title: Third-generation autologous chondrocyte implantation versus mosaicplasty for knee cartilage injury: 2-year randomized trial.
abstract: Numerous surgical techniques have been developed to treat osteochondral defects of the knee. A study reported encouraging outcomes of third-generation autologous chondrocyte implantation achieved using the solid agarose-alginate scaffold Cartipatch®. Whether this scaffold is better than conventional techniques remains unclear. This multicenter randomized controlled trial compared 2-year functional outcomes (IKDC score) after Cartipatch® versus mosaicplasty in patients with isolated symptomatic femoral chondral defects (ICRS III and IV) measuring 2.5-7.5 cm(2) . In addition, a histological evaluation based on the O'Driscoll score was performed after 2 years. We needed 76 patients to demonstrate an at least 10-point subjective IKDC score difference with α = 5% and 90% power. During the enrolment period, we were able to include 55 patients, 30 of them were allocated at random to Cartipatch® and 25 to mosaicplasty. After 2 years, eight patients had been lost to follow-up, six in the Cartipatch® group, and two in the mosaicplasty group. The baseline characteristics of the two groups were not significantly different. The mean IKDC score and score improvement after 2 years were respectively 73.7 ± 20.1 and 31.8 ± 20.8 with Cartipatch® and 81.5 ± 16.4 and 44.4 ± 15.2 with mosaicplasty. The 12.6-point absolute difference in favor of mosaicplasty is statistically significant. Twelve adverse events were recorded in the Cartipatch® group against six in the mosaicplasty group. After 2 years, functional outcomes were significantly worse after Cartipatch® treatment compared to mosaicplasty for isolated focal osteochondral defects of the femur.
authors.affiliation: Université de Bretagne Occidentale, Faculté de Médecine, 22 avenue Camille Desmoulins, 29200, Brest, France.|Service de Chirurgie Orthopédique et Traumatologique de la Cavale Blanche, CHRU Brest, bd Tanguy Prigent, 29200, Brest, France.|LaTIM, INSERM UMR 1101, 2 av Foch, 29609, Brest Cedex, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Clavé
authors.affiliation: Clinique Médipôle Garonne, 45 rue Gironis, 31036, Toulouse Cedex 1, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Potel
authors.affiliation: Centre Albert Trillat, service de chirurgie orthopédique, Hôpital de la Croix-Rousse, Hospices civils de Lyon, 103 grande rue de la Croix-Rousse, 69004, Lyon, France.
authors.forename: Elvire
authors.initials: E
authors.lastname: Servien
authors.affiliation: Centre Albert Trillat, service de chirurgie orthopédique, Hôpital de la Croix-Rousse, Hospices civils de Lyon, 103 grande rue de la Croix-Rousse, 69004, Lyon, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Neyret
authors.affiliation: Université de Bretagne Occidentale, Faculté de Médecine, 22 avenue Camille Desmoulins, 29200, Brest, France.|Service de Chirurgie Orthopédique et Traumatologique de la Cavale Blanche, CHRU Brest, bd Tanguy Prigent, 29200, Brest, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Dubrana
authors.affiliation: Université de Bretagne Occidentale, Faculté de Médecine, 22 avenue Camille Desmoulins, 29200, Brest, France.|Service de Chirurgie Orthopédique et Traumatologique de la Cavale Blanche, CHRU Brest, bd Tanguy Prigent, 29200, Brest, France.|LaTIM, INSERM UMR 1101, 2 av Foch, 29609, Brest Cedex, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Stindel
mesh_terms: D000328:Adult; D054544:Arthroplasty, Subchondral / Q000009:adverse effects / Q000379:methods*; D019902:Chondrocytes / Q000637:transplantation*; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
keywords: autologous chondrocyte implantation; cartilage; knee; mosaicplasty; scaffold