Bone Marrow Aspirate Concentrate on Hyaluronic Acid Scaffold Combined With Intraarticular Platelet-Rich Plasma for Full-Thickness Knee Cartilage Lesions: Clinical and Biological Outcomes in 165 Patients

ObjectiveThis study aimed to evaluate the clinical and biological outcomes of a one-step regenerative treatment using bone marrow aspirate concentrate (BMAC) on a hyaluronic acid scaffold combined with intraarticular platelet-rich plasma (PRP) for treatment of full-thickness cartilage lesions in the knee.Design/MethodsA total of 165 patients (mean age 26.4 years) with full thickness cartilage defects were included in the study. In a single-step procedure, bone marrow was aspirated from the iliac crest and centrifuged to obtain BMAC concentrate. PRP was prepared from whole blood. The BMAC concentrate was seeded onto a hyaluronic acid scaffold and implanted into the debrided cartilage defect and PRP was added intraarticularly. Clinical outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and a semiquantitative grading scale (Excellent, Good, Fair) at one-year follow-up. All patients underwent MRI preoperatively and at one year follow-up, with cartilage repair evaluated using the MOCART-2.0 scoring system.ResultsSignificant improvements were observed in all KOOS subscales at one year. Semiquantitative grading revealed excellent outcomes in 50% of patients, good in 28%, and poor in 22%. MRI analysis showed an average MOCART-2.0 score of 71, with 36% of patients achieving excellent cartilage repair (MOCART 2.0 >80).ConclusionThe combined use of BMAC on a hyaluronic acid scaffold and intraarticular PRP resulted in improved subjective clinical outcomes and demonstrated favourable biological cartilage healing responses at one year postoperatively. This one-step cartilage repair technique appears to be a clinically valid option for treatment of full-thickness cartilage lesions in the knee.