Evidence map›Paper›PMID 30705535›Full record

ArticleJournal of clinical orthopaedics and trauma

Microfractures and hydrogel scaffolds in the treatment of osteochondral knee defects: A clinical and histological evaluation.

Gennaro Pipino, Salvatore Risitano, Francesco Alviano, Edward J Wu, Laura Bonsi, Davide Corrado Vaccarisi, Pier Francesco Indelli

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical orthopaedics and trauma. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 3 pooled it
4.5field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 57 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 3 countries.

Gennaro PipinoFaculty of Medical Sciences, LUdeS HEI Malta Campus Lugano, Switzerland.
Salvatore RisitanoDept. Orthopaedic Surgery and Bioengineering, Stanford University School of Medicine, Stanford, USA.
Francesco AlvianoUniversity of Bologna School of Medicine, Department of Histology, Bologna, Italy.
Edward J WuDept. Orthopaedic Surgery and Bioengineering, Stanford University School of Medicine, Stanford, USA.
Laura BonsiUniversity of Bologna School of Medicine, Department of Histology, Bologna, Italy.
Davide Corrado VaccarisiFaculty of Medical Sciences, LUdeS HEI Malta Campus Lugano, Switzerland.
Pier Francesco IndelliDept. Orthopaedic Surgery and Bioengineering, Stanford University School of Medicine, Stanford, USA.
Stanford University · USLUdeS University · CHUniversity of Bologna · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOsteochondral knee defects (OCD) are often symptomatic, causing pain and functional impairment even in young and active patients. Regenerative surgical options, aiming to stimulate natural cartilage healing, have been recently used as a first line treatment. In this study, a new hydrogel is investigated in its capacity to regenerate the ultra-structural quality of hyaline cartilage when combined with a classical microfracture technique. MATERIAL AND

methodsForty-six patients, affected by grade III and IV knee chondropathies, were consecutively treated between 2013 and 2015 with microfractures followed by application of a modern hydrogel in the lesion site. All patients underwent clinical evaluation (WOMAC) pre-operatively, at 6,12 and at 24 months postoperatively: the results were compared with a subsequent, consecutive, matched, control group of 23 patients treated with microfractures alone. In a parallel and separate in-vitro histological study, adipose derived mesenchymal stem cells (ADMSCs) were encapsulated in the hydrogel scaffold, induced to differentiation into chondrocytes, and observed for a 3 weeks period.

resultsThe initial WOMAC score of 58.6 ± 11.0 in the study group was reduced by 88% at 6 months (7.1 ± 9.2) and 95% at 24 months (2.9 ± 5.9). The "in-vitro" study revealed a histological characterization typical of hyaline cartilage in study group. Separate biopsies performed at 12 months post-op in the study group also revealed type 2 collagen and hyaline-like cartilage in the regenerated tissue.

conclusionOur study demonstrated high patient satisfaction rates after microfractures combined with a modern hydrogel scaffold; histologic evaluation supported the hypothesis of creating an enhanced chondrogenic environment. Microfracture "augmentation" using modern acellular biomaterials, like hydrogels, might improve the clinical outcomes of this classical bone marrow stimulating procedure.

Indexed as

ACI, autologous chondrocyte implantationAMIC, Autologous Matrix Induced ChondrogenesisArthroscopicASCs, adipose mesenchymal stem cellsBMI, body mass indexBMS, bone marrow stem cellsBMS, bone marrow stimulationCartilagehASCs, Human adipose-derived stromal/stem cellsHydrogelsKneeMACI, mixed-assisted chondrocyte implantationMicrofracturesOAT, osteochondral autograft transferOCA, Osteochondral allograft transplantationOCDOCD, osteochondral defectOsteochondral defectPG/GC, polyglucosamine/glucosamine carbonateScaffoldWOMAC, (Western Ontario and McMaster Universities Osteoarthritis Index)

Identifiers

PMID30705535
PMCPMC6349629
OpenAlexW2790970342

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.