1. Conferences Overview
    2. Deutscher Kongress für Orthopädie und Unfallchirurgie 2025 (DKOU 2025)
    3. Treatment of large chondral lesions with an autologous minced cartilage technique and synovial flap lead to superior results compared to matrix associated autologous chondrocyte transplantation technique after 24 months. A controlled clinical trial
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German Congress of Orthopaedics and Traumatology (DKOU 2025)

Deutsche Gesellschaft für Orthopädie und Unfallchirurgie (DGOU), Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie (DGOOC), Deutsche Gesellschaft für Unfallchirurgie (DGU), Berufsverband für Orthopädie und Unfallchirurgie (BVOU)
28.-31.10.2025
Berlin


Meeting Abstract

Treatment of large chondral lesions with an autologous minced cartilage technique and synovial flap lead to superior results compared to matrix associated autologous chondrocyte transplantation technique after 24 months. A controlled clinical trial

Johanna Mayr 1
Fabian Blanke 1
1Schön Klinik München Harlaching, Universitätsmedizin Rostock, Rostock, Deutschland

Text

Objective: The treatment of large cartilage lesions is still a challenge for orthopedic knee surgeons. Matrix-associated autologous chondrocyte implantation (MACI) has evolved to become the gold standard procedure for medium and large lesions, but the minced cartilage technique has shown promising results in small and medium lesions. The application of enhancing biomaterials is being discussed to use or improve this technique even in larger lesions. However, it is still unclear whether this technique is effective in large lesions because of the achievable tissue quality and the lack of data about this topic. Aim of this retrospective study was to evaluate the outcome of the minced cartilage technique with coverage by an autologous synovial flap in large cartilage lesions and compare the results with the MACI technique in same lesions at the knee joint.

Design: 20 patients with a magnet resonance imaging (MRI) confirmed large grade III–IV cartilage defect (>6 cm2) at the knee joint were included. 10 patients were treated with a whole autologous minced cartilage procedure (AutoCart™) and synovial flap (Group A) and 10 with MACI technique (Group B). Clinical knee function was evaluated by Tegner score, visual analog scale (VAS), the subjective and objective evaluation form of the International Knee Documentation Committee (IKDC) and the Knee Injury and Osteoarthritis Outcome Score (KOOS). MRI analysis were performed by MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) 2.0 knee score before and 24 months after surgical intervention.

Results: All clinical scores significantly improved in group A after surgical intervention. In group B only VAS score, pain and sport/recreations level improved. Apart from pain all clinical scores were significantly superior in group A compared to group B (p< 0.05). Postoperative MRI evaluation showed almost similar results between both groups. Only volume fill of cartilage defect and subchondral changes were significantly better in group A compared to group B (p<0.05).

Conclusion: Present study showed that an all-autologous minced cartilage procedure with synovial flap seems to be an effective treatment method in large chondral lesions with similar or even better outcome results compared to matrix-associated chondrocyte transplantation in these patients.