PMID- 31785390 OWN - NLM STAT- MEDLINE DCOM- 20201109 LR - 20201109 IS - 1526-3231 (Electronic) IS - 0749-8063 (Linking) VI - 36 IP - 6 DP - 2020 Jun TI - Microfractures Versus a Porcine-Derived Collagen-Augmented Chondrogenesis Technique for Treating Knee Cartilage Defects: A Multicenter Randomized Controlled Trial. PG - 1612-1624 LID - S0749-8063(19)31100-4 [pii] LID - 10.1016/j.arthro.2019.11.110 [doi] AB - PURPOSE: The purpose of this study was to evaluate the clinical efficacy and safety of treating patients with a cartilage defect of the knee with microfractures and porcine-derived collagen-augmented chondrogenesis technique (C-ACT). METHODS: One hundred participants were randomly assigned to the control group (n = 48, microfracture) or the investigational group (n = 52, C-ACT). Clinical and magnetic resonance imaging (MRI) outcomes were assessed 12 and 24 months postoperatively for efficacy and adverse events. Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) assessment was used to analyze cartilage tissue repair. MRI outcomes for 50% defect filling and repaired tissue/reference cartilage (RT/RC) ratio were quantified using T2 mapping. Clinical outcomes were assessed using the visual analogue scale (VAS) for pain and 20% improvement, minimal clinically important difference (MCID), and patient acceptable symptom state for Knee Injury and Osteoarthritis Outcome Score (KOOS) and the International Knee Documentation Committee score. RESULTS: MOCART scores in the investigation group showed improved defect repair and filling (P = .0201), integration with the border zone (P = .0062), and effusion (P = .0079). MRI outcomes showed that the odds ratio (OR) for >/=50% defect filling at 12 months was statistically higher in the investigation group (OR 3.984, P = .0377). Moreover, the likelihood of the RT/RC OR becoming >/=1 was significantly higher (OR 11.37, P = .0126) in the investigation group. At 24 months postoperatively, the OR for the VAS 20% improvement rate was significantly higher in the investigational group (OR 2.808, P = .047). Twenty-three patients (52.3%) in the control group and 35 (77.8%) in the investigation group demonstrated more than the MCID of KOOS pain from baseline to 1 year postoperatively, with a significant difference between groups (P = .0116). CONCLUSION: In this multicenter randomized trial, the addition of C-ACT resulted in better filling of cartilage defect of the knee joint. LEVEL OF EVIDENCE: Level Ⅰ, Multicenter Randomized Controlled Trial. CI - Copyright (c) 2019 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved. FAU - Kim, Man Soo AU - Kim MS AD - Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. FAU - Chun, Churl Hong AU - Chun CH AD - Department of Orthopaedic Surgery, Wonkwang University Hospital, College of Medicine, Wonkwang University, Iksan, Korea. FAU - Wang, Joon Ho AU - Wang JH AD - Department of Orthopaedic Surgery, Samsung Medical Center, College of Medicine, Sungkyunkwan University of School of Medicine, Seoul, Korea. FAU - Kim, Jin Goo AU - Kim JG AD - Department of Orthopedic Surgery, Seoul Paik Hospital, College of Medicine, Inje University, Seoul, Korea. FAU - Kang, Seung-Baik AU - Kang SB AD - Department of Orthopaedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea. FAU - Yoo, Jae Doo AU - Yoo JD AD - Department of Orthopaedic Surgery, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul, Korea. FAU - Chon, Je-Gyun AU - Chon JG AD - Department of Orthopaedic Surgery, Daejeon Sun Hospital, Daejeon, Korea. FAU - Kim, Myung Ku AU - Kim MK AD - Department of Orthopaedic Surgery, Inha University Hospital, College of Medicine, Inha University, Incheon, Korea. FAU - Moon, Chan Woong AU - Moon CW AD - Department of Orthopaedic Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea. FAU - Chang, Chong Bum AU - Chang CB AD - Department of Orthopaedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea. FAU - Song, In Soo AU - Song IS AD - Department of Orthopaedic Surgery, Daejeon Sun Hospital, Daejeon, Korea. FAU - Ha, Jeong Ku AU - Ha JK AD - Department of Orthopedic Surgery, Seoul Paik Hospital, College of Medicine, Inje University, Seoul, Korea. FAU - Choi, Nam Yong AU - Choi NY AD - Department of Orthopaedic Surgery, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. FAU - In, Yong AU - In Y AD - Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. Electronic address: iy1000@catholic.ac.kr. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20191127 PL - United States TA - Arthroscopy JT - Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association JID - 8506498 RN - 9007-34-5 (Collagen) SB - IM CIN - Arthroscopy. 2020 Jun;36(6):1625-1628. PMID: 32503774 MH - Animals MH - Cartilage Diseases/complications/diagnosis/*therapy MH - Cartilage, Articular/*transplantation MH - Chondrogenesis/*physiology MH - Collagen/*pharmacology MH - Female MH - Follow-Up Studies MH - Fractures, Stress/etiology/pathology/*therapy MH - Humans MH - Knee Joint/diagnostic imaging/*surgery MH - Magnetic Resonance Imaging MH - Male MH - Middle Aged MH - Swine MH - Transplantation, Autologous MH - Treatment Outcome EDAT- 2019/12/01 06:00 MHDA- 2020/11/11 06:00 CRDT- 2019/12/01 06:00 PHST- 2019/05/21 00:00 [received] PHST- 2019/11/01 00:00 [revised] PHST- 2019/11/16 00:00 [accepted] PHST- 2019/12/01 06:00 [pubmed] PHST- 2020/11/11 06:00 [medline] PHST- 2019/12/01 06:00 [entrez] AID - S0749-8063(19)31100-4 [pii] AID - 10.1016/j.arthro.2019.11.110 [doi] PST - ppublish SO - Arthroscopy. 2020 Jun;36(6):1612-1624. doi: 10.1016/j.arthro.2019.11.110. Epub 2019 Nov 27.