الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Articular cartilage defects of the knee are a frequently
encountered injury. Cartilage damage may occur after a single severe
mechanical impact or following less severe but repetitive microtrauma. Another
etiology factor is the degenerative process. Articular cartilage has limited to no
ability to spontaneously repair because of its avascular status. When left
untreated, full-thickness chondral defects can lead to degenerative joint
symptoms such as pain, swelling, and joint dysfunction. Joint preservation
surgery (via reparative, reconstructive, and replacement techniques) has become
increasingly utilized over the past decades. However currently, there is great
interest in bone marrow aspirate concentrate (BMAC) as a cost-effective
method in delivering mesenchymal stem cells (MSCs) to aid in the repair and
regeneration of cartilage defects.
Aim of the work: The aim of this work was to evaluate the clinical and
radiological outcome of microfracture with versus without augmentation by
bone marrow aspirate concentrate in management of knee chondral lesions.
Patients and methods: Between August 2018 to May 2021, this
prospective cohort study included 30 patients of arthroscopically diagnosed
grade III or IV knee chondral lesions of weight-bearing surfaces of the femoral
condyles. Patients were mutually allocated into group-(A) of 15 patients
(managed by stand-alone microfracure); and group-(B) of 15 patients (managed
by bone marrow aspirate concentrate-augmented microfracture). Patients were
evaluated for demographics and for preoperative and 6-month postoperative
International Knee Documentation Committee (IKDC) scoring system and MRI
grading using Brittberg classification.
Results: Statistically, groups were matched in terms of demographics,
preoperative clinical and imaging findings, functional scoring and arthroscopic findings. There was significant improvement of postoperative subjective and
objective forms of IKDC in both groups. In addition, the most significant
postoperative functional improvement was evident in patients younger than 45
years notably in group-B but it was insignificant in those who were older than
45 years. Also, in both groups, analysis revealed significant improvement of
MRI grading of the chondral lesion. The most common postoperative
complication was mild effusion (66.7% of cases) which responded well to
medical treatment.