Systematic Reviews
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Dec 18, 2015; 6(11): 1006-1011
Published online Dec 18, 2015. doi: 10.5312/wjo.v6.i11.1006
Use of chondral fragments for one stage cartilage repair: A systematic review
Davide Edoardo Bonasia, Antongiulio Marmotti, Federica Rosso, Gianluca Collo, Roberto Rossi
Davide Edoardo Bonasia, Antongiulio Marmotti, Federica Rosso, Gianluca Collo, Roberto Rossi, Department of Orthopaedics and Traumatology, University of Torino, AO Mauriziano “Umberto I” Hospital, 10128 Torino, Italy
Author contributions: All authors contributed to this manuscript.
Conflict-of-interest statement: Dr. Rossi is a teaching program consultant for Zimmer. No other relevant financial disclosures regarding this paper.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Davide Edoardo Bonasia, MD, Department of Orthopaedics and Traumatology, University of Torino, AO Mauriziano “Umberto I” Hospital, Via Lamarmora 26, 10128 Torino, Italy. davidebonasia@virgilio.it
Telephone: +39-33-56068525
Received: May 21, 2015
Peer-review started: May 25, 2015
First decision: August 4, 2015
Revised: September 23, 2015
Accepted: October 23, 2015
Article in press: October 27, 2015
Published online: December 18, 2015
Processing time: 210 Days and 5.5 Hours
Abstract

AIM: To investigate the state of the art regarding Cartilage Autograft Implantation System (CAIS) or Particulated Juvenile Allograft Cartilage (PJAC).

METHODS: The authors searched the English literature regarding CAIS and PJAC. The search strategy was: (particulated cartilage) OR autologous cartilage fragments. All basic science articles were included. Clinical articles with less than 10 patients treated and less than 6 mo of follow-up were excluded. With these criteria, a total of 17 articles were available for the present review.

RESULTS: PJAC and CAIS are relatively novel techniques for cartilage repair. Good basic science evidence was described to support the concept. Although the preliminary clinical reports show encouraging results, clinical data are still limited, especially for CAIS. The indications for both techniques need to be precisely defined (age of the patients, size of the lesion, and involvement of the subchondral bone), together with other debated issues.

CONCLUSION: In conclusion, the authors can state that encouraging preliminary results are available for both techniques. However, further studies are necessary to precisely determine the indications, surgical techniques, and long term outcomes for PJAC and CAIS.

Keywords: Cartilage; Juvenile; Chondral fragments; Adult; Particulated cartilage

Core tip: In this systematic review regarding Cartilage Autograft Implantation System (CAIS) and Particulated Juvenile Allograft Cartilage (PJAC), basic science and clinical articles with more than 10 patients treated and more than 6 mo of follow-up were included. A total of 17 articles were available for the present review. Good basic science evidence in vitro and in vivo was described to support the concept of CAIS. Only one level II paper reported the clinical results of the CAIS technique. On the other hand, little basic science evidence and 4 preliminary clinical trials are available regarding the PJAC technique. CAIS and PJAC represent promising single step solutions for cartilage restoration with hyaline-like repair. However, many controversies still exist regarding both techniques, including the indications (age of the patients, size of the lesion, and involvement of the subchondral bone).