Philipp Niemeyer1, Volker Laute2, Wolfgang Zinser3, Christoph Becher4, Peter Diehl5, Thomas Kolombe6, Jakob Fay7, Rainer Siebold8, Stefan Fickert9. 1. Department of Orthopedic Surgery and Traumatology, Freiburg University Hospital, Germany and OCM Clinic, OCM | Orthopädische Chirurgie München, Steinerstrass 6, 83069, Munich, Germany. phniemeyer@gmail.com. 2. Joint and Spine Centre, Berlin, Germany. 3. Department of Orthopedic Surgery and Traumatology, St. Vinzenz-Hospital, Dinslaken, Germany. 4. Department of Orthopedic Surgery, Medical University Annastift Hanover, Hanover, Germany. 5. Department of Orthopedic Surgery and Traumatology, Orthopedic Center Munich East, Munich, Germany. 6. Traumatology and Reconstructive Surgery, DRK Hospital Luckenwalde, Luckenwalde, Germany. 7. Department of Traumatology and Arthroscopic Surgery, Lubinus Clinicum Kiel, Kiel, Germany. 8. Center for Hip, Knee and Foot Surgery, ATOS Clinic Heidelberg, Heidelberg, Germany. 9. Sporthopaedicum Straubing, Straubing, Germany.
Abstract
AIM: Cartilage defects of the patella are considered as a problematic entity. Purpose of the present study was to evaluate the outcome of patients treated with autologous chondrocyte implantation (ACI) for cartilage defects of the patella in comparison to patient with defects of the femoral condyles. PATIENTS AND METHODS: 73 patients with a follow-up of 5 years have been included in this subgroup analysis of the randomized controlled clinical trial (RCT). In dependence of defect location, patients were divided into two groups [patella defects (n = 45) and femoral condyle defects (n = 28)]. Clinical outcome was evaluated by the means of the KOOS score at baseline and 6 weeks, 3, 6, 12, 18, 24, 36, 48 and 60 months following ACI. RESULTS: "Responder rate" at 60 months (improvement from baseline of > 7 points in the KOOS score) in patients with patella defects was 86.2%. All scores showed a significant improvement from baseline. While overall KOOS score at 60 months was 81.9 (SD 18.6) points in femoral condyle defects, a mean of 82.6 (SD 14.0) was observed in patella defects (p = 0.2483). CONCLUSION:ACI seems an appropriate surgical treatment for cartilage defects of the patella leading to a high success rate. In this study, the clinical outcome in patients with patellar defects was even better than the already excellent results in patients with defects of the femoral condyle even though the study included relatively large defect sizes for both groups (mean defect size 6.0 ± 1.7 and 5.4 ± 1.6 for femur and patella, respectively).
RCT Entities:
AIM: Cartilage defects of the patella are considered as a problematic entity. Purpose of the present study was to evaluate the outcome of patients treated with autologous chondrocyte implantation (ACI) for cartilage defects of the patella in comparison to patient with defects of the femoral condyles. PATIENTS AND METHODS: 73 patients with a follow-up of 5 years have been included in this subgroup analysis of the randomized controlled clinical trial (RCT). In dependence of defect location, patients were divided into two groups [patella defects (n = 45) and femoral condyle defects (n = 28)]. Clinical outcome was evaluated by the means of the KOOS score at baseline and 6 weeks, 3, 6, 12, 18, 24, 36, 48 and 60 months following ACI. RESULTS: "Responder rate" at 60 months (improvement from baseline of > 7 points in the KOOS score) in patients with patella defects was 86.2%. All scores showed a significant improvement from baseline. While overall KOOS score at 60 months was 81.9 (SD 18.6) points in femoral condyle defects, a mean of 82.6 (SD 14.0) was observed in patella defects (p = 0.2483). CONCLUSION: ACI seems an appropriate surgical treatment for cartilage defects of the patella leading to a high success rate. In this study, the clinical outcome in patients with patellar defects was even better than the already excellent results in patients with defects of the femoral condyle even though the study included relatively large defect sizes for both groups (mean defect size 6.0 ± 1.7 and 5.4 ± 1.6 for femur and patella, respectively).
Authors: Philipp Niemeyer; Matthias Steinwachs; Christoph Erggelet; Peter C Kreuz; Nina Kraft; Wolfgang Köstler; Alexander Mehlhorn; Norbert P Südkamp Journal: Arch Orthop Trauma Surg Date: 2007-08-21 Impact factor: 3.067
Authors: P Niemeyer; S Andereya; P Angele; A Ateschrang; M Aurich; M Baumann; P Behrens; U Bosch; C Erggelet; S Fickert; J Fritz; H Gebhard; K Gelse; D Günther; A Hoburg; P Kasten; T Kolombe; H Madry; S Marlovits; N M Meenen; P E Müller; U Nöth; J P Petersen; M Pietschmann; W Richter; B Rolauffs; K Rhunau; B Schewe; A Steinert; M R Steinwachs; G H Welsch; W Zinser; D Albrecht Journal: Z Orthop Unfall Date: 2013-02-19 Impact factor: 0.923
Authors: M L Pachowsky; S Trattnig; B Wondrasch; S Apprich; S Marlovits; A Mauerer; Goetz H Welsch; M Blanke Journal: Knee Surg Sports Traumatol Arthrosc Date: 2013-05-21 Impact factor: 4.342
Authors: Thomas R Niethammer; David Gallik; Y Chevalier; Martin Holzgruber; Andrea Baur-Melnyk; Peter E Müller; Matthias F Pietschmann Journal: Int Orthop Date: 2020-12-06 Impact factor: 3.075
Authors: Arnd Hoburg; Philipp Niemeyer; Volker Laute; Wolfgang Zinser; Thilo John; Christoph Becher; Kaywan Izadpanah; Peter Diehl; Thomas Kolombe; Jakob Fay; Rainer Siebold; Stefan Fickert Journal: Orthop J Sports Med Date: 2022-01-18