Thomas R Niethammer1, Daniel Altmann2, Martin Holzgruber2, Mehmet F Gülecyüz2, Susan Notohamiprodjo2, Andrea Baur-Melnyk2, Peter E Müller2. 1. Department of Orthopaedics, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, Munich, Germany; Department of Radiology, University Hospital, LMU Munich, Munich, Germany. Electronic address: thomas.niethammer@med.uni-muenchen.de. 2. Department of Orthopaedics, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, Munich, Germany; Department of Radiology, University Hospital, LMU Munich, Munich, Germany.
Abstract
PURPOSE: To evaluate the long-term clinical and radiologic outcomes of third-generation autologous chondrocyte implantation (ACI) for the treatment of focal cartilage defects of the knee. METHODS: Data capture was carried out between 2004 and 2018. Included were patients with cartilage defects of the knee joint with an International Cartilage Repair Society grade of III or higher treated with third-generation ACI who had a minimum follow-up period of 10 years. International Knee Documentation Committee scores and assessment of pain at rest and on movement using visual analog scale scores were captured preoperatively and at 6 months postoperatively, as well as annually thereafter. In addition, we performed magnetic resonance imaging examinations in 13 cases after 10 years. The MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) score was used to evaluate the ACI cartilage. RESULTS: A total of 54 patients met the inclusion criteria. Of these, 30 reached the 10-year follow-up point and were included in this assessment. At 10 years postoperatively, all clinical outcome parameters showed a statistically significant improvement compared with the preoperative situation, with a responder rate of 70%. The average MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) score after 10 years was 59.2 points (range, 20-100 points), and over 60% of the evaluated patients showed good integration of the implant at 10 years postoperatively. CONCLUSIONS: The clinical and radiologic findings of this study show that third-generation ACI is a suitable and effective option in the treatment of full-thickness cartilage defects of the knee. At 10 years after surgery, third-generation ACI shows stable results and leads to significant improvement in all clinical outcome parameters. Despite these results, revision surgery after third-generation ACI is common and was needed in 23% of patients in this study. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
PURPOSE: To evaluate the long-term clinical and radiologic outcomes of third-generation autologous chondrocyte implantation (ACI) for the treatment of focal cartilage defects of the knee. METHODS: Data capture was carried out between 2004 and 2018. Included were patients with cartilage defects of the knee joint with an International Cartilage Repair Society grade of III or higher treated with third-generation ACI who had a minimum follow-up period of 10 years. International Knee Documentation Committee scores and assessment of pain at rest and on movement using visual analog scale scores were captured preoperatively and at 6 months postoperatively, as well as annually thereafter. In addition, we performed magnetic resonance imaging examinations in 13 cases after 10 years. The MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) score was used to evaluate the ACI cartilage. RESULTS: A total of 54 patients met the inclusion criteria. Of these, 30 reached the 10-year follow-up point and were included in this assessment. At 10 years postoperatively, all clinical outcome parameters showed a statistically significant improvement compared with the preoperative situation, with a responder rate of 70%. The average MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) score after 10 years was 59.2 points (range, 20-100 points), and over 60% of the evaluated patients showed good integration of the implant at 10 years postoperatively. CONCLUSIONS: The clinical and radiologic findings of this study show that third-generation ACI is a suitable and effective option in the treatment of full-thickness cartilage defects of the knee. At 10 years after surgery, third-generation ACI shows stable results and leads to significant improvement in all clinical outcome parameters. Despite these results, revision surgery after third-generation ACI is common and was needed in 23% of patients in this study. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
Authors: Thomas Richard Niethammer; Felix Uhlemann; Anja Zhang; Martin Holzgruber; Ferdinand Wagner; Peter Ernst Müller Journal: Knee Surg Sports Traumatol Arthrosc Date: 2022-02-28 Impact factor: 4.114
Authors: Julian Mehl; Matthias Feucht; Andrea Achtnich; Andreas B Imhoff; Philipp Niemeyer; Peter Angele; Wolfgang Zinser; Gunter Spahn; Ingo Loer; Heino Kniffler; Gunnar Schauf; Andreas Schmitt Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-10-09 Impact factor: 4.114
Authors: Thomas Richard Niethammer; Daniel Altmann; Martin Holzgruber; Sophia Goller; Andreas Fischer; Peter Ernst Müller Journal: Knee Surg Sports Traumatol Arthrosc Date: 2020-07-15 Impact factor: 4.342