Skip to main content
Erschienen in: European Journal of Trauma and Emergency Surgery 4/2011

01.08.2011 | Original Article

Comparison of two different matrix-based autologous chondrocyte transplantation systems: 1 year follow-up results

verfasst von: S. Flohé, M. Betsch, K. Ruße, M. Wild, J. Windolf, M. Schulz

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 4/2011

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The treatment of full-thickness cartilage defects of the knee is a common problem in orthopaedic surgery. Autologous chondrocyte transplantation (ACT) is one of the few reliable treatment options of cartilage defects with good long-term outcomes. The improvement of ACT led to the matrix-based ACT (MACT). The purpose of the study was to compare two different commercially available MACT systems.

Methods

Eleven patients with a cartilage defect of the knee were treated with the MACI® system and another nine patients with the CaRes® implant. The patients were prospectively followed and re-examined after one year.

Results

One year after surgery all but one patient have significantly improved in their clinical outcome. Both types of MACT revealed similar results in terms of increase in level of activity, pain relief and knee function.

Conclusion

The study showed that MACT is a good therapeutic option for full-size defects of the femoral condyle. The MACI® implant seems to be easier to handle which is reflected by smaller incisions and a shorter operation time.
Literatur
1.
Zurück zum Zitat Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L. Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med. 1994;331(14):889–95.PubMedCrossRef Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L. Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med. 1994;331(14):889–95.PubMedCrossRef
2.
Zurück zum Zitat Bentley G, Biant LC, Carrington RW, Akmal M, Goldberg A, Williams AM, et al. A prospective, randomised comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects in the knee. J Bone Joint Surg Br. 2003;85(2):223–30.PubMedCrossRef Bentley G, Biant LC, Carrington RW, Akmal M, Goldberg A, Williams AM, et al. A prospective, randomised comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects in the knee. J Bone Joint Surg Br. 2003;85(2):223–30.PubMedCrossRef
3.
Zurück zum Zitat Horas U, Pelinkovic D, Herr G, Aigner T, Schnettler R. Autologous chondrocyte implantation and osteochondral cylinder transplantation in cartilage repair of the knee joint. A prospective, comparative trial. J Bone Joint Surg Am. 2003;85-A(2):185–92.PubMed Horas U, Pelinkovic D, Herr G, Aigner T, Schnettler R. Autologous chondrocyte implantation and osteochondral cylinder transplantation in cartilage repair of the knee joint. A prospective, comparative trial. J Bone Joint Surg Am. 2003;85-A(2):185–92.PubMed
4.
Zurück zum Zitat Peterson L, Minas T, Brittberg M, Lindahl A. Treatment of osteochondritis dissecans of the knee with autologous chondrocyte transplantation: results at two to ten years. J Bone Joint Surg Am. 2003;85-A(Suppl 2):17–24.PubMed Peterson L, Minas T, Brittberg M, Lindahl A. Treatment of osteochondritis dissecans of the knee with autologous chondrocyte transplantation: results at two to ten years. J Bone Joint Surg Am. 2003;85-A(Suppl 2):17–24.PubMed
5.
Zurück zum Zitat Gooding CR, Bartlett W, Bentley G, Skinner JA, Carrington R, Flanagan A. A prospective, randomised study comparing two techniques of autologous chondrocyte implantation for osteochondral defects in the knee: periosteum covered versus type I/III collagen covered. Knee. 2006;13(3):203–10.PubMedCrossRef Gooding CR, Bartlett W, Bentley G, Skinner JA, Carrington R, Flanagan A. A prospective, randomised study comparing two techniques of autologous chondrocyte implantation for osteochondral defects in the knee: periosteum covered versus type I/III collagen covered. Knee. 2006;13(3):203–10.PubMedCrossRef
6.
Zurück zum Zitat Minas T. Autologous chondrocyte implantation for focal chondral defects of the knee. Clin Orthop Relat Res. 2001;391(Suppl):S349–61.PubMedCrossRef Minas T. Autologous chondrocyte implantation for focal chondral defects of the knee. Clin Orthop Relat Res. 2001;391(Suppl):S349–61.PubMedCrossRef
7.
Zurück zum Zitat Peterson L, Minas T, Brittberg M, Nilsson A, Sjogren-Jansson E, Lindahl A. Two- to 9-year outcome after autologous chondrocyte transplantation of the knee. Clin Orthop Relat Res. 2000;374:212–34.PubMedCrossRef Peterson L, Minas T, Brittberg M, Nilsson A, Sjogren-Jansson E, Lindahl A. Two- to 9-year outcome after autologous chondrocyte transplantation of the knee. Clin Orthop Relat Res. 2000;374:212–34.PubMedCrossRef
8.
Zurück zum Zitat Bartlett W, Skinner JA, Gooding CR, Carrington RW, Flanagan AM, Briggs TW, et al. Autologous chondrocyte implantation versus matrix-induced autologous chondrocyte implantation for osteochondral defects of the knee: a prospective, randomised study. J Bone Joint Surg Br. 2005;87(5):640–5.PubMedCrossRef Bartlett W, Skinner JA, Gooding CR, Carrington RW, Flanagan AM, Briggs TW, et al. Autologous chondrocyte implantation versus matrix-induced autologous chondrocyte implantation for osteochondral defects of the knee: a prospective, randomised study. J Bone Joint Surg Br. 2005;87(5):640–5.PubMedCrossRef
9.
Zurück zum Zitat Ruano-Ravina A, Jato Diaz M. Autologous chondrocyte implantation: a systematic review. Osteoarthritis Cartilage. 2006;14(1):47–51.PubMedCrossRef Ruano-Ravina A, Jato Diaz M. Autologous chondrocyte implantation: a systematic review. Osteoarthritis Cartilage. 2006;14(1):47–51.PubMedCrossRef
10.
Zurück zum Zitat Behrens P, Bosch U, Bruns J, Erggelet C, Esenwein SA, Gaissmaier C, et al. Indications and implementation of recommendations of the working group “tissue regeneration and tissue substitutes” for autologous chondrocyte transplantation (act). Z Orthop Ihre Grenzgeb. 2004;142(5):529–39.PubMedCrossRef Behrens P, Bosch U, Bruns J, Erggelet C, Esenwein SA, Gaissmaier C, et al. Indications and implementation of recommendations of the working group “tissue regeneration and tissue substitutes” for autologous chondrocyte transplantation (act). Z Orthop Ihre Grenzgeb. 2004;142(5):529–39.PubMedCrossRef
11.
Zurück zum Zitat Irrgang JJ, Anderson AF, Boland AL, Harner CD, Kurosaka M, Neyret P, et al. Development and validation of the international knee documentation committee subjective knee form. Am J Sports Med. 2001;29(5):600–13.PubMed Irrgang JJ, Anderson AF, Boland AL, Harner CD, Kurosaka M, Neyret P, et al. Development and validation of the international knee documentation committee subjective knee form. Am J Sports Med. 2001;29(5):600–13.PubMed
12.
Zurück zum Zitat Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985;198:43–9.PubMed Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985;198:43–9.PubMed
14.
Zurück zum Zitat Saris DB, Vanlauwe J, Victor J, Haspl M, Bohnsack M, Fortems Y, et al. Characterized chondrocyte implantation results in better structural repair when treating symptomatic cartilage defects of the knee in a randomized controlled trial versus microfracture. Am J Sports Med. 2008;36(2):235–46.PubMedCrossRef Saris DB, Vanlauwe J, Victor J, Haspl M, Bohnsack M, Fortems Y, et al. Characterized chondrocyte implantation results in better structural repair when treating symptomatic cartilage defects of the knee in a randomized controlled trial versus microfracture. Am J Sports Med. 2008;36(2):235–46.PubMedCrossRef
15.
Zurück zum Zitat Selmi TA, Verdonk P, Chambat P, Dubrana F, Potel JF, Barnouin L, et al. Autologous chondrocyte implantation in a novel alginate–agarose hydrogel: outcome at two years. J Bone Joint Surg Br. 2008;90(5):597–604.PubMedCrossRef Selmi TA, Verdonk P, Chambat P, Dubrana F, Potel JF, Barnouin L, et al. Autologous chondrocyte implantation in a novel alginate–agarose hydrogel: outcome at two years. J Bone Joint Surg Br. 2008;90(5):597–604.PubMedCrossRef
16.
Zurück zum Zitat Maus U, Schneider U, Gravius S, Muller-Rath R, Mumme T, Miltner O, et al. Clinical results after three years use of matrix-associated act for the treatment of osteochondral defects of the knee. Z Orthop Unfall. 2008;146(1):31–7.PubMedCrossRef Maus U, Schneider U, Gravius S, Muller-Rath R, Mumme T, Miltner O, et al. Clinical results after three years use of matrix-associated act for the treatment of osteochondral defects of the knee. Z Orthop Unfall. 2008;146(1):31–7.PubMedCrossRef
17.
Zurück zum Zitat Behrens P, Bitter T, Kurz B, Russlies M. Matrix-associated autologous chondrocyte transplantation/implantation (mact/maci)–5 year follow-up. Knee. 2006;13(3):194–202.PubMedCrossRef Behrens P, Bitter T, Kurz B, Russlies M. Matrix-associated autologous chondrocyte transplantation/implantation (mact/maci)–5 year follow-up. Knee. 2006;13(3):194–202.PubMedCrossRef
18.
Zurück zum Zitat Marcacci M, Zaffagnini S, Kon E, Visani A, Iacono F, Loreti I. Arthroscopic autologous chondrocyte transplantation: technical note. Knee Surg Sports Traumatol Arthrosc. 2002;10(3):154–9.PubMedCrossRef Marcacci M, Zaffagnini S, Kon E, Visani A, Iacono F, Loreti I. Arthroscopic autologous chondrocyte transplantation: technical note. Knee Surg Sports Traumatol Arthrosc. 2002;10(3):154–9.PubMedCrossRef
19.
Zurück zum Zitat Nehrer S, Domayer S, Dorotka R, Schatz K, Bindreiter U, Kotz R. Three-year clinical outcome after chondrocyte transplantation using a hyaluronan matrix for cartilage repair. Eur J Radiol. 2006;57(1):3–8.PubMedCrossRef Nehrer S, Domayer S, Dorotka R, Schatz K, Bindreiter U, Kotz R. Three-year clinical outcome after chondrocyte transplantation using a hyaluronan matrix for cartilage repair. Eur J Radiol. 2006;57(1):3–8.PubMedCrossRef
20.
Zurück zum Zitat Steinwachs M, Kreuz PC. Autologous chondrocyte implantation in chondral defects of the knee with a type I/III collagen membrane: a prospective study with a 3 year follow-up. Arthroscopy. 2007;23(4):381–7.PubMedCrossRef Steinwachs M, Kreuz PC. Autologous chondrocyte implantation in chondral defects of the knee with a type I/III collagen membrane: a prospective study with a 3 year follow-up. Arthroscopy. 2007;23(4):381–7.PubMedCrossRef
21.
Zurück zum Zitat Kon E, Gobbi A, Filardo G, Delcogliano M, Zaffagnini S, Marcacci M. Arthroscopic second-generation autologous chondrocyte implantation compared with microfracture for chondral lesions of the knee: prospective non-randomized study at 5 years. Am J Sports Med. 2009;37(1):33–41.PubMedCrossRef Kon E, Gobbi A, Filardo G, Delcogliano M, Zaffagnini S, Marcacci M. Arthroscopic second-generation autologous chondrocyte implantation compared with microfracture for chondral lesions of the knee: prospective non-randomized study at 5 years. Am J Sports Med. 2009;37(1):33–41.PubMedCrossRef
22.
Zurück zum Zitat Concaro S, Nicklasson E, Ellowsson L, Lindahl A, Brittberg M, Gatenholm P. Effect of cell seeding concentration on the quality of tissue engineered constructs loaded with adult human articular chondrocytes. J Tissue Eng Regen Med. 2008;2(1):14–21.PubMedCrossRef Concaro S, Nicklasson E, Ellowsson L, Lindahl A, Brittberg M, Gatenholm P. Effect of cell seeding concentration on the quality of tissue engineered constructs loaded with adult human articular chondrocytes. J Tissue Eng Regen Med. 2008;2(1):14–21.PubMedCrossRef
23.
Zurück zum Zitat Dowthwaite GP, Bishop JC, Redman SN, Khan IM, Rooney P, Evans DJ, et al. The surface of articular cartilage contains a progenitor cell population. J Cell Sci. 2004;117(Pt 6):889–97.PubMedCrossRef Dowthwaite GP, Bishop JC, Redman SN, Khan IM, Rooney P, Evans DJ, et al. The surface of articular cartilage contains a progenitor cell population. J Cell Sci. 2004;117(Pt 6):889–97.PubMedCrossRef
24.
Zurück zum Zitat Gigante A, Bevilacqua C, Zara C, Travasi M, Chillemi C. Autologous chondrocyte implantation: cells phenotype and proliferation analysis. Knee Surg Sports Traumatol Arthrosc. 2001;9(4):254–8.PubMedCrossRef Gigante A, Bevilacqua C, Zara C, Travasi M, Chillemi C. Autologous chondrocyte implantation: cells phenotype and proliferation analysis. Knee Surg Sports Traumatol Arthrosc. 2001;9(4):254–8.PubMedCrossRef
25.
Zurück zum Zitat Gigante A, Bevilacqua C, Ricevuto A, Mattioli-Belmonte M, Greco F. Membrane-seeded autologous chondrocytes: cell viability and characterization at surgery. Knee Surg Sports Traumatol Arthrosc. 2007;15(1):88–92.PubMedCrossRef Gigante A, Bevilacqua C, Ricevuto A, Mattioli-Belmonte M, Greco F. Membrane-seeded autologous chondrocytes: cell viability and characterization at surgery. Knee Surg Sports Traumatol Arthrosc. 2007;15(1):88–92.PubMedCrossRef
26.
Zurück zum Zitat Brittberg M, Sjogren-Jansson E, Lindahl A, Peterson L. Influence of fibrin sealant (tisseel) on osteochondral defect repair in the rabbit knee. Biomaterials. 1997;18(3):235–42.PubMedCrossRef Brittberg M, Sjogren-Jansson E, Lindahl A, Peterson L. Influence of fibrin sealant (tisseel) on osteochondral defect repair in the rabbit knee. Biomaterials. 1997;18(3):235–42.PubMedCrossRef
27.
Zurück zum Zitat Gille J, Meisner U, Ehlers EM, Muller A, Russlies M, Behrens P. Migration pattern, morphology and viability of cells suspended in or sealed with fibrin glue: a histomorphologic study. Tissue Cell. 2005;37(5):339–48.PubMedCrossRef Gille J, Meisner U, Ehlers EM, Muller A, Russlies M, Behrens P. Migration pattern, morphology and viability of cells suspended in or sealed with fibrin glue: a histomorphologic study. Tissue Cell. 2005;37(5):339–48.PubMedCrossRef
28.
Zurück zum Zitat Marlovits S, Striessnig G, Kutscha-Lissberg F, Resinger C, Aldrian SM, Vecsei V, et al. Early postoperative adherence of matrix-induced autologous chondrocyte implantation for the treatment of full-thickness cartilage defects of the femoral condyle. Knee Surg Sports Traumatol Arthrosc. 2005;13(6):451–7.PubMedCrossRef Marlovits S, Striessnig G, Kutscha-Lissberg F, Resinger C, Aldrian SM, Vecsei V, et al. Early postoperative adherence of matrix-induced autologous chondrocyte implantation for the treatment of full-thickness cartilage defects of the femoral condyle. Knee Surg Sports Traumatol Arthrosc. 2005;13(6):451–7.PubMedCrossRef
29.
Zurück zum Zitat Sha′ban M, Kim SH, Idrus RB, Khang G. Fibrin and poly (lactic-co-glycolic acid) hybrid scaffold promotes early chondrogenesis of articular chondrocytes: an in vitro study. J Orthop Surg. 2008;3:17.CrossRef Sha′ban M, Kim SH, Idrus RB, Khang G. Fibrin and poly (lactic-co-glycolic acid) hybrid scaffold promotes early chondrogenesis of articular chondrocytes: an in vitro study. J Orthop Surg. 2008;3:17.CrossRef
30.
Zurück zum Zitat Ronga M, Grassi FA, Bulgheroni P. Arthroscopic autologous chondrocyte implantation for the treatment of a chondral defect in the tibial plateau of the knee. Arthroscopy. 2004;20(1):79–84.PubMedCrossRef Ronga M, Grassi FA, Bulgheroni P. Arthroscopic autologous chondrocyte implantation for the treatment of a chondral defect in the tibial plateau of the knee. Arthroscopy. 2004;20(1):79–84.PubMedCrossRef
31.
Zurück zum Zitat Marcacci M, Kon E, Zaffagnini S, Filardo G, Delcogliano M, Neri MP, et al. Arthroscopic second generation autologous chondrocyte implantation. Knee Surg Sports Traumatol Arthrosc. 2007;15(5):610–9.PubMedCrossRef Marcacci M, Kon E, Zaffagnini S, Filardo G, Delcogliano M, Neri MP, et al. Arthroscopic second generation autologous chondrocyte implantation. Knee Surg Sports Traumatol Arthrosc. 2007;15(5):610–9.PubMedCrossRef
32.
Zurück zum Zitat Wasiak J, Clar C, Villanueva E. Autologous cartilage implantation for full thickness articular cartilage defects of the knee. Cochrane Database Syst Rev. 2006;3:CD003323. Wasiak J, Clar C, Villanueva E. Autologous cartilage implantation for full thickness articular cartilage defects of the knee. Cochrane Database Syst Rev. 2006;3:CD003323.
Metadaten
Titel
Comparison of two different matrix-based autologous chondrocyte transplantation systems: 1 year follow-up results
verfasst von
S. Flohé
M. Betsch
K. Ruße
M. Wild
J. Windolf
M. Schulz
Publikationsdatum
01.08.2011
Verlag
Springer-Verlag
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 4/2011
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-010-0057-2

Weitere Artikel der Ausgabe 4/2011

European Journal of Trauma and Emergency Surgery 4/2011 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.