The Role of Bone Marrow Aspirate Concentrate for the Treatment of Focal Chondral Lesions of the Knee: A Systematic Review and Critical Analysis of Animal and Clinical Studies

摘要: Purpose To summarize currently available data regarding the use of bone marrow aspirate concentrate (BMAC) for treatment focal chondral lesions knee in experimental animal models and human clinical studies. Methods A systematic review searching terms “(bone marrow)” AND “(aspirate OR concentrate)” “(cartilage osteochondral)” was performed databases PubMed, Cochrane Central Register Controlled Trials, Google Scholar BMAC knee. The inclusion criteria were studies published English that used autologous to treat defects We excluded evaluated nonconcentrated preparations or culture expanded. Results total 23 included: 10 13 Animal showed inconsistent outcomes efficacy osteochondral lesions, assessed by gross morphology, second-look arthroscopy, magnetic resonance imaging, histology, immunohistochemistry, mechanical testing, micro-tomography. Chondral defect filling achieved with fibrocartilage “hyaline-like” cartilage. Cells present did not meet be characterized as mesenchymal stem cells according International Society Cell Therapy because freshly isolated failed show tri-lineage differentiation. Overall, all studies, independent study group level evidence, reported improved higher macroscopic, histology scores. Comparative trials favored over microfracture equivalent between matrix-induced chondrocyte implantation. However, scant low scientific rigor, poor methodologic quality, levels evidence on average. Conclusions Although success short-term midterm applications has been suggested application restoration cartilage knee, current designs are generally rigor. In addition, this technology model investigations have shown outcomes. Thus, clinicians should apply cautiously. Level Evidence IV, II, III, IV