Kompendium 2021 Forschung & Klinik

TOP-Studien
23
A B C
Figure 1: Preoperative (A) and follow-up MRI after one year (B) and two years (C) of a 25-year-old female patient after matrix-associated autologous
chondrocyte transplantation procedure with the Hyalograft®C Transplantation system.
„Our data demonstrated that MACT
resulted in good clinical improvement
for tibio-femoral defects two years
after transplantation, regardless of
the graft type used.“
Harald Binder
Hyalograft ® C consists of a hyaluronan web seeded with previously obtained
cells that are cultivated in 2D for at least two weeks. MACI ® is a collagen
type I/III membrane seeded with Chondrocytes that are cultivated in 3D for
one week. CaReS ® is composed of a collagen type I gel, the obtained cells are
mixed with the gel directly without monolayer cultivation, instead, a three
weeklong 3D-cultivation is performed. Novocart ® 3D is a bilayered collagen
type I sponge, containing chondroitin-sulphate. The cells are isolated from
full depth cartilage cylinders, multiplied in monolayers, and seeded onto the
scaffold. Cultivation lasts for two days and is performed in 3D.
Aim and Methods
This retrospective study aims to determine the possible differences in shortterm
clinical outcome among these four different types of MACT, since up to
now, no comparison of these four commonly used transplant types has been
documented.
This case control study includes 88 patients (mean age: 34 years, mean
BMI: 25) with full-thickness chondral lesions of the tibiofemoral joint who
underwent MACT. Clinical examinations were performed preoperatively, and
24 months after transplantation. Clinical outcomes were evaluated using the
International Knee Documentation Committee (IKDC), the Brittberg score,
the Tegner Activity Scale, and the visual analog scale (VAS) for pain. The
Kruskal-Wallis test by ranks was used to compare the clinical scores of the
different transplant types.
Results and Conclusion
The average defect size of the tibiofemoral joint compartment was 4.28 cm 2 .
Eleven patients (12.6 %) underwent transplantation with Chondro-Gide
(MACI), 40 patients (46.0 %) with Hyalograft (HYAFF) (Figure 1), 21 patients
(24.1 %) with CaReS and 15 patients (17.2 %) with Novocart 3D. The mean
IKDC score improved from 35.71 (± 6,44) preoperatively to 75.26 (± 18.36)