Background:One-step cell-based techniques of cartilage repair that lead to restoration of durable chondral tissue and long-term maintenance of joint function are cost-effective and ideal for routine use.Purposes:To examine the long-term clinical outcomes, after a mean follow-up duration of 14 years, of cartilage repair in the knee using a hyaluronic acid–based scaffold in association with bone marrow aspirate concentrate (HA-BMAC) and to evaluate the effect of age, lesion characteristics, and associated treatments on the outcome of this cartilage repair method.Study Design:Case series; Level of evidence, 4.Methods:Patients were followed prospectively for a mean duration of 14.0 years after undergoing treatment of knee full-thickness articular cartilage injury using HA-BMAC. Clinical evaluation consisted of the patient-reported scoring tools of the visual analog scale and the Knee injury and Osteoarthritis Outcome Score, which were completed preoperatively and at the time of final follow-up.Results:A total of 26 patients with a mean age of 48.3 years (17 male, 9 female) and median chondral lesion size of 6.6 cm2 (range, 1-27 cm2) were followed prospectively. There were 3 treatment failures, and 1 patient who underwent medial compartment unicompartmental arthroplasty 12 years after HA-BMAC treatment of patellar chondral injury. Of the 22 remaining patients, after a mean final follow-up duration of 14.0 years (range, 12-16 years), the median visual analog scale score of 0.6 was significantly decreased from the preoperative median score of 5.0 ( P < .001). The median Knee injury and Osteoarthritis Outcome Score Pain (92), Symptoms (86), Activities of Daily Living (96), Sports (85), and Quality of Life (88) subscale values were all increased compared with the preoperative scores ( P≤ .001). There was no correlation of clinical outcome score and body mass index.Conclusion:One-step cartilage repair of full-thickness chondral defects in the knee using an HA-BMAC led to successful long-term clinical outcomes and maintenance of joint junction after a mean follow-up duration of 14 years. Long-term clinical success in active, nonobese patients has been uniformly demonstrated across a wide range of patient ages and lesion types, including cases of multicompartment involvement, treatment of associated conditions, and large or bipolar chondral lesions.

中文翻译：

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使用嵌入骨髓抽吸物浓缩物的透明质酸基支架对全层膝关节软骨病变进行一步软骨修复：平均随访 14 年后的长期结果


背景： 基于细胞的一步软骨修复技术可恢复耐用的软骨组织和长期维持关节功能，具有成本效益，非常适合常规使用。目的： 在平均随访 14 年后，使用基于透明质酸的支架联合骨髓抽吸物浓缩物 （HA-BMAC） 进行膝关节软骨修复的长期临床结局，并评估年龄、病变特征和相关治疗对这种软骨修复方法结果的影响。研究设计： 病例系列;证据水平， 4.方法： 患者在接受 HA-BMAC 膝关节全层关节软骨损伤治疗后，平均随访时间为 14.0 年。临床评估包括患者报告的视觉模拟评分量表和膝关节损伤和骨关节炎结局评分，这些工具在术前和最终随访时完成。结果： 前瞻性随访共 26 例患者，平均年龄 48.3 岁 （17 例男性，9 例女性） 和中位软骨病变大小 6.6 cm2 （范围，1-27 cm2）。有 3 例治疗失败，1 例患者在 HA-BMAC 治疗髌骨软骨损伤 12 年后接受了内侧隔室单髁关节置换术。在其余 22 例患者中，平均最终随访时间为 14.0 年 （范围，12-16 年） 后，中位视觉模拟量表评分 0.6 比术前中位评分 5.0 显着降低 （P < .001）。 与术前评分相比，膝关节损伤和骨关节炎结局评分中位数疼痛 （92）、症状 （86）、日常生活活动 （96）、运动 （85） 和生活质量 （88） 分量表值均有所增加 （P≤ .001）。临床结局评分与体重指数无相关性。结论： 使用 HA-BMAC 对膝关节全层软骨缺损进行一步软骨修复，平均随访 14 年后，成功获得长期临床结局和关节连接维持。活动性、非肥胖患者的长期临床成功已在广泛的患者年龄和病变类型中得到一致证明，包括多隔室受累病例、相关疾病的治疗以及大或双极软骨病变。