1 Recommendations

1 Recommendations

1.1 The evidence on microstructural scaffold insertion without autologous cell implantation for repairing symptomatic chondral knee defects raises no major safety concerns; however, current evidence on its efficacy is inadequate in both quality and quantity. Therefore, this procedure should only be used with special arrangements for clinical governance, consent, and audit or research.

1.2 Clinicians wishing to do microstructural scaffold insertion without autologous cell implantation for repairing symptomatic chondral knee defects should:

  • Inform the clinical governance leads in their NHS trusts.

  • Ensure that patients understand the uncertainty about the procedure's safety and efficacy and provide them with clear written information. In addition, the use of NICE's information for the public is recommended.

  • Audit and review clinical outcomes of all patients having microstructural scaffold insertion without autologous cell implantation for repairing symptomatic chondral knee defects (see section 7.1).

1.3 NICE encourages further data collection, including randomised controlled trials on microstructural scaffold insertion without autologous cell implantation for repairing symptomatic chondral knee defects. Studies should clearly describe patient selection, clinical indications and adjunctive treatments. Outcome measures should include symptom relief, functional ability, long-term outcomes measured by appropriate imaging techniques and patient-reported outcomes.

  • National Institute for Health and Care Excellence (NICE)