Trial reportOrthopaedic surgery2026
Long-Term Efficacy of Arthroscopic Microfracture Combined With Autologous Collagen-Induced Chondrogenesis for Knee Cartilage Defects: A 5-Year Prospective Pilot Randomized Controlled Trial.
Trial report in Orthopaedic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
objectivesCartilage defect of the knee joint is a common cause of knee pain and can result in significant functional disability due to its limited capability of spontaneous healing. Existing surgical options-such as microfracture, cartilage or chondrocyte transplantation, and joint replacement-remain limited by inconsistent restoration of durable hyaline cartilage. Autologous collagen-induced chondrogenesis (ACIC), which employs a collagen scaffold, has emerged as a promising single-stage alternative. Nevertheless, high-quality evidence evaluating its long-term efficacy relative to microfracture alone is still lacking. This study investigates the clinical effect of arthroscopic microfracture combined with autologous collagen-induced chondrogenesis for knee cartilage defects over a 5-year follow-up.
methodsTwenty patients with knee cartilage defects were randomized to receive ACIC + microfracture (n = 10) or microfracture alone (MF, n = 10). Outcomes were assessed using Lysholm, VAS, and IKDC scores at baseline, 1 week, 3, 6, 12 months, and 5 years, alongside MRI-based MOCART scoring. Analyses employed linear mixed-effects models with multiplicity correction and effect size reporting.
resultsBoth groups showed significant within-group improvements in Lysholm, VAS, and IKDC over time, but there were no between-group differences and no significant Group × Time interactions, indicating comparable functional recovery. In contrast, the MOCART score showed a significant long-term Group × Time interaction at 5 years (β = 53.1, 95% CI 29.0-77.2, p < 0.001), favoring ACIC + MF. At 5 years, ACIC + MF demonstrated a large structural advantage, although the unadjusted Mann-Whitney p = 0.0196 did not remain significant after multiplicity correction (adjusted p = 0.098).
conclusionACIC + MF resulted in superior long-term structural repair compared with MF, as reflected in MOCART scores, but this did not translate into superior patient-reported outcomes. These findings underscore the divergence between imaging-based repair and clinical function and highlight the need for prospective trials establishing anchor-based MCID and Patient Acceptable Symptom State (PASS) thresholds for MOCART to clarify its clinical significance.
trial registrationChinese National Medical Research Registration and Archival Information System: ChiCTR2400080094.
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