Background: There is still a lack of consensus about the best treatment of chondral defects of the knee. We conducted a systematic PRISMA review to evaluate clinical outcomes of Autologous Chondrocyte Implantation (ACI) and Mesenchymal Stem Cell (MSC) injections for the treatment of focal chondral defects of the knee.

Methods: A systematic review of literature was performed according to the PRISMA guidelines. All the articles reporting data on ACI and MSC treatments for chondral defects of the knee were considered for inclusion. The main databases were accessed: PubMed, Medline, CINAHL, Cochrane, Embase and Google Scholar. The statistical analysis was performed using the Review Manager Software.

Results: In the p-ACI group (987 knees), the Cincinnati Score improved by 18.94% (p=0.1), VAS by 38% (p=0.01), Tegner score by 19.11% (p=0.03), Lysholm score by 22.40% (p=0.01), IKCD by 27.36% (p=0.003). In the c-ACI group (444 knees), the Cincinnati Score improved by 23.80% (p=0.08), KOOS by 23.48% (p=0.03), VAS by 33.2% (p=0.005), IKDC by 33.30% (p=0.005). In the m-ACI group (599 knees), the Cincinnati Score improved by 26.80% (p=0.08), KOOS by 31.59% (p=0.1), VAS by 30.43% (p=0.4), Tegner score by 23.1% (p=0.002), Lysholm score by 31.14% (p=0.004), IKCD by 30.57% (p<0.001). In the MSCs group (291 knees), the KOOS improved by 29.7% (p=0.003), VAS by 41.89% (p<0.001), Tegner score by 25.81% (p=0.003), Lysholm score by 36.96% (p<0.001), IKCD by 30.57% (p=0.001).

Conclusion: Both ACI and MSC therapies can be considered as a concrete solution to treat focal chondral defects of the knee.

背景：关于如何治疗膝关节软骨缺损仍缺乏共识。我们进行了系统的PRISMA评估，以评估自体软骨细胞植入（ACI）和间充质干细胞（MSC）注射治疗膝关节局灶性软骨缺损的临床效果。

方法：根据PRISMA指南对文献进行系统评价。所有报道关于膝关节软骨缺损的ACI和MSC治疗数据的文章都被认为包括在内。访问了主要数据库：PubMed，Medline，CINAHL，Cochrane，Embase和Google Scholar。使用Review Manager软件进行统计分析。

结果：在p-ACI组（987膝）中，辛辛那提得分提高了18.94％（p = 0.1），VAS提高了38％（p = 0.01），Tegner得分提高了19.11％（p = 0.03），Lysholm得分提高了22.40％（p = 0.01），IKCD为27.36％（p = 0.003）。在c-ACI组（444膝）中，辛辛那提得分提高了23.80％（p = 0.08），KOOS得分提高了23.48％（p = 0.03），VAS增长了33.2％（p = 0.005），IKDC提高了33.30％（p = 0.005）。在m-ACI组（599膝）中，辛辛那提得分提高了26.80％（p = 0.08），KOOS得分提高了31.59％（p = 0.1），VAS得分提高了30.43％（p = 0.4），Tegner得分提高了23.1％（ p = 0.002），Lysholm评分31.14％（p = 0.004），IKCD 30.57％（p <0.001）。在MSCs组（291膝）中，KOOS改善了29.7％（p = 0.003），VAS改善了41.89％（p <0.001），Tegner评分改善了25.81％（p = 0.003），Lysholm评分改善了36.96％（p < 0.001），IKCD降低30.57％（p = 0.001）。

结论：ACI和MSC疗法均可被认为是治疗膝关节局灶性软骨缺损的具体解决方案。