Autologous chondrocyte implantation for focal cartilage defects in athletes: histology and second-look arthroscopy

Scorrano, Antonio; Biggi, Francesco; G, Turi

doi:10.1007/pl00021718

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…[18][19][20][21] ACI has demonstrated successful graft incorporation with histology closely matching native hyaline cartilage. 22,23 Young patients have comparable, if not improved, knee functional outcome scores and 10-year survivorship approaching 90% when comparing ACI to other surgical techniques. 20,[24][25][26][27][28] Although studies corroborate the success of ACI, donor site morbidity remains a concern.…”

Section: Discussionmentioning

confidence: 94%

“…In 1743, William Hunter highlighted that “ulcerated cartilage is a troublesome thing, once destroyed it is not repaired.”17 Although many years later it remains true that there is limited biological regenerative capacity to restore articular cartilage, ACI has shown promise in the treatment of full-thickness cartilage defects larger than 2 cm² in younger patients 18–21. ACI has demonstrated successful graft incorporation with histology closely matching native hyaline cartilage 22,23. Young patients have comparable, if not improved, knee functional outcome scores and 10-year survivorship approaching 90% when comparing ACI to other surgical techniques 20,24–28.…”

Section: Discussionmentioning

confidence: 99%

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Loose Body Versus Trochlear Biopsy Matrix-Induced Autologous Chondrocyte Implantation (MACI) MOCART Scores and IKDC Reported Outcomes in Pediatric Patients

Hill

Delman

Shelton

et al. 2022

Journal of Pediatric Orthopaedics

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Background: Matrix-induced autologous chondrocyte implantation (MACI) has shown promising results in the treatment of osteochondral lesions of the knee. A recent study showed similar viability comparing chondrocytes harvested from the intercondylar notch compared to those harvested from osteochondral loose bodies. However, there is limited evidence assessing how these different biopsies perform clinically. The goal of this study was to compare both radiographic and patient-reported outcomes in patients with patellar and femoral osteochondral lesions treated with MACI using either a standard intercondylar notch biopsy or an osteochondral loose body biopsy. Methods: A retrospective study was performed on all pediatric autologous chondrocyte implantation procedures performed from 2014 to 2017 at a single institution. Patients were divided into 2 groups: one group had cartilage derived from a standard intercondylar notch biopsy (n = 9) and the other group had cartilage derived from an osteochondral loose body found within the ipsilateral knee (n = 10). At a minimum of 1-year postimplantation, magnetic resonance imagings of the operative knee were performed and the Magnetic Resonance Observation of Cartilage Repair Tissue Knee Score (MOCART 2.0) knee score was used to assess the integrity and quality of the cartilage repair tissue. Interclass correlation coefficients were calculated between the 2 groups. International Knee Documentation Committee (IKDC) outcome scores were determined at a minimum 2 years post-implantation. Results: The interclass correlation coefficient between three independent examiners for the MOCART scoring was excellent at 0.94. With regards to the MOCART score, the loose body group had an insignificant 17-point lower median score at 63 [interquartile range (IQR): 58 to 89] compared to the intercondylar group at 80 (IQR: 65 to 90) (P = 0.15). There was no difference in IKDC scores with the loose body group having a median score of 82 (IQR: 65 to 95) and the intercondylar group having a median score of 84 (IQR: 53 to 99) (P = 0.90). Conclusion: These results demonstrate that osteochondral loose bodies can be used as viable harvest site in MACI procedures with no difference in functional and radiographic outcomes at 2 years postimplantation. This may limit both short and longterm donor site morbidity.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Loose Body Versus Trochlear Biopsy Matrix-Induced Autologous Chondrocyte Implantation (MACI) MOCART Scores and IKDC Reported Outcomes in Pediatric Patients

Hill

Delman

Shelton

et al. 2022

Journal of Pediatric Orthopaedics

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Autologous chondrocyte implantation, matrix‐induced autologous chondrocyte implantation, osteochondral autograft transplantation and osteochondral allograft improve knee function and pain with considerations for patient and cartilage defects characteristics: A systematic review and meta‐analysis

Nassar,

Guerin,

Keel

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposePrevious studies have reported on the outcomes of autologous chondrocyte implantation (ACI) versus matrix‐induced ACI (MACI) and microfracture. Specific clinical outcomes of ACI, MACI, osteochondral autograft transplantation (OAT) and osteochondral allograft (OCA) have not been well studied. The purpose of this systematic review and meta‐analysis was to analyze the outcomes of these regenerative surgical techniques with an emphasis on comparing their effectiveness using the International Knee Documentation Committee (IKDC) subjective score, the Lysholm Knee Scoring Scale, the Tegner Activity Scale and the Visual Analogue Scale (VAS) score for the surgical treatment of tibiofemoral joint cartilage defects.MethodsAn electronic search of MEDLINE, Embase and Cochrane Library was performed to identify studies that reported clinical outcomes for ACI, MACI, OAT and OCA procedures. The literature review was conducted following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines and only studies involving cartilage defects in the tibiofemoral joint were included. Outcomes were measured with the IKDC evaluation, Lysholm Knee Scoring Scale, Tegner Activity Scale and the VAS. Outcomes were compared to the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS). The methodological quality of the included studies was analyzed by the Methodological Index for Nonrandomized Studies and the Jadad scale.ResultsForty‐seven studies were included representing a total of 1993 patients with a mean follow‐up time of 57.2 ± 40.3 months (range: 4.0–160.0 months). The location of cartilage defects was reported in 46 studies, with a total of 1922 cartilage defects. There were 1277 medial femoral condyle cartilage defects, 488 lateral femoral condyle cartilage defects, 139 unspecified femoral condyle cartilage defects and 18 tibial plateau cartilage defects. All four procedures reported significant improvements in the Lysholm, IKDC, Tegner and VAS scores with no significant differences between them. The OAT technique surpassed the PASS threshold for the IKDC score while all four techniques surpassed the PASS threshold for Tegner and Lysholm scores. Additionally, all procedures met the MCID for each clinical outcome.ConclusionThis systematic review and meta‐analysis indicate that ACI, MACI, OAT and OCA all result in significant improvements in knee function and pain for cartilage defects of the tibiofemoral joint. When selecting a procedure, patient and cartilage defect characteristics should be assessed to determine the best technique for each individual patient.Study DesignSystematic review and meta‐analysis.Level of EvidenceLevel III.

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Assessment of Cartilage Growth After Biopsy of Osteochondral Loose Bodies in Adolescent Knees for Use in Autologous Chondrocyte Implantation

Robinson¹,

Kramer²,

Shelton

et al. 2020

Journal of Pediatric Orthopaedics

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Autologous chondrocyte implantation for focal cartilage defects in athletes: histology and second-look arthroscopy

Cited by 3 publications

References 23 publications

Loose Body Versus Trochlear Biopsy Matrix-Induced Autologous Chondrocyte Implantation (MACI) MOCART Scores and IKDC Reported Outcomes in Pediatric Patients

Loose Body Versus Trochlear Biopsy Matrix-Induced Autologous Chondrocyte Implantation (MACI) MOCART Scores and IKDC Reported Outcomes in Pediatric Patients

Autologous chondrocyte implantation, matrix‐induced autologous chondrocyte implantation, osteochondral autograft transplantation and osteochondral allograft improve knee function and pain with considerations for patient and cartilage defects characteristics: A systematic review and meta‐analysis

Assessment of Cartilage Growth After Biopsy of Osteochondral Loose Bodies in Adolescent Knees for Use in Autologous Chondrocyte Implantation

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