Arthroscopic Assessment of Cartilage Repair: A Validation Study of 2 Scoring Systems

Smith, G.; Taylor, Jacqui; Almqvist, Karl; Erggelet, Christoph; Knutsen, Gunnar; Portabella, M. García; Smith, T. Assheton; Richardson, James B.

doi:10.1016/j.arthro.2005.09.007

Cited by 125 publications

(134 citation statements)

References 15 publications

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“…The data were collected preoperatively and postoperatively (after 6, 12, and 24 months), and the results were recorded in the standardized ICRS form. The IKDC and VAS scores used in this study are established and validated scores in the follow-up examination of cartilage regeneration procedures and show a high rate of reliability and reproduction, 11,22 hence the frequent use of these scores in follow-up examinations after p-ACI and mb-ACI. 9,14,17,18,21 Magnetic Resonance Imaging A follow-up magnetic resonance imaging (MRI) examination was performed after 3, 6, 12, and 24 months using a 1.5-T machine (Magnetom Sonata, Fa Siemens AG, Erlangen, Germany) with the use of a commercially available circular polarizing 1-channel knee spool in a predetermined protocol.…”

Section: Clinical Scoresmentioning

confidence: 99%

The Incidence and Clinical Relevance of Graft Hypertrophy After Matrix-Based Autologous Chondrocyte Implantation

et al. 2011

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Background: Graft hypertrophy is the most common complication of periosteal autologous chondrocyte implantation (p-ACI). Purpose: The aim of this prospective study was to analyze the development, the incidence rate, and the persistence of graft hypertrophy after matrix-based autologous chondrocyte implantation (mb-ACI) in the knee joint within a 2-year postoperative course. Study Design: Case series; Level of evidence, 4. Methods: Between 2004 and 2007, a total of 41 patients with 44 isolated cartilage defects of the knee were treated with the mb-ACI technique. The mean age of the patients was 35.8 years (standard deviation [SD], 11.3 years), and the mean body mass index was 25.9 (SD, 4.2; range, 19-35.3). The cartilage defects were arthroscopically classified as Outerbridge grades III and IV. The mean area of the cartilage defect measured 6.14 cm2 (SD, 2.3 cm2). Postoperative clinical and magnetic resonance imaging (MRI) examinations were conducted at 3, 6, 12, and 24 months to analyze the incidence and course of the graft. Results: Graft hypertrophy developed in 25% of the patients treated with mb-ACI within a postoperative course of 1 year; 16% of the patients developed hypertrophy grade 2, and 9% developed hypertrophy grade 1. Graft hypertrophy occurred primarily in the first 12 months and regressed in most cases within 2 years. The International Knee Documentation Committee (IKDC) and visual analog scale (VAS) scores improved during the postoperative follow-up time of 2 years. There was no difference between the clinical results regarding the IKDC and VAS pain scores and the presence of graft hypertrophy. Conclusion: The mb-ACI technique does not lead to graft hypertrophy requiring treatment as opposed to classic p-ACI. The frequency of occurrence of graft hypertrophy after p-ACI and mb-ACI is comparable. Graft hypertrophy can be considered as a temporary excessive growth of regenerative cartilage tissue rather than a true graft hypertrophy. It is therefore usually not a persistent or systematic complication in the treatment of circumscribed cartilage defects with mb-ACI.

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Section: Clinical Scoresmentioning

confidence: 99%

The Incidence and Clinical Relevance of Graft Hypertrophy After Matrix-Based Autologous Chondrocyte Implantation

et al. 2011

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“…At this point, only biomechanical outcomes are validated via direct readings from tensile testing systems [1,3,9]. There are several, objective grading systems for looking at cartilage repair that include the Pineda scale [14,15], the International Cartilage Repair Society cartilage repair assessment score [13], the O'Driscoll scale [14], and the Oswestry Arthroscopy Score [19]. However, there are no detailed, objective scoring systems that grade the success of tendon repair.…”

Section: Introductionmentioning

confidence: 99%

Histologic Stages of Healing Correlate with Restoration of Tensile Strength in a Model of Experimental Tendon Repair

Rosenbaum

Wicker

Dines

et al. 2010

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Much current research is focused on biologic enhancement of the tendon repair process. To evaluate the different methods, which include a variety of gene therapy and tissue engineering techniques, histological and biomechanical testing is often employed. Both modalities offer information on the progress and quality of repair; however, they have been historically considered as two separate entities. Histological evaluation is a less costly undertaking; however, there is no validated scoring scale to compare the results of different studies or even the results within a given study. Biomechanical testing can provide validated outcome measures; however, it is associated with increased cost and is more labor intensive. We hypothesized that a properly developed, objective histological scoring system would provide a validated outcome measure to compare histological results and correlate with biomechanics. In an Achilles tendon model, we have developed a histological scoring scale to assess tendon repair. The system grades collagen orientation, angiogenesis, and cartilage induction. In this study, histology scores were plotted against biomechanical testing results of healing tendons which indicated that a strong linear correlation exists between the histological properties of repaired tendons and their biomechanical characteristics. Concordantly, this study provides a pragmatic and financially feasible means of evaluating repair while accounting for both the histology and biomechanical properties observed in surgically repaired, healing tendon.

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“…The validated arthroscopy score 22 for the repair site at 1.3 years was seen to have a significant positive correlation with the one and five year clinical outcome. This is the first report demonstrating an association of the functional outcome with the macroscopic quality of the repair site after simultaneous ACI and bone graft technique, where a poor arthroscopy score, indicative of sub-optimal graft, was linked with a higher rate of treatment failure.…”

Section: Discussionmentioning

confidence: 87%

“…Arthroscopic assessment-Patients had arthroscopic assessment of the repair site documented in the knee map using the validated Oswestry Arthroscopy Score (OAS; 22 ) approximately one year after the second stage of the procedure. MRI Scans -MRI scans were also used to assess the quality of repair following the surgery.…”

Section: Outcome Assessmentmentioning

confidence: 99%

Autologous Bone Plug Supplemented With Autologous Chondrocyte Implantation in Osteochondral Defects of the Knee

et al. 2016

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Arthroscopic Assessment of Cartilage Repair: A Validation Study of 2 Scoring Systems

Cited by 125 publications

References 15 publications

The Incidence and Clinical Relevance of Graft Hypertrophy After Matrix-Based Autologous Chondrocyte Implantation

The Incidence and Clinical Relevance of Graft Hypertrophy After Matrix-Based Autologous Chondrocyte Implantation

Histologic Stages of Healing Correlate with Restoration of Tensile Strength in a Model of Experimental Tendon Repair

Autologous Bone Plug Supplemented With Autologous Chondrocyte Implantation in Osteochondral Defects of the Knee

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