Chi Zhang1,2, You-Zhi Cai1,2, Xiang-Jin Lin3,4. 1. Department of Orthopedics, The First Affiliated Hospital, College of Medicine Zhejiang University, 79 Qingchun Road, Hangzhou, 310008, China. 2. Center for Sport Medicine, The First Affiliated Hospital, College of Medicine Zhejiang University, Hangzhou, China. 3. Department of Orthopedics, The First Affiliated Hospital, College of Medicine Zhejiang University, 79 Qingchun Road, Hangzhou, 310008, China. locuszc@icloud.com. 4. Center for Sport Medicine, The First Affiliated Hospital, College of Medicine Zhejiang University, Hangzhou, China. locuszc@icloud.com.
Abstract
PURPOSE: A literature review of the first-, second- and third-generation autologous chondrocyte implantation (ACI) technique for the treatment of large-sized (>4 cm(2)) and full-thickness knee cartilage defects in young adults was conducted, examining the current literature on features, clinical scores, complications, magnetic resonance image (MRI) and histological outcomes, rehabilitation and cost-effectiveness. METHODS: A literature review was carried out in the main medical databases to evaluate the several studies concerning ACI treatment of large-sized and full-thickness knee cartilage defects in young adults. RESULTS: ACI technique has been shown to relieve symptoms and improve functional assessment in large-sized (>4 cm(2)) and full-thickness knee articular cartilage defect of young adults in short- and medium-term follow-up. Besides, low level of evidence demonstrated its efficiency and durability at long-term follow-up after implantation. Furthermore, MRI and histological evaluations provided the evidence that graft can return back to the previous nearly normal cartilage via ACI techniques. Clinical outcomes tend to be similar in different ACI techniques, but with simplified procedure, low complication rate and better graft quality in the third-generation ACI technique. CONCLUSION: ACI based on the experience of cell-based therapy, with the high potential to regenerate hyaline-like tissue, represents clinical development in treatment of large-sized and full-thickness knee cartilage defects. LEVEL OF EVIDENCE: IV.
PURPOSE: A literature review of the first-, second- and third-generation autologous chondrocyte implantation (ACI) technique for the treatment of large-sized (>4 cm(2)) and full-thickness knee cartilage defects in young adults was conducted, examining the current literature on features, clinical scores, complications, magnetic resonance image (MRI) and histological outcomes, rehabilitation and cost-effectiveness. METHODS: A literature review was carried out in the main medical databases to evaluate the several studies concerning ACI treatment of large-sized and full-thickness knee cartilage defects in young adults. RESULTS: ACI technique has been shown to relieve symptoms and improve functional assessment in large-sized (>4 cm(2)) and full-thickness knee articular cartilage defect of young adults in short- and medium-term follow-up. Besides, low level of evidence demonstrated its efficiency and durability at long-term follow-up after implantation. Furthermore, MRI and histological evaluations provided the evidence that graft can return back to the previous nearly normal cartilage via ACI techniques. Clinical outcomes tend to be similar in different ACI techniques, but with simplified procedure, low complication rate and better graft quality in the third-generation ACI technique. CONCLUSION: ACI based on the experience of cell-based therapy, with the high potential to regenerate hyaline-like tissue, represents clinical development in treatment of large-sized and full-thickness knee cartilage defects. LEVEL OF EVIDENCE: IV.
Authors: Yan Lu; H Davis Adkisson; John Bogdanske; Vicki Kalscheur; William Maloney; Regina Cheung; Alan J Grodzinsky; Keith A Hruska; Mark D Markel Journal: J Knee Surg Date: 2005-01 Impact factor: 2.757
Authors: Jan M Pestka; Gerrit Bode; Gian Salzmann; Mathias Steinwachs; Hagen Schmal; Norbert P Südkamp; Philipp Niemeyer Journal: Am J Sports Med Date: 2013-10-28 Impact factor: 6.202
Authors: Philipp Niemeyer; Jan M Pestka; Peter C Kreuz; Christoph Erggelet; Hagen Schmal; Norbert P Suedkamp; Matthias Steinwachs Journal: Am J Sports Med Date: 2008-09-18 Impact factor: 6.202
Authors: C Clar; E Cummins; L McIntyre; S Thomas; J Lamb; L Bain; P Jobanputra; N Waugh Journal: Health Technol Assess Date: 2005-12 Impact factor: 4.014
Authors: Philipp Niemeyer; Gian Salzmann; Matthias Feucht; Jan Pestka; Stella Porichis; Peter Ogon; Norbert Südkamp; Hagen Schmal Journal: Int Orthop Date: 2014-05-17 Impact factor: 3.075
Authors: E Kon; M Delcogliano; G Filardo; D Pressato; M Busacca; B Grigolo; G Desando; M Marcacci Journal: Injury Date: 2009-12-24 Impact factor: 2.586