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Repair of osteochondral lesions in the knee by chondrocyte implantation using the MACI® technique

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Matrix-associated autologous chondrocyte implantation (MACI®) is an innovative therapeutic option for the treatment of chondral and osteochondral lesions of the knee.

Methods

Fifty-three patients (54 knees) with MRI-documented osteochondral lesions were treated with MACI®. A clinical assessment was performed using VAS score, Lysholm score, and Tegner activity level after an average follow-up of 27 months (SD: 2.3). MRI scans were performed 12 and 24 months after surgery. Seventeen patients were reevaluated after an average time of 59 months (SD: 6.7) after surgery.

Results

Two years after transplantation, Lysholm score increased from a preoperative mean value of 70 (SD: 13.4) to 95 (SD: 6.4); the average VAS score decreased from a preoperative value of 5.2 (SD: 2.9) to 1.9 (SD: 2.1). The difference with respect to Tegner activity level did not prove to be significant. At 1 year, MRI scans documented a completely repaired defect with slight subchondral bone abnormality in 38 cases (70%). Satisfying outcomes were confirmed on 17 patients who were reevaluated 5 years after surgery. At 60 months, MRI scans showed complete integration with the surrounding native cartilage without any sign of detachment or bone marrow edema in 15 cases (88%).

Conclusion

The MACI® technique is a safe and clinically effective procedure, which has been proven to be valuable in treating osteochondral defects even over the long term.

Level of evidence

Therapeutic study, Level III-2 (retrospective cohort study).

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Conflict of interest

Each author discloses any financial and personal relationships (e.g., employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications/registrations, grants or other funding) that might pose a conflict of interest in connection with the submitted article.

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Authors and Affiliations

  1. U.O.S.D. Chirurgia Articolare Mininvasiva (Minimally Invasive Articular Surgery), Istituto Ortopedico G. Pini, Milan, Italy

    Alberto Ventura, Enrico Borgo & Clara Terzaghi

  2. S.C. Ortopedia e Traumatologia Pediatrica, Istituto Ortopedico G. Pini, Milan, Italy

    Antonio Memeo

  3. Scuola di Specializzazione in Ortopedia e Traumatologia, Università degli Studi di Milano, Milan, Italy

    Claudio Legnani

  4. Istituto Ortopedico G. Pini, Università degli Studi di Milano, Milan, Italy

    Walter Albisetti

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  1. Alberto Ventura
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  2. Antonio Memeo
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  3. Enrico Borgo
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  4. Clara Terzaghi
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  5. Claudio Legnani
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Correspondence to Alberto Ventura.

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Ventura, A., Memeo, A., Borgo, E. et al. Repair of osteochondral lesions in the knee by chondrocyte implantation using the MACI® technique. Knee Surg Sports Traumatol Arthrosc 20, 121–126 (2012). https://doi.org/10.1007/s00167-011-1575-0

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  • DOI: https://doi.org/10.1007/s00167-011-1575-0

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