BACKGROUND: Studies that compare the effectiveness of different cartilage repair treatments are needed to update treatment algorithms. HYPOTHESIS: Autologous chondrocyte implantation provides greater improvement in overall condition score than does debridement at a minimum of 3 years' follow-up. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Cohorts for debridement and autologous chondrocyte implantation each included 58 Cartilage Repair Registry patients who met study criteria. A retrospective analysis was performed on prospectively collected baseline and follow-up data. RESULTS: Patients in the autologous chondrocyte implantation and debridement groups had similar demographics and chondral lesions at baseline. However, more autologous chondrocyte implantation patients failed a previous debridement or marrow stimulation procedure than did debridement patients. Follow-up outcome assessments were completed by 54 autologous chondrocyte implantation patients and 42 debridement patients. Eighty-one percent of the autologous chondrocyte implantation patients and 60% of the debridement patients reported median improvements of 5 points and 2 points, respectively, in the overall condition score. Autologous chondrocyte implantation patients also reported greater improvements in the median pain and swelling scores than did debridement patients. The treatment failure rate was the same for both autologous chondrocyte implantation and debridement patients. Eighteen autologous chondrocyte implantation patients and 1 debridement patient had at least 1 subsequent operation. CONCLUSION: Although patients treated with debridement for symptomatic, large, focal, chondral defects of the distal femur had some functional improvement at follow-up, patients who received autologous chondrocyte implantations obtained higher levels of knee function and had greater relief from pain and swelling at 3 years.
BACKGROUND: Studies that compare the effectiveness of different cartilage repair treatments are needed to update treatment algorithms. HYPOTHESIS: Autologous chondrocyte implantation provides greater improvement in overall condition score than does debridement at a minimum of 3 years' follow-up. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Cohorts for debridement and autologous chondrocyte implantation each included 58 Cartilage Repair Registry patients who met study criteria. A retrospective analysis was performed on prospectively collected baseline and follow-up data. RESULTS:Patients in the autologous chondrocyte implantation and debridement groups had similar demographics and chondral lesions at baseline. However, more autologous chondrocyte implantation patients failed a previous debridement or marrow stimulation procedure than did debridement patients. Follow-up outcome assessments were completed by 54 autologous chondrocyte implantation patients and 42 debridement patients. Eighty-one percent of the autologous chondrocyte implantation patients and 60% of the debridement patients reported median improvements of 5 points and 2 points, respectively, in the overall condition score. Autologous chondrocyte implantation patients also reported greater improvements in the median pain and swelling scores than did debridement patients. The treatment failure rate was the same for both autologous chondrocyte implantation and debridement patients. Eighteen autologous chondrocyte implantation patients and 1 debridement patient had at least 1 subsequent operation. CONCLUSION: Although patients treated with debridement for symptomatic, large, focal, chondral defects of the distal femur had some functional improvement at follow-up, patients who received autologous chondrocyte implantations obtained higher levels of knee function and had greater relief from pain and swelling at 3 years.
Authors: Laetitia Gerlier; Mark Lamotte; Micheline Wille; Peter C Kreuz; Johan Vanlauwe; Dominique Dubois; François M Meurgey Journal: Pharmacoeconomics Date: 2010 Impact factor: 4.981
Authors: Santiago Pérez-Cachafeiro; Alberto Ruano-Raviña; José Couceiro-Follente; Jose Antonio Benedí-Alcaine; Ignacio Nebot-Sanchis; Ciriaco Casquete-Román; Santiago Bello-Prats; Gonzalo Couceiro-Sánchez; Francisco J Blanco Journal: Open Orthop J Date: 2010-01-15