BACKGROUND: Autologous chondrocyte implantation is indicated as a second-line treatment of large, irregularly shaped chondral defects after failure of first-line surgical intervention. This study examines the clinical results of a patient cohort undergoing autologous chondrocyte implantation and elucidates factors associated with subjective improvement after implantation. HYPOTHESIS: Autologous chondrocyte implantation will result in long-term functional and symptomatic improvement. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: The cohort included 137 subjects (140 knees) who underwent autologous chondrocyte implantation of the knee. Mean defect size per patient was 5.2 +/- 3.5 cm(2) (range, 0.8-26.6 cm(2)). Patients averaged 30.3 +/- 9.1 years of age (range, 13.9-49.9 years) and were followed for 4.3 +/- 1.8 years (range, 2.0-9.7 years). Outcomes were assessed via clinical assessment and established outcome scales, including the Lysholm scale, International Knee Documentation Committee scale, and Short Form-12. RESULTS: A significant improvement after surgery was observed in all outcome assessments including the Lysholm (41 to 69; P < .001) and International Knee Documentation Committee (34 to 64; P < .001) scales. Subjectively, 75% of patients indicated they were completely or mostly satisfied with the outcome and 83% would have the procedure again. Preoperatively, 32% of patients had a Tegner score of 6 or greater, compared with 82% before injury and 65% at most recent follow-up. Multivariate analysis identified age (P < .021) and receiving workers' compensation (P < .018) as independent predictors of follow-up Lysholm score. Twenty-one patients (16%) required debridement of the autologous chondrocyte implantation site secondary to persistent symptoms, whereas 9 knees (6.4%) clinically failed and underwent a revision procedure. CONCLUSION: Autologous chondrocyte implantation is a viable treatment option for chondral defects of the knee, resulting in durable functional and symptomatic improvement. Age and workers' compensation status are independent predictors of outcome.
BACKGROUND: Autologous chondrocyte implantation is indicated as a second-line treatment of large, irregularly shaped chondral defects after failure of first-line surgical intervention. This study examines the clinical results of a patient cohort undergoing autologous chondrocyte implantation and elucidates factors associated with subjective improvement after implantation. HYPOTHESIS: Autologous chondrocyte implantation will result in long-term functional and symptomatic improvement. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: The cohort included 137 subjects (140 knees) who underwent autologous chondrocyte implantation of the knee. Mean defect size per patient was 5.2 +/- 3.5 cm(2) (range, 0.8-26.6 cm(2)). Patients averaged 30.3 +/- 9.1 years of age (range, 13.9-49.9 years) and were followed for 4.3 +/- 1.8 years (range, 2.0-9.7 years). Outcomes were assessed via clinical assessment and established outcome scales, including the Lysholm scale, International Knee Documentation Committee scale, and Short Form-12. RESULTS: A significant improvement after surgery was observed in all outcome assessments including the Lysholm (41 to 69; P < .001) and International Knee Documentation Committee (34 to 64; P < .001) scales. Subjectively, 75% of patients indicated they were completely or mostly satisfied with the outcome and 83% would have the procedure again. Preoperatively, 32% of patients had a Tegner score of 6 or greater, compared with 82% before injury and 65% at most recent follow-up. Multivariate analysis identified age (P < .021) and receiving workers' compensation (P < .018) as independent predictors of follow-up Lysholm score. Twenty-one patients (16%) required debridement of the autologous chondrocyte implantation site secondary to persistent symptoms, whereas 9 knees (6.4%) clinically failed and underwent a revision procedure. CONCLUSION: Autologous chondrocyte implantation is a viable treatment option for chondral defects of the knee, resulting in durable functional and symptomatic improvement. Age and workers' compensation status are independent predictors of outcome.
Authors: A H Gomoll; G Filardo; L de Girolamo; J Espregueira-Mendes; J Esprequeira-Mendes; M Marcacci; W G Rodkey; J R Steadman; R J Steadman; S Zaffagnini; E Kon Journal: Knee Surg Sports Traumatol Arthrosc Date: 2011-11-24 Impact factor: 4.342
Authors: Thomas R Niethammer; Peter E Müller; Elem Safi; Andreas Ficklscherer; Björn P Roßbach; Volkmar Jansson; Matthias F Pietschmann Journal: Knee Surg Sports Traumatol Arthrosc Date: 2013-07-10 Impact factor: 4.342
Authors: Jakob Ackermann; Takahiro Ogura; Robert A Duerr; Alexandre Barbieri Mestriner; Andreas H Gomoll Journal: Cartilage Date: 2018-07-04 Impact factor: 4.634
Authors: Erik I Waldorff; Blake J Roessler; Terri A Zachos; Bruce S Miller; Jonathan McHugh; Steven A Goldstein Journal: J Arthroplasty Date: 2013-03-20 Impact factor: 4.757