2017 ISAKOS Biennial Congress Paper #30


Arthroscopic Treatment of Patellar and Trochlear Cartilage Lesions with Matrix Encapsulated Chondrocyte Implantation Versus Microfracture: Quantitative Assessment with T2-Mapping-MRI at 4-Years Follow-Up

Anell Olivos-Meza, PhD, Mexico City MEXICO
Reynaldo Arredondo, MD, Mexico City, Mexico city MEXICO
Socorro Cortes, MD, Mexico City, San cristobal xochim MEXICO
Francisco Perez-Jimenez, MD, Mexico City MEXICO
Arturo Almazan, MD, Mexico City, CDMX MEXICO
Enrique Villalobos, MD, Mexico City MEXICO
Monica SaldaƱa, MD, Mexico City MEXICO
Clemente Ibarra, MD, Mexico City MEXICO

Instituto Nacional de Rehabilitacional de Rehabilitacion, Mexico city, Mexico city, MEXICO

FDA Status Not Applicable


Cartilage lesions are commonly found during routine knee arthroscopy (60-63%). Among these 11-23% are located in patella and 6-15% in trochlea. Low percentage of good results (7%) compared to condyle cartilage repair (90%) with ACI is reported. Quantitative assessment of repaired cartilage in PFJ with chondrocytes implantation showed significant improvement since 12-months post-op compared to MF


Problem: Cartilage lesions are commonly found during routine knee arthroscopy (60 to 63%). Among these injuries 11% to 23% are located in the patella and 6% to 15% in the trochlea. A low percentage of good to very good results (7%) treating patellar an trochlear lesions with ACI have been reported compared with 90% of success on femoral condyles. Few reports have evaluated quantitative assessment of cartilage repair in the PFJ with Chondrocyte Implantation comparing to Microfracture. Methods: Seventeen patients with full-thickness articular cartilage lesion in the Patello-femoral joint (PFJ) were randomized into two groups: Matrix Encapsulated Chondrocyte Implantation (MECI) or Microfracture (MF). Both procedures were performed by arthroscopy combining cartilage restoration procedures with unloading/realigning PFJ techniques. An identical rehabilitation protocol was implemented for both groups. Clinical assessment and T2-mapping-MRI were evaluated at 3, 12, 24 and 48 months. Results: Clinically the difference between baseline and 48 months post-op for both MECI and MF improve significant in Lysholm, IKDCs, KOOS (pain, DLA, Sport/Rec, symptoms & QoL) and Kujala (p<0.05). Tegner was significant between baseline and 48 months only for MECI (p<0.05). No significant difference was observed between groups for any of the evaluated scores at 3, 12, 24 & 4-years follow-up (p>0.05) (Tab. 1). T2-mapping values improved significantly over time in MECI compared to MF at 24 & 48-months (p<0.05). When comparing control values to MECI repaired tissue at 12, 24 and 48-month no significant different was (p<0.05) (Tab. 2). Conclusion: Clinically both techniques showed significant difference over the time. However, quantitative assessment showed that new-formed tissue with MECI improves significantly since 12-months post-operatively and maintain stable values compared to native cartilage until 48 months follow-up.