{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T19:22:21Z","timestamp":1773602541282,"version":"3.50.1"},"reference-count":30,"publisher":"Royal College of Surgeons of England","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The morbidity and significant health economic impact associated with the chondral lesion has led to a large number of strategies for therapeutic neochondrogenesis. The challenge has been to develop techniques that are cost effective single-stage procedures with minimal surgical trauma that have undergone rigorous preclinical scrutiny and robust reproducible assessment of effectiveness. A biological repair requires the generation of a cellular and matrix composite with appropriate signalling for chondrogenic differentiation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>A technique was developed that allowed chondrogenic primary (uncultured) cells from bone marrow aspirate concentrate, combined with a composite hydrophilic and fibrillar matrix to be applied arthroscopically to a site of a chondral lesion. The construct was tested in vitro and in animal experiments before clinical trials. Clinical trials involved 60 patients in a prospective study. Symptomatic International Cartilage Repair Society grade 3 and 4a lesions were mapped and treated. Pre- and postoperative clinical assessments showed statistically significant improved outcomes; Lysholm Knee Scoring Scale (mean 52.8 to &gt;\u00a076.4; P &lt; 0.05) International Knee Documentation Committee (mean 39 to &gt; 79 P &lt; 0.05) and Knee injury and Osteoarthritis Outcome Score (64.5 to &gt;89.2 P &lt; 0.05). Postoperative magnetic resonance imaging was evaluated morphologically (magnetic resonance observation of cartilage repair tissue, average MOCART score 72) and qualitatively; the regenerate was comparable to native cartilage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This technique is effective, affordable, requires no complex tools and delivers a single-stage treatment that is potentially accessible to any centre capable of performing arthroscopic surgery. Good clinical results were found to be sustained at five years of follow-up with a regenerate that appears hyaline like using multiple magnetic resonance measures.<\/jats:p><\/jats:sec>","DOI":"10.1308\/rcsann.2017.0223","type":"journal-article","created":{"date-parts":[[2018,3,1]],"date-time":"2018-03-01T15:04:21Z","timestamp":1519916661000},"page":"240-246","source":"Crossref","is-referenced-by-count":8,"title":["A cost-effective cell- and matrix-based minimally invasive single-stage chondroregenerative technique developed with validated vertical translation methodology"],"prefix":"10.1308","volume":"100","author":[{"given":"AA","family":"Shetty","sequence":"first","affiliation":[{"name":"Institute of Medical Sciences, Faculty of Health and Social Sciences, Canterbury Christ Church University, Chatham Maritime, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SJ","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, 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