{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T02:44:27Z","timestamp":1775616267107,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2026,4]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n Cartilage defect of the knee joint is a common cause of knee pain and can result in significant functional disability due to its limited capability of spontaneous healing. Existing surgical options\u2014such as microfracture, cartilage or chondrocyte transplantation, and joint replacement\u2014remain limited by inconsistent restoration of durable hyaline cartilage. Autologous collagen\u2010induced chondrogenesis (ACIC), which employs a collagen scaffold, has emerged as a promising single\u2010stage alternative. Nevertheless, high\u2010quality evidence evaluating its long\u2010term efficacy relative to microfracture alone is still lacking. This study investigates the clinical effect of arthroscopic microfracture combined with autologous collagen\u2010induced chondrogenesis for knee cartilage defects over a 5\u2010year follow\u2010up.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Twenty patients with knee cartilage defects were randomized to receive ACIC\u2009+\u2009microfracture (\n n<\/jats:italic>\n \u2009=\u200910) or microfracture alone (MF,\n n<\/jats:italic>\n \u2009=\u200910). Outcomes were assessed using Lysholm, VAS, and IKDC scores at baseline, 1\u2009week, 3, 6, 12\u2009months, and 5\u2009years, alongside MRI\u2010based MOCART scoring. Analyses employed linear mixed\u2010effects models with multiplicity correction and effect size reporting.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Both groups showed significant within\u2010group improvements in Lysholm, VAS, and IKDC over time, but there were no between\u2010group differences and no significant Group\u2009\u00d7\u2009Time interactions, indicating comparable functional recovery. In contrast, the MOCART score showed a significant long\u2010term Group\u2009\u00d7\u2009Time interaction at 5\u2009years (\n \u03b2<\/jats:italic>\n \u2009=\u200953.1, 95% CI 29.0\u201377.2,\n p<\/jats:italic>\n \u2009<\u20090.001), favoring ACIC\u2009+\u2009MF. At 5\u2009years, ACIC\u2009+\u2009MF demonstrated a large structural advantage, although the unadjusted Mann\u2013Whitney\n p<\/jats:italic>\n \u2009=\u20090.0196 did not remain significant after multiplicity correction (adjusted\n p<\/jats:italic>\n \u2009=\u20090.098).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n ACIC\u2009+\u2009MF resulted in superior long\u2010term structural repair compared with MF, as reflected in MOCART scores, but this did not translate into superior patient\u2010reported outcomes. These findings underscore the divergence between imaging\u2010based repair and clinical function and highlight the need for prospective trials establishing anchor\u2010based MCID and Patient Acceptable Symptom State (PASS) thresholds for MOCART to clarify its clinical significance.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n Chinese National Medical Research Registration and Archival Information System: ChiCTR2400080094<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/os.70226","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:32:09Z","timestamp":1773012729000},"page":"631-640","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Term Efficacy of Arthroscopic Microfracture Combined With Autologous Collagen\u2010Induced Chondrogenesis for Knee Cartilage Defects: A 5\u2010Year Prospective Pilot Randomized Controlled Trial"],"prefix":"10.1111","volume":"18","author":[{"given":"Shuofang","family":"Ren","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Peking Union Medical College Hospital Chinese Academy of Medical Sciences Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhuosong","family":"Bai","sequence":"additional","affiliation":[{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Peking Union Medical College Hospital Chinese Academy of Medical Sciences Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Peking Union Medical College Hospital Chinese Academy of Medical Sciences Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu","family":"Sun","sequence":"additional","affiliation":[{"name":"Operating Room, Peking Union Medical College Hospital Chinese Academy of Medical Sciences Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Tang","sequence":"additional","affiliation":[{"name":"Operating Room, Peking Union Medical College Hospital Chinese Academy of Medical Sciences Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3223-9936","authenticated-orcid":false,"given":"Bo","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Peking Union Medical College Hospital Chinese Academy of Medical Sciences Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Peking Union Medical College Hospital Chinese Academy of Medical Sciences Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guixing","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Peking Union Medical College Hospital Chinese Academy of Medical Sciences Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2002.32839"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1024\/0040-5930\/a000712"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2006.033548"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-8063(97)90124-9"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2014.06.004"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2015.02.010"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina59030530"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2014.11.017"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s005860050020"},{"issue":"2","key":"e_1_2_12_11_1","first-page":"83","article-title":"The Microfracture Technique in the Treatment of Full\u2010Thickness Chondral Lesions of the Knee in National Football League Players","volume":"16","author":"Steadman J. R.","year":"2003","journal-title":"Journal of Knee Surgery"},{"issue":"3","key":"e_1_2_12_12_1","first-page":"170","article-title":"Microfracture to Treat Full\u2010Thickness Chondral Defects: Surgical Technique, Rehabilitation, and Outcomes","volume":"15","author":"Steadman J. R.","year":"2002","journal-title":"Journal of Knee Surgery"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2003.50112"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00018-005-5527-z"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tice.2005.05.004"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508328414"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2006.05.003"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-013-2676-8"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506288853"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2016.01.017"},{"issue":"2","key":"e_1_2_12_21_1","first-page":"260","article-title":"Autologous Matrix\u2010Induced Chondrogenesis (AMIC). A One\u2010Step Procedure for Retropatellar Articular Resurfacing","volume":"76","author":"Benthien J. P.","year":"2010","journal-title":"Acta Orthopaedica Belgica"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-010-1042-3"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-011-1840-2"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2016.05.003"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20130426-30"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2019.11.110"},{"key":"e_1_2_12_27_1","unstructured":"A. N.Silva W. A. J.Lim J. W. G.Cheok C.Gatot andH. C. A.Tan \u201cAutologous Collagen\u2010Induced Chondrogenesis Versus Microfracture for Chondral Defects of the Knee: Surgical Technique and 2\u2010Year Comparison Outcome Study\u201d."}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.70226","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/os.70226","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.70226","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T01:52:17Z","timestamp":1775613137000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.70226"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,25]]},"references-count":26,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/os.70226"],"URL":"https:\/\/doi.org\/10.1111\/os.70226","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,25]]},"assertion":[{"value":"2025-05-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}