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      Matrix-induced autologous chondrocyte implantation for the treatment of chondral defects of the knees in Chinese patients

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          Abstract

          Articular cartilage injury is the most common type of damage seen in clinical orthopedic practice. The matrix-induced autologous chondrocyte implant (MACI) was developed to repair articular cartilage with an advance on the autologous chondrocyte implant procedure. This study aimed to evaluate whether MACI is a safe and efficacious cartilage repair treatment for patients with knee cartilage lesions. The primary outcomes were the Knee Injury and Osteoarthritis Outcome Score (KOOS) domains and magnetic resonance imaging (MRI) results, compared between baseline and postoperative months 3, 6, 12, and 24. A total of 15 patients (20 knees), with an average age of 33.9 years, had a mean defect size of 4.01 cm 2. By 6-month follow-up, KOOS results demonstrated significant improvements in symptoms and knee-related quality of life. MRI showed significant improvements in four individual graft scoring parameters at 24 months postoperatively. At 24 months, 90% of MACI grafts had filled completely and 10% had good-to-excellent filling of the chondral defect. Most (95%) of the MACI grafts were isointense and 5% were slightly hyperintense. Histologic evaluation at 15 and 24 months showed predominantly hyaline cartilage in newly generated tissue. There were no postoperative complications in any patients and no adverse events related to the MACI operation. This 2-year study has confirmed that MACI is safe and effective with the advantages of a simple technique and significant clinical improvements. Further functional and mechanistic studies with longer follow-up are needed to validate the efficacy and safety of MACI in patients with articular cartilage injuries.

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          Most cited references 39

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          The etiology of chondromalacia patellae.

           E Outerbridge (1961)
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            Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis.

            To determine the relationship between change in body mass and knee-joint moments and forces during walking in overweight and obese older adults with knee osteoarthritis (OA) following an 18-month clinical trial of diet and exercise. Data were obtained from 142 sedentary, overweight, and obese older adults with self-reported disability and radiographic evidence of knee OA who underwent 3-dimensional gait analysis. Gait kinetic outcome variables included peak knee-joint forces and peak internal knee-joint moments. Mixed regression models were created to predict followup kinetic values, using followup body mass as the primary explanatory variable. Baseline body mass was used as a covariate, and thus followup body mass was a surrogate measure for change in body mass (i.e., weight loss). There was a significant direct association between followup body mass and peak followup values of compressive force (P = 0.001), resultant force (P = 0.002), abduction moment (P = 0.03), and medial rotation moment (P = 0.02). A weight reduction of 9.8 N (1 kg) was associated with reductions of 40.6 N and 38.7 N in compressive and resultant forces, respectively. Thus, each weight-loss unit was associated with an approximately 4-unit reduction in knee-joint forces. In addition, a reduction in body weight of 9.8 N (1 kg) was associated with a 1.4% reduction (0.496 Nm) in knee abduction moment. Our results indicate that each pound of weight lost will result in a 4-fold reduction in the load exerted on the knee per step during daily activities. Accumulated over thousands of steps per day, a reduction of this magnitude would appear to be clinically meaningful.
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              Evidence-based status of microfracture technique: a systematic review of level I and II studies.

              Although many newer cartilage repair techniques have evolved over the past 2 decades, microfracture is still being advocated as the first line of treatment. Therefore it is timely to conduct a comprehensive review of the literature to assess and report on the current status of Level I and II evidence studies related to microfracture techniques.
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                Author and article information

                Journal
                Drug Des Devel Ther
                Drug Des Devel Ther
                Drug Design, Development and Therapy
                Drug Design, Development and Therapy
                Dove Medical Press
                1177-8881
                2014
                05 December 2014
                : 8
                : 2439-2448
                Affiliations
                [1 ]Department of Orthopedics, General Hospital of Chinese People’s Armed Police Forces (CAPF), Beijing
                [2 ]Department of MRI Center, General Hospital of CAPF, Beijing, People’s Republic of China
                [3 ]Center for Orthopedic Research, School of Surgery and Pathology, University of Western Australia, Perth, Western Australia, Australia
                [4 ]Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL, USA
                [5 ]Guizhou Provincial Key Laboratory for Regenerative Medicine, Stem Cell and Tissue Engineering Research Center and Sino–US Joint Laboratory for Medical Sciences, Guiyang Medical University, Guiyang, Guizhou
                [6 ]Medical Research Center, General Hospital of Chinese People’s Armed Police Forces (CAPF), Beijing, People’s Republic of China
                Author notes
                Correspondence: Aibing Liu, Medical Research Center, General Hospital of Chinese People’s Armed Police Forces (CAPF), 69 Yongding Road, Beijing, People’s Republic of China, Tel +86 10 5797 5922, Fax +86 10 6863 9576, Email doctor_liuaibing@ 123456aliyun.com
                Shu-Feng Zhou, Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, 12901 Bruce B Downs Blvd, MDC 30, Tampa, FL, USA, Tel +1 813 974 6276, Fax +1 813 905 9885, Email szhou@ 123456health.usf.edu
                Article
                dddt-8-2439
                10.2147/DDDT.S71356
                4266264
                25525334
                © 2014 Zhang et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License

                The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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                Original Research

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