{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:29:32Z","timestamp":1792369772386,"version":"4.4.0"},"reference-count":54,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2016,7,30]],"date-time":"2016-07-30T00:00:00Z","timestamp":1469836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Articular cartilage injury is frequently encountered, yet treatment options capable of providing durable cartilage repair are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To investigate the medium-term clinical outcomes of cartilage repair using a 1-stage technique of a hyaluronic acid\u2013based scaffold with activated bone marrow aspirate concentrate (HA-BMAC) and compare results with those of microfracture. A secondary aim of this study was to identify specific patient demographic factors and cartilage lesion characteristics that are associated with superior outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cohort study; Level of evidence, 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Fifty physically active patients (mean age, 45 years) with grade IV cartilage injury of the knee (lesion size, 1.5-24 cm\n                      <jats:sup>2<\/jats:sup>\n                      ) were treated with HA-BMAC or microfracture and were observed prospectively for 5 years. Patients were placed into the HA-BMAC group if the health insurance policy of the treating institution supported this option; otherwise, they were placed into the microfracture group. Objective and subjective clinical assessment tools were used preoperatively and at 2 and 5 years postoperatively to compare treatment outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Significant improvements in outcome scores were achieved in both treatment groups at 2 years ( P &lt; .001). In the microfracture group, 64% were classified as normal or nearly normal according to the International Knee Documentation Committee (IKDC) objective score at 2 years, compared with 100% of those treated with HA-BMAC ( P &lt; .001). Normal or nearly normal objective assessments in the microfracture group declined significantly after 5 years to 28% of patients ( P = .004). All patients treated with HA-BMAC maintained improvement at 5 years according to Lysholm, Tegner, IKDC objective, and IKDC subjective scores. Tegner, IKDC objective, and Knee injury and Osteoarthritis Outcome Score (KOOS) assessments demonstrated higher scores in the HA-BMAC treatment group compared with microfracture at 5 years. Lysholm and IKDC subjective scores were similar between treatment groups at 5 years. Poorer outcomes in the microfracture group were demonstrated in cases of lesions larger than 4 cm\n                      <jats:sup>2<\/jats:sup>\n                      and nonsolitary lesions. Age greater than 45 years, large size of lesion, and treatment of multiple lesions were not associated with poorer outcome in patients treated with HA-BMAC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Repair of chondral injury using a hyaluronic acid\u2013based scaffold with activated bone marrow aspirate concentrate provides better clinical outcomes and more durable cartilage repair at medium-term follow-up compared with microfracture. Positive short-term clinical outcomes can be achieved with either microfracture or HA-BMAC. Cartilage repair using HA-BMAC leads to successful medium-term outcomes independent of age or lesion size.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0363546516656179","type":"journal-article","created":{"date-parts":[[2016,7,29]],"date-time":"2016-07-29T23:13:53Z","timestamp":1469834033000},"page":"2846-2854","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":198,"title":["One-Stage Cartilage Repair Using a Hyaluronic Acid\u2013Based Scaffold With Activated Bone Marrow\u2013Derived Mesenchymal Stem Cells Compared With Microfracture"],"prefix":"10.1177","volume":"44","author":[{"given":"Alberto","family":"Gobbi","sequence":"first","affiliation":[{"name":"Orthopaedic Arthroscopic Surgery International (OASI) Bioresearch Foundation Gobbi NPO, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graeme P.","family":"Whyte","sequence":"additional","affiliation":[{"name":"Orthopaedic Arthroscopic Surgery International (OASI) Bioresearch Foundation Gobbi NPO, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,7,30]]},"reference":[{"key":"bibr1-0363546516656179","doi-asserted-by":"publisher","DOI":"10.1089\/ten.tea.2008.0015"},{"key":"bibr2-0363546516656179","doi-asserted-by":"publisher","DOI":"10.1111\/j.2517-6161.1995.tb02031.x"},{"key":"bibr3-0363546516656179","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511399382"},{"key":"bibr4-0363546516656179","doi-asserted-by":"publisher","DOI":"10.1177\/1947603511435271"},{"key":"bibr5-0363546516656179","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514525910"},{"key":"bibr6-0363546516656179","first-page":"139","volume-title":"Impact on Cartilage Repair of the Knee: Patient Profiling and Single-Stage Regeneration","volume":"2015","author":"de Windt TS"},{"key":"bibr7-0363546516656179","doi-asserted-by":"publisher","DOI":"10.2217\/17460751.1.4.529"},{"key":"bibr8-0363546516656179","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-011-1777-5"},{"key":"bibr9-0363546516656179","doi-asserted-by":"publisher","DOI":"10.1006\/bbrc.2001.6270"},{"key":"bibr10-0363546516656179","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513518552"},{"key":"bibr11-0363546516656179","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-010-1042-3"},{"key":"bibr12-0363546516656179","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1247726"},{"key":"bibr13-0363546516656179","doi-asserted-by":"publisher","DOI":"10.1177\/1947603514563597"},{"key":"bibr14-0363546516656179","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-013-2676-8"},{"key":"bibr15-0363546516656179","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513518007"},{"key":"bibr16-0363546516656179","doi-asserted-by":"publisher","DOI":"10.1177\/1947603510392023"},{"key":"bibr17-0363546516656179","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509331419"},{"key":"bibr18-0363546516656179","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-004-0499-3"},{"key":"bibr19-0363546516656179","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514523927"},{"key":"bibr20-0363546516656179","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-010-1072-x"},{"key":"bibr21-0363546516656179","unstructured":"Harvest BMAC Cellular System. 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