Fabian Blanke1, Nicola Oehler2, Maximilian Haenle1, Robert Lenz3, Stephan Vogt4, Thomas Tischer3. 1. Department of Orthopedic Sports Medicine and Arthroscopic Surgery, Hessing Stiftung, Augsburg, Germany; Clinic and Policlinic for Orthopedic Surgery, University Rostock, Rostock, Germany. 2. Department of Orthopedic Sports Medicine and Arthroscopic Surgery, Hessing Stiftung, Augsburg, Germany. Electronic address: Nicola.Oehler@hessing-stiftung.de. 3. Clinic and Policlinic for Orthopedic Surgery, University Rostock, Rostock, Germany. 4. Department of Orthopedic Sports Medicine and Arthroscopic Surgery, Hessing Stiftung, Augsburg, Germany; Department of Orthopedic Sports Medicine and Arthroscopic Surgery, Technical University Munich, Klinikum Rechts der Isar, Munich, Germany.
Abstract
PURPOSE: To evaluate subjective and objective clinical and magnetic resonance imaging-based radiologic outcomes after short-term follow-up in patients with focal full-size cartilage lesions of the knee joint treated with all-arthroscopic hydrogel-based autologous chondrocyte transplantation. METHODS: A retrospective study on patients with isolated focal cartilage defects of the knee joint who were treated with arthroscopically conducted matrix-induced autologous chondrocyte transplantation was performed. Clinical scores were assessed at baseline and final follow-up using the Tegner Score, visual analog scale, the International Knee Documentation Committee, and the 5 subscales of the Knee Injury and Osteoarthritis Outcome Score. Magnetic resonance imaging scans of the treated knee joints were evaluated with the updated MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) 2.0 scoring system at follow-up. RESULTS: Twenty-nine consecutive patients were included in the study. Mean time to follow-up was 24.9 ± 1.1 months. Average visual analog scale decreased significantly from 6.5 ± 3.1 preoperatively to 2.3 ± 1.6 at follow-up (P < .0001). Tegner score increased from 3.1 ± 1.3 to 4.3 ± 1.2 (P < .0001) and the International Knee Documentation Committee from 43.8 ± 21.9 to 64.9 ± 18.9 (P < .0001). Also, all Knee Injury and Osteoarthritis Outcome Score subscales displayed significant improvements. Patients showed similar improvements of nearly all clinical scores independent of the defect size. Average MOCART2.0 score was 70.0 ± 13.6 and 20 patients scored ≥70 points. All 8 patients with large defects (>5 cm2) scored ≥75 points. CONCLUSIONS: In this small study, injectable matrix-induced autologous chondrocyte transplantation therapy in the knee joint led to favourable clinical and radiologic short-term results with significant improvements in all clinical scores and MOCART2.0 scores, confirming morphologic integrity of the transplanted chondrocytes. Therefore, this minimally invasive procedure represents a promising operative technique for cartilage regeneration, even for large-diameter lesions. LEVEL OF EVIDENCE: IV, therapeutic case series.
PURPOSE: To evaluate subjective and objective clinical and magnetic resonance imaging-based radiologic outcomes after short-term follow-up in patients with focal full-size cartilage lesions of the knee joint treated with all-arthroscopic hydrogel-based autologous chondrocyte transplantation. METHODS: A retrospective study on patients with isolated focal cartilage defects of the knee joint who were treated with arthroscopically conducted matrix-induced autologous chondrocyte transplantation was performed. Clinical scores were assessed at baseline and final follow-up using the Tegner Score, visual analog scale, the International Knee Documentation Committee, and the 5 subscales of the Knee Injury and Osteoarthritis Outcome Score. Magnetic resonance imaging scans of the treated knee joints were evaluated with the updated MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) 2.0 scoring system at follow-up. RESULTS: Twenty-nine consecutive patients were included in the study. Mean time to follow-up was 24.9 ± 1.1 months. Average visual analog scale decreased significantly from 6.5 ± 3.1 preoperatively to 2.3 ± 1.6 at follow-up (P < .0001). Tegner score increased from 3.1 ± 1.3 to 4.3 ± 1.2 (P < .0001) and the International Knee Documentation Committee from 43.8 ± 21.9 to 64.9 ± 18.9 (P < .0001). Also, all Knee Injury and Osteoarthritis Outcome Score subscales displayed significant improvements. Patients showed similar improvements of nearly all clinical scores independent of the defect size. Average MOCART2.0 score was 70.0 ± 13.6 and 20 patients scored ≥70 points. All 8 patients with large defects (>5 cm2) scored ≥75 points. CONCLUSIONS: In this small study, injectable matrix-induced autologous chondrocyte transplantation therapy in the knee joint led to favourable clinical and radiologic short-term results with significant improvements in all clinical scores and MOCART2.0 scores, confirming morphologic integrity of the transplanted chondrocytes. Therefore, this minimally invasive procedure represents a promising operative technique for cartilage regeneration, even for large-diameter lesions. LEVEL OF EVIDENCE: IV, therapeutic case series.
Authors: Øystein Øvrebø; Giuseppe Perale; Jonathan P Wojciechowski; Cécile Echalier; Jonathan R T Jeffers; Molly M Stevens; Håvard J Haugen; Filippo Rossi Journal: Bioeng Transl Med Date: 2022-03-15
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