*; D001707:Biopsy, Needle; D016026:Bone Marrow Transplantation; D002358:Cartilage, Articular / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid; D007150:Immunohistochemistry; D007718:Knee Injuries / Q000175:diagnosis / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011100:Polyglycolic Acid; D018570:Risk Assessment; D012494:Sampling Studies; D023822:Tissue Engineering; D054457:Tissue Scaffolds; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D011100:Polyglycolic Acid; D006820:Hyaluronic Acid
keywords: Arthroscopy; Bone marrow concentrate; Cartilage repair; Knee; Scaffold; Tissue engineering