الفهرس | Only 14 pages are availabe for public view |
Abstract Articular cartilage defects of the knee are a frequently encountered injury. Cartilage damage may occur after a single severe mechanical impact or following less severe but repetitive microtrauma. Another etiology factor is the degenerative process. Articular cartilage has limited to no ability to spontaneously repair because of its avascular status. When left untreated, full-thickness chondral defects can lead to degenerative joint symptoms such as pain, swelling, and joint dysfunction. Joint preservation surgery (via reparative, reconstructive, and replacement techniques) has become increasingly utilized over the past decades. However currently, there is great interest in bone marrow aspirate concentrate (BMAC) as a cost-effective method in delivering mesenchymal stem cells (MSCs) to aid in the repair and regeneration of cartilage defects. Aim of the work: The aim of this work was to evaluate the clinical and radiological outcome of microfracture with versus without augmentation by bone marrow aspirate concentrate in management of knee chondral lesions. Patients and methods: Between August 2018 to May 2021, this prospective cohort study included 30 patients of arthroscopically diagnosed grade III or IV knee chondral lesions of weight-bearing surfaces of the femoral condyles. Patients were mutually allocated into group-(A) of 15 patients (managed by stand-alone microfracure); and group-(B) of 15 patients (managed by bone marrow aspirate concentrate-augmented microfracture). Patients were evaluated for demographics and for preoperative and 6-month postoperative International Knee Documentation Committee (IKDC) scoring system and MRI grading using Brittberg classification. Results: Statistically, groups were matched in terms of demographics, preoperative clinical and imaging findings, functional scoring and arthroscopic findings. There was significant improvement of postoperative subjective and objective forms of IKDC in both groups. In addition, the most significant postoperative functional improvement was evident in patients younger than 45 years notably in group-B but it was insignificant in those who were older than 45 years. Also, in both groups, analysis revealed significant improvement of MRI grading of the chondral lesion. The most common postoperative complication was mild effusion (66.7% of cases) which responded well to medical treatment. |