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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 5/2022

23.04.2021 | KNEE

Good healing potential of patellar chondral defects after all-arthroscopic autologous chondrocyte implantation with spheroids: a second-look arthroscopic assessment

verfasst von: Yoshikazu Sumida, Kaori Nakamura, Sven Feil, Maja Siebold, Joachim Kirsch, Rainer Siebold

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 5/2022

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Abstract

Purpose

To report second-look arthroscopic assessment after all-arthroscopic autologous chondrocyte implantation (ACI) for articular cartilage defects at the patella.

Methods

A second-look arthroscopy after all-arthroscopic ACI using chondrospheres® (ACT3D) was performed in 30 patients with 30 full-thickness retropatellar cartilage defects. The mean time from ACI to second-look arthroscopy was 14.9 ± 16.3 (6–71) months. The quality of cartilage regeneration was evaluated by the International Cartilage-Repair Score (ICRS)—Cartilage Repair Assessment (CRA).

Results

Eleven lesions (36.7%) were classified as CRA grade I (normal) and 19 lesions (63.3%) as grade II (nearly normal). Concerning the degree of defect repair, 25 lesions (83.3%) were repaired up to the height of the surrounding articular retropatellar cartilage. Five lesions (16.7%) showed 75% repair of defect depth. The border zone was completely integrated into the surrounding articular cartilage shoulder in 28 lesions (93.3%) and demarcated within 1 mm in 2 lesions (6.7%). Macroscopically and by probing, 12 lesions (40%) had intact smooth surface, 17 lesions (56.7%) had fibrillated surface and 1 lesion (3.3%) had small, scattered fissures. A negative correlation was found between the overall repair assessment score and the defect size (r2 = − 0.430, p = 0.046) and between integration into border zone and defect size (r2 = − 0.340, p = 0.045). A positive correlation was found between macroscopic appearance and age (r2 =  + 0.384, p = 0.036).

Conclusions

All-arthroscopic ACI using chondrospheres® (ACT3D) for full-thickness retropatellar articular cartilage defects proved to be reproducible and reliable. The advantage of the procedure is that it is minimal invasive. Arthroscopic second-look demonstrated a high grade of normal or nearly normal cartilage regeneration. Although statistically significant differences were not observed, larger defect size and younger age may compromise the result of overall repair.

Level of evidence

III.
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Metadaten
Titel
Good healing potential of patellar chondral defects after all-arthroscopic autologous chondrocyte implantation with spheroids: a second-look arthroscopic assessment
verfasst von
Yoshikazu Sumida
Kaori Nakamura
Sven Feil
Maja Siebold
Joachim Kirsch
Rainer Siebold
Publikationsdatum
23.04.2021
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 5/2022
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-021-06584-x

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