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Erschienen in: Archives of Orthopaedic and Trauma Surgery 6/2020

26.08.2019 | Orthopaedic Surgery

Clinical outcome and success rates of ACI for cartilage defects of the patella: a subgroup analysis from a controlled randomized clinical phase II trial (CODIS study)

verfasst von: Philipp Niemeyer, Volker Laute, Wolfgang Zinser, Christoph Becher, Peter Diehl, Thomas Kolombe, Jakob Fay, Rainer Siebold, Stefan Fickert

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 6/2020

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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).
Literatur
1.
Zurück zum Zitat Niemeyer P, Andereya S, Angele P, Ateschrang A, Aurich M, Baumann M, Behrens P, Bosch U, Erggelet C, Fickert S, Fritz J, Gebhard H, Gelse K, Gunther D, Hoburg A, Kasten P, Kolombe T, Madry H, Marlovits S, Meenen NM, Muller PE, Noth U, Petersen JP, Pietschmann M, Richter W, Rolauffs B, Rhunau K, Schewe B, Steinert A, Steinwachs MR, Welsch GH, Zinser W, Albrecht D (2013) Autologous chondrocyte implantation (ACI) for cartilage defects of the knee: a guideline by the working group "Tissue Regeneration" of the German society of orthopaedic surgery and traumatology (DGOU). Z Orthop Unfall 151(1):38–47. https://doi.org/10.1055/s-0032-1328207 CrossRefPubMed Niemeyer P, Andereya S, Angele P, Ateschrang A, Aurich M, Baumann M, Behrens P, Bosch U, Erggelet C, Fickert S, Fritz J, Gebhard H, Gelse K, Gunther D, Hoburg A, Kasten P, Kolombe T, Madry H, Marlovits S, Meenen NM, Muller PE, Noth U, Petersen JP, Pietschmann M, Richter W, Rolauffs B, Rhunau K, Schewe B, Steinert A, Steinwachs MR, Welsch GH, Zinser W, Albrecht D (2013) Autologous chondrocyte implantation (ACI) for cartilage defects of the knee: a guideline by the working group "Tissue Regeneration" of the German society of orthopaedic surgery and traumatology (DGOU). Z Orthop Unfall 151(1):38–47. https://​doi.​org/​10.​1055/​s-0032-1328207 CrossRefPubMed
4.
8.
9.
Zurück zum Zitat Peterson L, Brittberg M, Kiviranta I, Akerlund EL, Lindahl A (2002) Autologous chondrocyte transplantation Biomechanics and long-term durability. Am J Sports Med 30(1):2–12CrossRef Peterson L, Brittberg M, Kiviranta I, Akerlund EL, Lindahl A (2002) Autologous chondrocyte transplantation Biomechanics and long-term durability. Am J Sports Med 30(1):2–12CrossRef
11.
Zurück zum Zitat Pachowsky ML, Trattnig S, Wondrasch B, Apprich S, Marlovits S, Mauerer A, Welsch GH, Blanke M (2014) In vivo evaluation of biomechanical properties in the patellofemoral joint after matrix-associated autologous chondrocyte transplantation by means of quantitative T2 MRI. Knee Surg Sports Traumatol Arthrosc 22(6):1360–1369. https://doi.org/10.1007/s00167-013-2527-7 CrossRefPubMed Pachowsky ML, Trattnig S, Wondrasch B, Apprich S, Marlovits S, Mauerer A, Welsch GH, Blanke M (2014) In vivo evaluation of biomechanical properties in the patellofemoral joint after matrix-associated autologous chondrocyte transplantation by means of quantitative T2 MRI. Knee Surg Sports Traumatol Arthrosc 22(6):1360–1369. https://​doi.​org/​10.​1007/​s00167-013-2527-7 CrossRefPubMed
17.
Zurück zum Zitat Niemeyer P, Laute V, John T, Becher C, Diehl P, Kolombe T, Fay J, Siebold R, Niks M, Fickert S, Zinser W (2016) The effect of cell dose on the early magnetic resonance morphological outcomes of autologous cell implantation for articular cartilage defects in the knee: a randomized clinical trial. Am J Sports Med. https://doi.org/10.1177/0363546516646092 CrossRefPubMed Niemeyer P, Laute V, John T, Becher C, Diehl P, Kolombe T, Fay J, Siebold R, Niks M, Fickert S, Zinser W (2016) The effect of cell dose on the early magnetic resonance morphological outcomes of autologous cell implantation for articular cartilage defects in the knee: a randomized clinical trial. Am J Sports Med. https://​doi.​org/​10.​1177/​0363546516646092​ CrossRefPubMed
20.
Zurück zum Zitat Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD (1998) Knee injury and osteoarthritis outcome score (KOOS)–development of a self-administered outcome measure. J Orthop Sports Phys Ther 28(2):88–96CrossRef Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD (1998) Knee injury and osteoarthritis outcome score (KOOS)–development of a self-administered outcome measure. J Orthop Sports Phys Ther 28(2):88–96CrossRef
22.
Zurück zum Zitat Peterson L, Minas T, Brittberg M, Nilsson A, Sjogren-Jansson E, Lindahl A (2000) Two- to 9-year outcome after autologous chondrocyte transplantation of the knee. Clin Orthop Relat Res 374:212–234CrossRef Peterson L, Minas T, Brittberg M, Nilsson A, Sjogren-Jansson E, Lindahl A (2000) Two- to 9-year outcome after autologous chondrocyte transplantation of the knee. Clin Orthop Relat Res 374:212–234CrossRef
27.
Zurück zum Zitat Assche DV, Caspel DV, Staes F, Saris DB, Bellemans J, Vanlauwe J, Luyten FP (2011) Implementing one standardized rehabilitation protocol following autologous chondrocyte implantation or microfracture in the knee results in comparable physical therapy management. Physiother Theory Pract 27(2):125–136. https://doi.org/10.3109/09593981003681046 CrossRefPubMed Assche DV, Caspel DV, Staes F, Saris DB, Bellemans J, Vanlauwe J, Luyten FP (2011) Implementing one standardized rehabilitation protocol following autologous chondrocyte implantation or microfracture in the knee results in comparable physical therapy management. Physiother Theory Pract 27(2):125–136. https://​doi.​org/​10.​3109/​0959398100368104​6 CrossRefPubMed
28.
Metadaten
Titel
Clinical outcome and success rates of ACI for cartilage defects of the patella: a subgroup analysis from a controlled randomized clinical phase II trial (CODIS study)
verfasst von
Philipp Niemeyer
Volker Laute
Wolfgang Zinser
Christoph Becher
Peter Diehl
Thomas Kolombe
Jakob Fay
Rainer Siebold
Stefan Fickert
Publikationsdatum
26.08.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 6/2020
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-019-03264-x

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