Biphasic scaffold loaded with autologous cartilage yields better clinical outcome and MRI filling compared with Marrow Stimulation for Focal Osteochondral Lesions in the Knee

PurposeThe purpose of this study was to evaluate the effectiveness of Marrow stimulation (MS) versus biphasic scaffold loaded with autologous cartilage (Scaffold) in treating focal osteochondral lesions of the knee.Methods54 patients with symptomatic focal chondral or osteochondral lesion in the knee were randomized to either the Scaffold group or the MS group. International Knee Documentation Committee (IKDC) subjective score, the Knee Injury Osteoarthritis Outcome Score (KOOS), and Magnetic Resonance Imaging (MRI) were assessed preoperatively, and at one and two years postoperatively to compare treatment outcomes. Biopsy and second-look arthroscopy were performed one year postoperatively for consenting patients.ResultsThere were 27 patients (Mean age 31.33 ± 10.95) in the Scaffold group, and 27 patients (31.74 ± 11.44) in the MS group. The scaffold group and the MS group both included 23 patients with lesions ≤12.5 × 12.5 mm2 mm in size. Additionally, each group had 4 patients with lesions between than 12.5 × 12.5 mm2 and ≤ 12.5 × 25 mm2. Both interventions achieved significant improvement in clinical outcome scores at two years. The Scaffold group had higher IKDC score than the MS group at two years (93.85 ± 9.55 vs 92.11 ± 9.84) and in the Symptoms/stiffness and Sport/recreation subscales of KOOS at two years (96.57 ± 5.97 vs 93.57 ± 6.52, P < 0.05) and (90.2 ± 17.76 vs 82.8 ± 16.08, P < 0.05).ConclusionThe use of biphasic scaffold loaded with autologous cartilage in treating focal osteochondral lesions demonstrates superior clinical outcomes and better cartilage refill on MRI at the two-year follow-up compared to marrow stimulation.