Clinical relevance of engineered cartilage maturation in a randomized multicenter trial for articular cartilage repair

This multicenter, randomized phase II clinical trial evaluated whether maturation of autologous nasal chondrocyte–based engineered cartilage (N-TEC) before implantation improves articular cartilage repair outcomes compared with immature neocartilage (N-CAM). Matured N-TEC grafts cultured for 14 days exhibited greater collagen II and glycosaminoglycan content, increased stiffness, and more homogeneous matrix organization. At 24 months, patients treated with N-TEC showed significantly higher KOOS and MOCART scores, reduced pain, and improved graft integration relative to N-CAM. The results demonstrate that biomechanical maturation of engineered cartilage enhances clinical function and durability of cartilage repair.