One-stage minced cartilage autograft with platelet-rich plasma improves early clinical outcomes: A multicentric retrospective study

IF 2.7 Q2 ORTHOPEDICS Journal of Experimental Orthopaedics Pub Date : 2025-02-10 DOI:10.1002/jeo2.70162

Arthur Barbaret, Frank Wein, Christophe Jacquet, Matthieu Ollivier

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Abstract

Purpose

Knee cartilage defects are a therapeutic challenge, often requiring multiple costly procedures with modest improvements. This study evaluates whether a one-stage minced cartilage autograft with platelet-rich plasma (PRP) improves clinical and radiological outcomes after at least 1 year.

Methods

A multicentric, non-randomized, retrospective analysis was conducted using data from two sports medicine centres. Sixty-six patients aged 18–50 years with symptomatic International Cartilage Repair Society Grade III/IV chondral defects underwent the minced cartilage autograft and PRP procedure between January 2021 and April 2023. The minimum follow-up was 1 year. Clinical scores for Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) Score and Self Knee Value (SKV) were collected from medical records and by an independent examiner at the latest follow-up. Magnetic resonance imaging (MRI) assessments using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 scoring system were performed at the latest follow-up in 46 patients (70%).

Results

The mean follow-up was 20.5 ± 7.5 months. The study demonstrated significant improvements in knee function and pain relief following the minced cartilage autograft with the PRP procedure. The mean KOOS total score started from 45.3 to 71.5 points, mean KOOS pain started from 51.9 to 80.4 points, mean KOOS activities of daily living started from 62.1 to 85.3 points, mean KOOS symptoms started from 53.1 to 79 points, mean KOOS sports started from 38.7 to 74.8 points, mean KOOS quality of life started from 43.3 to 73.7 points. The mean IKDC score improved by 27.7 ± 15.7 points. All these scores have been significantly improved (p < 0.05). MRI assessments confirmed the successful integration of repair tissue with a mean MOCART 2.0 score of 80.5 ± 12.5 points.

Conclusion

The minced autograft cartilage technique with PRP provides favourable early clinical and radiological outcomes for limited chondral defects in the knee. This method offers a single-procedure approach with minimal grafting requirements and does not necessitate a laboratory or specialized personnel, unlike other techniques.

Level of Evidence

Level III retrospective multicentric study.

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一项多中心回顾性研究：富血小板血浆一期自体碎软骨移植改善早期临床结果

目的膝关节软骨缺损是治疗上的挑战，通常需要多次昂贵的手术和适度的改善。本研究评估了富血小板血浆（PRP）一期切碎软骨自体移植物是否在至少1年后改善临床和放射学结果。方法采用多中心、非随机、回顾性分析两家运动医学中心的资料。在2021年1月至2023年4月期间，66名年龄在18-50岁、有症状的国际软骨修复协会III/IV级软骨缺损的患者接受了自体碎软骨移植和PRP手术。最小随访时间为1年。膝关节损伤和骨关节炎结局评分（oos）、国际膝关节文献委员会（IKDC）评分和自我膝关节价值（SKV）的临床评分由独立审查员在最近的随访中从医疗记录中收集。46例（70%）患者最新随访时采用MOCART 2.0评分系统进行磁共振成像（MRI）评估。结果平均随访20.5±7.5个月。研究表明，PRP手术后自体软骨碎骨移植在膝关节功能和疼痛缓解方面有显著改善。平均KOOS总分从45.3分上升到71.5分，平均KOOS疼痛从51.9分上升到80.4分，平均KOOS日常生活活动从62.1分上升到85.3分，平均KOOS症状从53.1分上升到79分，平均KOOS运动从38.7分上升到74.8分，平均KOOS生活质量从43.3分上升到73.7分。平均IKDC评分提高27.7±15.7分。这些评分均有显著提高（p < 0.05）。MRI评估证实修复组织整合成功，MOCART 2.0平均评分为80.5±12.5分。结论自体软骨碎化技术结合PRP治疗膝关节局部软骨缺损具有良好的早期临床和影像学效果。与其他技术不同，这种方法提供了一种单一程序的方法，移植需求最小，不需要实验室或专业人员。证据水平：III级回顾性多中心研究。

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