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Peer-reviewedCC BYJournal of experimental orthopaedics

Injectable autologous chondrocyte transplantation yields sustained clinical mid‐term improvement in acetabular cartilage defects in femoroacetabular impingement: A comparative analysis from the German Cartilage Registry (KnorpelRegister DGOU)

9 affiliations
  1. 1Department of Trauma Surgery University Regensburg Medical Center Regensburg Germany.
  2. 2Department of Orthopaedics and Orthopaedic Surgery Saarland University Medical Center Homburg Germany.
  3. 3Orthopädische Chirurgie Heidelberg ATOS Clinic Heidelberg Heidelberg Germany.
  4. 4OrthoExpert Knittelfeld/Graz Austria.
  5. 5Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine University Medicine Greifswald Greifswald Germany.
  6. 6Clinic of Orthopaedics and Sports Orthopaedics, School of Medicine and Health TUM University Hospital, Technical University of Munich Munich Germany.
  7. 7Department of Orthopaedics University Medicine Rostock Rostock Germany.
  8. 8Orthopaedic-Neurosurgery Center Recklinghausen Germany.
  9. 9Sporthopaedicum Straubing Straubing Germany.

Abstract

Purpose

To evaluate mid-term outcomes of injectable matrix-associated autologous chondrocyte transplantation (MACT) for acetabular cartilage defects in femoroacetabular impingement (FAI), comparing two different ACT products (NOVOCART® Inject vs. Chondrosphere®) using data from the German Cartilage Registry.Methods

This retrospective analysis included 91 FAI patients (mean age 31.5 years) with isolated International Cartilage Repair Society (ICRS) Grade 3 or 4 acetabular cartilage defects treated arthroscopically with either NOVOCART® Inject (n = 48) or Chondrosphere® (n = 43), with a mean follow-up of 41.8 ± 18.5 months. Clinical outcomes were assessed using the International Hip Outcome Tool (iHOT33) and Visual Analogue Scale (VAS) for pain at 6, 12, 24, 36 and 60 months. Clinically important outcome values (minimum clinically important difference, Patient Acceptable Symptom State, substantial clinical benefit) were calculated at 36 months. Subgroup analysis compared defect severity (ICRS Grade 3 vs. 4) and product-specific outcomes.Results

Significant improvement in hip function (iHOT33) was observed across all follow-up time points in both groups (p < 0.01), with no significant between-group differences in iHOT33 scores or longitudinal trajectories. Within-group VAS pain scores improved significantly over time in the Chondrosphere® group (p < 0.01), whereas the improvement in the NOVOCART® Inject group did not reach statistical significance; however, no significant difference in pain outcomes was found between the two products. At 12 months, patients with ICRS grade 3 defects had significantly higher iHOT33 scores (73.1 vs. 60.5) and lower VAS pain scores (2.1 vs. 2.8) than those with grade 4 lesions.Conclusion

Arthroscopic MACT was associated with clinical improvement in pain and function up to 5 years in FAI patients with acetabular cartilage defects, with no statistically significant differences detected between hydrogel-based and spheroid-based products; follow-up data at later time points were more limited for NOVOCART® Inject. Although statistically significant pain improvement over time was observed only in the Chondrosphere® group, no significant differences in pain outcomes between the two products were detected.Level of evidence

Level III.

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BibTeX
@article{riedl2026injectable,
  title = {{Injectable autologous chondrocyte transplantation yields sustained clinical mid‐term improvement in acetabular cartilage defects in femoroacetabular impingement: A comparative analysis from the German Cartilage Registry (KnorpelRegister DGOU)}},
  author = {Moritz Riedl and Stefan Landgraeber and Steffen Thier and Wolfgang Zinser and Alexander Zimmerer and Ingo Jörg Banke and Wolfram Steens and Volker Alt and Stefan Fickert},
  journal = {Journal of experimental orthopaedics},
  year = {2026},
  month = oct,
  doi = {10.1002/jeo2.70971},
  url = {https://europepmc.org/article/PMC/PMC13718615},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Injectable autologous chondrocyte transplantation yields sustained clinical mid‐term improvement in acetabular cartilage defects in femoroacetabular impingement: A comparative analysis from the German Cartilage Registry (KnorpelRegister DGOU)
AU  - Moritz Riedl
AU  - Stefan Landgraeber
AU  - Steffen Thier
AU  - Wolfgang Zinser
AU  - Alexander Zimmerer
AU  - Ingo Jörg Banke
AU  - Wolfram Steens
AU  - Volker Alt
AU  - Stefan Fickert
PY  - 2026
DA  - 2026/10/01
JO  - Journal of experimental orthopaedics
DO  - 10.1002/jeo2.70971
UR  - https://europepmc.org/article/PMC/PMC13718615
AB  - Purpose  To evaluate mid-term outcomes of injectable matrix-associated autologous chondrocyte transplantation (MACT) for acetabular cartilage defects in femoroacetabular impingement (FAI), comparing two different ACT products (NOVOCART® Inject vs. Chondrosphere®) using data from the German Cartilage Registry.Methods  This retrospective analysis included 91 FAI patients (mean age 31.5 years) with isolated International Cartilage Repair Society (ICRS) Grade 3 or 4 acetabular cartilage defects treated arthroscopically with either NOVOCART® Inject (n = 48) or Chondrosphere® (n = 43), with a mean follow-up of 41.8 ± 18.5 months. Clinical outcomes were assessed using the International Hip Outcome Tool (iHOT33) and Visual Analogue Scale (VAS) for pain at 6, 12, 24, 36 and 60 months. Clinically important outcome values (minimum clinically important difference, Patient Acceptable Symptom State, substantial clinical benefit) were calculated at 36 months. Subgroup analysis compared defect severity (ICRS Grade 3 vs. 4) and product-specific outcomes.Results  Significant improvement in hip function (iHOT33) was observed across all follow-up time points in both groups (p < 0.01), with no significant between-group differences in iHOT33 scores or longitudinal trajectories. Within-group VAS pain scores improved significantly over time in the Chondrosphere® group (p < 0.01), whereas the improvement in the NOVOCART® Inject group did not reach statistical significance; however, no significant difference in pain outcomes was found between the two products. At 12 months, patients with ICRS grade 3 defects had significantly higher iHOT33 scores (73.1 vs. 60.5) and lower VAS pain scores (2.1 vs. 2.8) than those with grade 4 lesions.Conclusion  Arthroscopic MACT was associated with clinical improvement in pain and function up to 5 years in FAI patients with acetabular cartilage defects, with no statistically significant differences detected between hydrogel-based and spheroid-based products; follow-up data at later time points were more limited for NOVOCART® Inject. Although statistically significant pain improvement over time was observed only in the Chondrosphere® group, no significant differences in pain outcomes between the two products were detected.Level of evidence  Level III.
SN  - 2197-1153
ER  -