Single-Stage Arthroscopic Cartilage Repair With Gel Scaffold and BMAC

Area of Science:

• Orthopedic Surgery
• Regenerative Medicine
• Biomaterials Science

Background:

• Injectable scaffold augmentation is an emerging single-stage cartilage repair method.
• It enhances microfracture techniques by stabilizing the clot and providing a matrix for mesenchymal stem cell (MSC) retention and chondrogenic differentiation.
• Bone marrow aspirate concentrate (BMAC) is an alternative MSC source that may overcome microfracture limitations.

Purpose of the Study:

• To describe a technique using autologous matrix-induced chondrogenesis with a type 1 collagen scaffold (CartiFill) and BMAC.
• To present an alternative to traditional microfracture techniques for cartilage repair.

Main Methods:

• Utilized CartiFill, a porcine-derived type 1 collagen scaffold.
• Combined the scaffold with autologous bone marrow aspirate concentrate (BMAC) as the source of mesenchymal stem cells (MSCs).
• This technique avoids the need for microfracture.

Main Results:

• Injectable scaffold augmentation demonstrates superior radiological fill and histological repair quality compared to microfracture alone.
• This method offers versatility for treating challenging lesions, including vertical or inverted defects.
• Augmentation with BMAC provides MSCs without subchondral bone perforation.

Conclusions:

• Scaffold augmentation, particularly with BMAC, represents a significant advancement over conventional microfracture for cartilage repair.
• The technique offers enhanced versatility for complex cartilage defects.
• BMAC is a viable alternative source of MSCs for cartilage regeneration.