Arthroscopic and open treatment of cartilage lesions with BST-CARGEL scaffold and microfracture: A cohort study of consecutive patients

BACKGROUND: CARGEL (Smith & Nephew Inc.), a chitosan-based polymer scaffolding biomaterial, has been used since 2012 for treating articular cartilage lesions. Limited data are available on patient outcomes following CARGEL treatment. This study aimed to describe short-term clinical and radiographic outcomes in a cohort of patients treated with CARGEL and microfracture surgery for articular cartilage defects in the knee. METHODS: A retrospective cohort study was conducted of consecutive patients with articular cartilage defects who had undergone microfracture surgery with CARGEL, or in patellar lesions microfracture and CARGEL plus Chondro-Gide (at SportsClinic Zurich). Study outcomes included reoperations, infections, allergic reactions, pain, swelling, range of motion, and tissue quality and quantity. Ethics approval was obtained from the local ethics committee on 05/09/2017 (Basec. Nr: 2017-01441). RESULTS: A total of 91 participants, with 93 treated lesions, consenting to chart review were included. No participants required reoperation due to complications on the index lesion. Fifteen participants had second-look surgery on the index knee for other reasons, allowing for visual confirmation of cartilage repair. No study participants experienced a post-surgical infection or suffered an allergic reaction. No significant changes in range of motion or T2 values were observed from pre-treatment to post-treatment follow-up. However, significant decreases were found in pain (P < 0.001) and swelling (P < 0.001), along with significant increases in MOCART II scores (P < 0.001). Similar results were found in a subgroup of patients with patellar lesions. CONCLUSIONS: Patients treated with CARGEL experienced few postoperative complications and reported promising reductions in pain and swelling after treatment. LEVEL OF EVIDENCE: IV.