title: One-step cartilage repair in the knee: collagen-covered microfracture and autologous bone marrow concentrate. A pilot study.
abstract: BACKGROUND
  Different single-stage surgical approaches are currently under evaluation to repair cartilage focal lesions. To date, only little is known on even short-term clinical follow-up and almost no knowledge exists on histological results of such treatments. The present paper aims to analyze the clinical and histological results of the collagen-covered microfracture and bone marrow concentrate (C-CMBMC) technique in the treatment of focal condylar lesions of knee articular cartilage.
  
  
  METHODS
  Nine patients with focal lesions of the condylar articular cartilage were consecutively treated with arthroscopic microfractures (MFX) covered with a collagen membrane immersed in autologous bone marrow concentrate (BMC) from the iliac crest. Patients were retrospectively assessed using several standardized outcome assessment tools and MRI scans. Four patients consented to undergo second look arthroscopy and biopsy harvest.
  
  
  RESULTS
  Every patient was arthroscopically treated for a focal condylar lesion (mean area 2.5 SD(0.4) cm(2)). All the patients (mean age 43 SD(9) years) but one experienced a significant clinical improvement from the pre-operative condition to the latest follow-up (mean 29 SD(11) months). Cartilage macroscopic assessment at 12 months revealed that all the repairs appeared almost normal. Histological analysis showed a hyaline-like cartilage repair in one lesion, a fibrocartilaginous repair in two lesions and a mixture of both in one lesion.
  
  
  CONCLUSIONS
  The first clinical experience with single-stage C-CMBMC for focal cartilage defects in the knee suggests that it is safe, it improves the short-term knee function and that it has the potential to recreate hyaline-like cartilage.
authors.affiliation: Department of Orthopedics, Polytechnic University of Marche, Via Tronto 10/A, 60020 Ancona, Italy. Electronic address: enea.davide@gmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Enea
authors.affiliation: Department of Orthopedics, Polytechnic University of Marche, Via Tronto 10/A, 60020 Ancona, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Cecconi
authors.affiliation: Sestri Levante Hospital, Sestri Levante, GE, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Calcagno
authors.affiliation: Department of Orthopedics, Polytechnic University of Marche, Via Tronto 10/A, 60020 Ancona, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Busilacchi
authors.affiliation: Department of Orthopedics, Polytechnic University of Marche, Via Tronto 10/A, 60020 Ancona, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Manzotti
authors.affiliation: Department of Orthopedics, Polytechnic University of Marche, Via Tronto 10/A, 60020 Ancona, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Gigante
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D054544:Arthroplasty, Subchondral / Q000379:methods*; D016026:Bone Marrow Transplantation; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery*; D003094:Collagen; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012189:Retrospective Studies; D023822:Tissue Engineering; D054457:Tissue Scaffolds
chemical_list: D003094:Collagen
keywords: Arthroscopy; Bone marrow concentrate; Cartilage; Knee; Scaffold; Tissue engineering