Single/two-step scaffold-based cartilage repair in the knee and ankle joint

Wolf S, Rosian K
Record ID 32018000346
Authors' objectives: Articular (chondral) cartilage is a thin layer of connective tissue. A damage of the cartilage can occur due to traumatic events, degeneration of the joint or due to osteochondritis dissecans. In this report, we analysed whether single-step/two-step scaffold-based cartilage repair (AMIC/MACI) is more effective and safer in comparison to microfracturing (MFx) or as effective but safer in comparison to autologous chondrocyte implantation.
Authors' results and conclusions: In total, for the knee joint data from six controlled trials for AMIC and five randomised controlled trials for MACI that met our inclusion criteria were extracted. No controlled trials for the ankle joint were identified. Overall, the level of evidence was rated as "very low" to "low" for the outcomes of clinical effectiveness and safety. The current evidence is not sufficient to conclude that AMIC or MACI is more effective and safer than MFx or as effective, but safer than ACI.
Authors' recomendations: We currently do not recommend the inclusion of the procedures in the Austrian hospital benefit catalogue. A re-evaluation of AMIC is recommended not before 2022 and of MACI not before 2021, as the publication of ongoing RCTs is to be awaited.
Project Status: Completed
Year Published: 2019
URL for additional information:
English language abstract: An English language summary is available
Publication Type: Full HTA
Country: Austria
MeSH Terms
  • Cartilage
  • Knee Joint
  • Ankle Joint
  • Therapeutics
  • Surgical Procedures, Operative
  • Transplantation, Autologous
  • Chondrogenesis
  • Tissue Scaffolds
  • Scaffold-based cartilage repair
  • cartilage defects
  • microfracturing
  • autologous chondrocyte implantation
  • chondrogenesis
  • AMIC
  • MACI
Organisation Name: Ludwig Boltzmann Institute for Health Technology Assessment
Contact Address: Ludwig Boltzmann Institute for fuer Health Technology Assessment (LBI-HTA), Garnisongasse 7/rechte Stiege Mezzanin (Top 20), 1090 Vienna, Austria. Tel: +43 1 236 8119 - 0 Fax: +43 1 236 8119 - 99
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This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.