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The combination of microfracture and a cell-free polymer-based implant immersed with autologous serum for cartilage defect coverage

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Abstract
The purpose of this short-term pilot study was to determine the clinical and MRI outcome of a combination of microfracture with a cell-free polymer-based matrix for the treatment of cartilage defects in the knee. The technique was used for treatment of symptomatic cartilage defects in the knee. Five patients were prospectively evaluated during 2 years with use of the Knee injury and Osteoarthritis Outcome Score (KOOS), the Tegner activity scale and the visual analog scale (VAS). MRI data were analyzed based on the original and modified MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) scoring system at 6, 12 and 24 months of follow-up. A gradual clinical improvement was observed during the follow-up. Adverse reactions to the matrix were not observed. The scaffold was firmly fixed with the use of bioresorbable pins. Both MOCART scoring systems revealed no significant deterioration or improvement in the repair tissue during the follow-up period. However, the majority of the patients exhibited subchondral lamina and bone changes. The formation of an intralesional osteophyte was observed in one case. The key finding in this study was that this procedure is safe for the treatment of cartilage defects in the knee. The patients showed a gradual clinical improvement postoperatively. Sixty percent (3/5) of the defects were adequately (complete or hypertrophic) filled with repair tissue at 2 years of follow-up.
Keywords
Cell-free matrix, Knee, Microfracture, Cartilage defect, VISUAL ANALOG SCALE, OUTCOME SCORE KOOS, ARTICULAR-CARTILAGE, CHONDROCYTE TRANSPLANTATION, REPAIR TISSUE, KNEE INJURY, OSTEOARTHRITIS, DIFFERENTIATION, RELIABILITY, FIXATION

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MLA
Dhollander, Aad, et al. “The Combination of Microfracture and a Cell-Free Polymer-Based Implant Immersed with Autologous Serum for Cartilage Defect Coverage.” KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, vol. 20, no. 9, 2012, pp. 1773–80, doi:10.1007/s00167-011-1763-y.
APA
Dhollander, A., Verdonk, P., Lambrecht, S., Almqvist, K., Elewaut, D., Verbruggen, A., & Verdonk, R. (2012). The combination of microfracture and a cell-free polymer-based implant immersed with autologous serum for cartilage defect coverage. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 20(9), 1773–1780. https://doi.org/10.1007/s00167-011-1763-y
Chicago author-date
Dhollander, Aad, Peter Verdonk, Stijn Lambrecht, Karl Almqvist, Dirk Elewaut, August Verbruggen, and René Verdonk. 2012. “The Combination of Microfracture and a Cell-Free Polymer-Based Implant Immersed with Autologous Serum for Cartilage Defect Coverage.” KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY 20 (9): 1773–80. https://doi.org/10.1007/s00167-011-1763-y.
Chicago author-date (all authors)
Dhollander, Aad, Peter Verdonk, Stijn Lambrecht, Karl Almqvist, Dirk Elewaut, August Verbruggen, and René Verdonk. 2012. “The Combination of Microfracture and a Cell-Free Polymer-Based Implant Immersed with Autologous Serum for Cartilage Defect Coverage.” KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY 20 (9): 1773–1780. doi:10.1007/s00167-011-1763-y.
Vancouver
1.
Dhollander A, Verdonk P, Lambrecht S, Almqvist K, Elewaut D, Verbruggen A, et al. The combination of microfracture and a cell-free polymer-based implant immersed with autologous serum for cartilage defect coverage. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY. 2012;20(9):1773–80.
IEEE
[1]
A. Dhollander et al., “The combination of microfracture and a cell-free polymer-based implant immersed with autologous serum for cartilage defect coverage,” KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, vol. 20, no. 9, pp. 1773–1780, 2012.
@article{3001116,
  abstract     = {{The purpose of this short-term pilot study was to determine the clinical and MRI outcome of a combination of microfracture with a cell-free polymer-based matrix for the treatment of cartilage defects in the knee. 
The technique was used for treatment of symptomatic cartilage defects in the knee. Five patients were prospectively evaluated during 2 years with use of the Knee injury and Osteoarthritis Outcome Score (KOOS), the Tegner activity scale and the visual analog scale (VAS). MRI data were analyzed based on the original and modified MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) scoring system at 6, 12 and 24 months of follow-up. 
A gradual clinical improvement was observed during the follow-up. Adverse reactions to the matrix were not observed. The scaffold was firmly fixed with the use of bioresorbable pins. Both MOCART scoring systems revealed no significant deterioration or improvement in the repair tissue during the follow-up period. However, the majority of the patients exhibited subchondral lamina and bone changes. The formation of an intralesional osteophyte was observed in one case. 
The key finding in this study was that this procedure is safe for the treatment of cartilage defects in the knee. The patients showed a gradual clinical improvement postoperatively. Sixty percent (3/5) of the defects were adequately (complete or hypertrophic) filled with repair tissue at 2 years of follow-up.}},
  author       = {{Dhollander, Aad and Verdonk, Peter and Lambrecht, Stijn and Almqvist, Karl and Elewaut, Dirk and Verbruggen, August and Verdonk, René}},
  issn         = {{0942-2056}},
  journal      = {{KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY}},
  keywords     = {{Cell-free matrix,Knee,Microfracture,Cartilage defect,VISUAL ANALOG SCALE,OUTCOME SCORE KOOS,ARTICULAR-CARTILAGE,CHONDROCYTE TRANSPLANTATION,REPAIR TISSUE,KNEE INJURY,OSTEOARTHRITIS,DIFFERENTIATION,RELIABILITY,FIXATION}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{1773--1780}},
  title        = {{The combination of microfracture and a cell-free polymer-based implant immersed with autologous serum for cartilage defect coverage}},
  url          = {{http://doi.org/10.1007/s00167-011-1763-y}},
  volume       = {{20}},
  year         = {{2012}},
}

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