Biophysical stimulation improves clinical results of matrix-assisted autologous chondrocyte implantation in the treatment of chondral lesions of the knee.

Abstract

The purpose of the present study was to evaluate the effects of pulsed electromagnetic fields (PEMFs) on clinical outcome in patients who underwent arthroscopic matrix-assisted autologous chondrocyte implantation (MACI) for chondral lesions of the knee. Thirty patients affected by grade III and IV International Cartilage Repair Society chondral lesions of the knee underwent MACI. After surgery, patients were randomly assigned to either experimental group (PEMFs 4h per day for 60days) or control group . Clinical outcome was evaluated through International Knee Documentation Committee (IKDC) subjective knee evaluation form, Visual Analog Scale, Short Form-36 (SF-36) and EuroQoL before surgery and 1, 2, 6, and 60months postoperative. Mean size of chondral lesion was 2.4±0.6cm2 in the PEMFs group and 2.5±0.5cm2 in the control one. No differences were found between groups at baseline. IKDC score increased in both groups till 6months, but afterward improvement was observed only in the experimental group with a significant difference between groups at 60months (p=0.001). A significant difference between groups was recorded at 60months for SF-36 (p=0.006) and EuroQol (p=0.020). A significant pain reduction was observed in the experimental group at 1-, 2- and 60-month follow-up. Biophysical stimulation with PEMFs improves clinical outcome after arthroscopic MACI for chondral lesions of the knee in the short- and long-term follow-up. Biophysical stimulation should be considered as an effective tool in order to ameliorate clinical results of regenerative medicine. The use of PEMFs represents an innovative therapeutic approach for the survival of cartilage-engineered constructs and consequently the success of orthopaedic surgery. II.