Autologous Adipose-Derived MSCs Seeded on a Collagen I/III Scaffold for Focal Knee Cartilage Defects: A Prospective Case Series With 24-Month Follow-up
C.C. Kaleka, P.D. Vargas, M. Cohen, M. Mascarenhas, E. Antonioli, L.N.F. De LimaObjective:
Adipose-derived mesenchymal stromal cells (ADMSCs) are a promising strategy for focal full-thickness knee chondral defects repair. This prospective case series evaluated the feasibility and safety of a tissue-engineered construct consisting of autologous ADMSCs seeded onto a type I/III collagen scaffold for symptomatic focal tibiofemoral cartilage defects.
Methods:
Four symptomatic patients with full-thickness focal chondral lesions (ICRS grade IV) underwent implantation of an autologous ADMSC–collagen construct and were followed for 24 months. Adipose tissue was harvested using a minimally invasive outpatient procedure. ADMSCs were isolated and expanded ex vivo, seeded onto a type I/III collagen scaffold, and implanted after defect debridement via arthrotomy; fixation was performed with sutures and fibrin glue. Patient-reported and clinician-reported outcomes were assessed at baseline and postoperative follow-up visits. Cartilage repair was evaluated by MRI using the MOCART scoring system at 6 and 12 months.
Results:
No serious adverse events were observed during follow-up. Improvements in clinical outcome scores were observed over time across participants. MRI-based MOCART assessments suggested defect fill and repair tissue maturation in the treated lesions; however, given the uncontrolled design and concomitant postoperative rehabilitation, treatment effectiveness cannot be inferred, and findings should be considered hypothesis-generating.
Conclusion:
In this case series, implantation of an autologous ADMSC–collagen I/III construct was feasible and appeared safe through 24 months, with observed improvements in clinical and MRI outcomes. Larger, prospectively registered comparative studies with standardized rehabilitation reporting and longer follow-up are needed to validate these preliminary findings.