Academic Journal
Does the Choice of Acellular Scaffold and Augmentation With Bone Marrow Aspirate Concentrate Affect Short-term Outcomes in Cartilage Repair? A Systematic Review and Meta-analysis
| العنوان: | Does the Choice of Acellular Scaffold and Augmentation With Bone Marrow Aspirate Concentrate Affect Short-term Outcomes in Cartilage Repair? A Systematic Review and Meta-analysis |
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| المؤلفون: | Ow, Zachariah Gene Wing, Cheang, Hannah Li Xin, Koh, Jin Hean, Koh, Joshua Zhi En, Lim, Katelyn Kaye-Ling, Wang, Dean, Minas, Tom, Carey, James L., Lin, Heng An, Wong, Keng Lin |
| المصدر: | The American Journal of Sports Medicine ; volume 51, issue 6, page 1622-1633 ; ISSN 0363-5465 1552-3365 |
| بيانات النشر: | SAGE Publications |
| سنة النشر: | 2022 |
| الوصف: | Background: Matrix-induced chondrogenesis (MIC) is a promising treatment option for critical-size cartilage lesions of the knee; however, there exists substantial heterogeneity in the choice of acellular scaffold matrix for MIC cartilage repairs. Hypothesis: The choice of acellular matrix will not affect patient outcomes after MIC cartilage repair procedures, and the addition of concentrated bone marrow aspirate (cBMA) will improve short-term patient outcomes regardless of matrix choice. Study Design: Meta-analysis; Level of evidence, 4. Methods: Studies were stratified by matrix type: multilayered, single layered, and gel based. Continuous outcomes were analyzed with pairwise meta-analysis using the inverse variance model with random effects applied. Binary outcomes were analyzed as pooled proportions in a single-arm fashion; after which, reconstruction of relative risks (RRs) with confidence intervals was performed using the Katz logarithmic method. Results: A total of 876 patients were included: 469 received multilayered bioscaffolds; 238, gel-based scaffolds; and 169, single-layered scaffolds. The mean age of patients was 36.2 years (95% CI, 33.9 to 38.4), while the mean lesion size was 3.91 cm 2 (95% CI, 3.40 to 4.42). The weighted mean follow-up was 23.8 months (95% CI, 20.1 to 27.6). Multilayered bioscaffolds were most effective at improving visual analog scale scores ( P = .03; weighted mean difference [WMD], −4.44 [95% CI, −4.83 to −4.06]; P < .001). There were significantly lower risks of incomplete defect filling for gel-based scaffolds when compared with multilayered scaffolds (RR, 0.78 [95% CI, 0.69 to 0.88]; P < .001) and single-layered scaffolds (RR, 0.58 [95% CI, 0.41 to 0.81]; P = .001). Augmentation with cBMA further improved clinical scores across all scaffolds, with significant improvements in Tegner score ( P = .02), while decreasing incomplete defect filling rates as well. There was significantly greater improvement in visual analog scale scores ( P = .01) for single-layered scaffolds ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1177/03635465211069565 |
| الاتاحة: | https://doi.org/10.1177/03635465211069565 http://journals.sagepub.com/doi/pdf/10.1177/03635465211069565 http://journals.sagepub.com/doi/full-xml/10.1177/03635465211069565 |
| Rights: | http://journals.sagepub.com/page/policies/text-and-data-mining-license |
| رقم الانضمام: | edsbas.800CBBAD |
| قاعدة البيانات: | BASE |
| DOI: | 10.1177/03635465211069565 |
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