| Summary: | ABSTRACT: Background: Scaffold-implanted mesenchymal stem cells (MSCs) are gaining popularity for the treatment of cartilage defects. However, there is little evidence comparing its efficacy against the currently well-established technique of utilizing acellular scaffolds (ACs) with concentrated bone marrow aspirate (cBMA) for treating knee chondral defects. Objectives: To compare scaffold-implanted MSCs against ACs with cBMA for the repair of knee cartilage lesions. Data Sources: Medline and Embase. Study Eligibility Criteria, Participants, and Interventions: Inclusion: (1) Studies involving patients with high grade chondral lesions on the tibiofemoral or patellofemoral articular surfaces, (2) studies involving patients that received either scaffold-implanted MSCs or ACs for treatment, and (3) studies with postoperative patient follow-up of at least 1 year. Study Appraisal and Synthesis Methods: Single-arm meta-analysis of studies reporting patient-reported outcome measures, reoperation and incomplete filling rates was performed. Results: Degree of postoperative International Knee Documentation Committee score improvement in patients receiving ACs augmented with cBMA was significantly higher compared to those receiving scaffold-implanted MSCs (P < .01). Additionally, patients receiving ACs with cBMA augmentation were at significantly lower risk of incomplete defect filling when compared to patients receiving either scaffold-implanted MSCs (P < .01), or patients receiving non-cBMA augmented ACs (P < .01). Conclusion: This meta-analysis demonstrates that cartilage repair with ACs with cBMA augmentation yields marginally better short-term outcomes when compared to scaffold-implanted MSCs. This suggests that even with the advent of MSCs increasing in availability as a treatment modality, ACs with cBMA augmentation remains as a competitive, cost-effective option for cartilage repair.
|
|---|