Autologous minced cartilage implantation combined with arthroscopic platelet-rich fibrin membrane in large chondral defects of the knee: a prospective comparative study
Journal of Cartilage and Joint Preservation, vol.6, no.2, 2026 (Scopus)
- Publication Type: Article / Article
- Volume: 6 Issue: 2
- Publication Date: 2026
- Doi Number: 10.1016/j.jcjp.2025.100270
- Journal Name: Journal of Cartilage and Joint Preservation
- Journal Indexes: Scopus
- Keywords: Articular cartilage, Biological healing enhancement, Chondroplasty, Minced cartilage, Nanofracture, Patient-reported outcome
- Hacettepe University Affiliated: Yes
Abstract
Introduction: Autologous minced cartilage implantation combined with platelet-rich fibrin membrane (m-PRF) may enhance chondrocyte viability by facilitating cell signaling between chondrocytes. Objectives: The study evaluated the clinical outcomes of nanofracture with m-PRF–combined minced cartilage implantation vs nanofracture alone for large chondral lesions of the knee Methods: A total of 79 physically active adult patients (mean age 46 ± 5.3 years) with International Cartilage Repair Society grade III to IV cartilage lesions >2 cm² of the femoral condyle or trochlea were included in this study. Patients who met the inclusion criteria were randomized into 2 surgical treatment groups. Group 1 underwent arthroscopic nanofracture followed by implantation of minced cartilage utilizing a membrane made from platelet rich in fibrin (m-PRF). Group 2 underwent arthroscopic debridement and nanofracture alone. All patients were evaluated prospectively with a minimum 2-year follow-up period, including 36 patients in Group 1 and 43 in Group 2 and assessed with International Knee Documentation Committee (IKDC) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) knee scores. Results: IKDC and WOMAC scores showed significant improvements in both groups at final follow-up. IKDC scores in Group 1 at final follow-up were significantly higher (87.1 ± 3.8) than Group 2 (84.4 ± 6.3) (P = .03). WOMAC scores improved from 52 ± 8.6 to 19.1 ± 5.1 in Group 1 and from 55 ± 6.2 to 24.2 ± 7.1 in Group 2. The complication rate was low for both groups. Conclusions: Arthroscopic m-PRF-combined minced cartilage implantation is an effective method for addressing chondral defects in the knee joint with low complication rates. m-PRF may function as a biological scaffold without the need for fixation.