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Subject Area

Orthopedic Surgery

Article Type

Original Study

Abstract

Objective To evaluate the clinical and radiological outcomes of microfracture alone versus with augmentation by bone marrow aspirate concentrate (BMAC) in the management of knee chondral lesions. Background Bone marrow aspirate is a cost-effective method in delivering mesenchymal stem cells to aid in the repair of cartilage defects. Patients and methods Patients were mutually allocated into two groups at a ratio of 1: 1: in group A 15 patients were managed by microfracture and in group B 15 patients were managed by BMAC augmented microfracture. All patients had grade III or IV chondral lesion at the weight-bearing surface of femoral condyles. The International Knee Documentation committee score was used for the clinical evaluation of patients. Also, radiograph and MRI were used for radiographic evaluation. Results The patients were followed up for 6 months. The International Knee Documentation Committee score was significantly improved in both groups (P = 0.023 in group A and 0.002 in group B). Group B showed better improvement than group A in patients younger than 45 years old. Also, MRI signal was significantly improved in both groups. The most common postoperative complication was mild effusion (66.7% of cases), which responded well to medical treatment. Conclusion Augmentation of microfracture with BMAC for the treatment of knee chondral lesions provides better clinical outcomes in patients younger than or equal to 45 years old.

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