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Meta-analysis shows better short-term results with ACI than microfracture

MONTREAL — Results of a meta-analysis presented here indicated superior short- and mid-term outcomes with autologous chondrocyte implantation procedures compared to microfracture.

Lukas L. Negrin, MD, of Vienna, presented the findings at the International Cartilage Repair Society World Congress 2012.

Negrin and colleagues reviewed four databases for controlled, prospective, observational studies or controlled clinical trials in which microfracture was compared to ACI in patients with full-thickness knee cartilage lesions. They identified four studies that noted the eligibility criteria for inclusion and consisted of a total 318 patients aged 16 years to 60 years with chondral defects sized 1 cm² to 10 cm². All patients were followed up for 2 years to 5 years, Negrin said.

“Three of the four studies showed significant superiority of ACI over the microfracture technique,” Negrin said. “Our meta-analysis reveals clinically relevant superior short- and mid-term results achieved by ACI compared to microfracture in this representative patient population.”

Negrin noted that limitations of the meta-anlysis included a review of four variations of ACI techniques and that the failures were managed differently in each study.

Reference:

  • Negrin LL, Vecsei V. Does a meta-analysis reveal differences in the clinical outcome achieved by microfracture and autologous chondrocyte implantation? Paper #16.3.6. Presented at the International Cartilage Repair Society World Congress 2012. May 12-15. Montreal.

MONTREAL — Results of a meta-analysis presented here indicated superior short- and mid-term outcomes with autologous chondrocyte implantation procedures compared to microfracture.

Lukas L. Negrin, MD, of Vienna, presented the findings at the International Cartilage Repair Society World Congress 2012.

Negrin and colleagues reviewed four databases for controlled, prospective, observational studies or controlled clinical trials in which microfracture was compared to ACI in patients with full-thickness knee cartilage lesions. They identified four studies that noted the eligibility criteria for inclusion and consisted of a total 318 patients aged 16 years to 60 years with chondral defects sized 1 cm² to 10 cm². All patients were followed up for 2 years to 5 years, Negrin said.

“Three of the four studies showed significant superiority of ACI over the microfracture technique,” Negrin said. “Our meta-analysis reveals clinically relevant superior short- and mid-term results achieved by ACI compared to microfracture in this representative patient population.”

Negrin noted that limitations of the meta-anlysis included a review of four variations of ACI techniques and that the failures were managed differently in each study.

Reference:

  • Negrin LL, Vecsei V. Does a meta-analysis reveal differences in the clinical outcome achieved by microfracture and autologous chondrocyte implantation? Paper #16.3.6. Presented at the International Cartilage Repair Society World Congress 2012. May 12-15. Montreal.

    Perspective

    It is important to realize that if you want to compare microfracture to ACI, you need to include the well-designed rehabilitation. That would make it a more fair comparison.

    • Marc J. Philippon, MD
    • Session moderator Managing Partner, The Steadman Clinic Vail, Colo.

    Disclosures: Philippon is a paid speaker or consultant for and receives royalties and research or institutional support from Smith & Nephew. He also receives royalties or support from Bledsoe, DonJoy, Arthrosurface, SLACK Inc. and Elsevier; research or institutional support from Ossur, Arthrex, OrthoRehab and Siemens; and has stock options in Arthrosurface, Hipco and MIS.

    Perspective

    The good news is, there were not that many studies to look at. The bad news is, there were not that many studies to look at. I am not too sure how much of a conclusion you can draw from this.

    • William G. Rodkey, DVM
    • Session moderator Chief Scientific Officer and Director of Basic Science Research Steadman Philippon Research Institute Vail, Colo.

    Disclosures: Rodkey has no relevant financial disclosures.

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