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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 6/2014

01.06.2014 | Knee

Early resumption of physical activities leads to inferior clinical outcomes after matrix-based autologous chondrocyte implantation in the knee

verfasst von: Thomas R. Niethammer, Peter E. Müller, Elem Safi, Andreas Ficklscherer, Björn P. Roßbach, Volkmar Jansson, Matthias F. Pietschmann

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 6/2014

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Abstract

Purpose

Matrix-based autologous chondrocyte implantation is a well-established operation procedure for full cartilage defects. When to resume physical activity after matrix-based autologous chondrocyte implantation is controversial. Our hypothesis was that early resumption of physical activity leads to a worse clinical outcome after matrix-based autologous chondrocyte implantation in the knee two years post-operatively. Physical activity is defined as any kind of impact sport.

Methods

Forty-four patients with cartilage defects of the knee were treated with matrix-based autologous chondrocyte implantation (Novocart®3D). All patients were assessed preoperatively and after a period of 24 months with the University of California Los Angeles (UCLA) Activity score. The return to physical activities or sports after matrix-based autologous chondrocyte implantation was documented. Patients were evaluated using the International Knee Documentation Committee Knee Examination Form and visual analogue scale for pain after 6, 12 and 24 months.

Results

Fifty-five percent showed an unchanged level of physical activity in the UCLA Activity score post-operatively. About 35 % showed a lower level and 10 % a higher level of physical activity. The average return to physical activities or sports after matrix-based autologous chondrocyte implantation procedure was 10.2 months. Patients with a later return of sports after 12 months showed significantly better clinical results after two years. In particular, patients who started practicing impact sport after 12 months post-operatively showed significantly better results.

Conclusion

Resuming physical activity including impact sports without waiting at least 12 months after the operation leads to inferior outcomes up to 24 months after matrix-based autologous chondrocyte implantation.

Level of evidence

Level IV.
Literatur
1.
Zurück zum Zitat Amstutz HC, Thomas BJ, Jinnah R, Kim W, Grogan T, Yale C (1984) Treatment of primary osteoarthritis of the hip. A comparison of total joint and surface replacement arthroplasty. J Bone Joint Surg Am 66(2):228–241PubMed Amstutz HC, Thomas BJ, Jinnah R, Kim W, Grogan T, Yale C (1984) Treatment of primary osteoarthritis of the hip. A comparison of total joint and surface replacement arthroplasty. J Bone Joint Surg Am 66(2):228–241PubMed
2.
Zurück zum Zitat Behrens P, Bosch U, Bruns J, Erggelet C, Esenwein SA, Gaissmaier C, Krackhardt T, Lohnert J, Marlovits S, Meenen NM, Mollenhauer J, Nehrer S, Niethard FU, Noth U, Perka C, Richter W, Schafer D, Schneider U, Steinwachs M, Weise K (2004) Indications and implementation of recommendations of the working group “tissue regeneration and tissue substitutes” for autologous chondrocyte transplantation (ACT). Z Orthop Ihre Grenzgeb 142(5):529–539PubMedCrossRef Behrens P, Bosch U, Bruns J, Erggelet C, Esenwein SA, Gaissmaier C, Krackhardt T, Lohnert J, Marlovits S, Meenen NM, Mollenhauer J, Nehrer S, Niethard FU, Noth U, Perka C, Richter W, Schafer D, Schneider U, Steinwachs M, Weise K (2004) Indications and implementation of recommendations of the working group “tissue regeneration and tissue substitutes” for autologous chondrocyte transplantation (ACT). Z Orthop Ihre Grenzgeb 142(5):529–539PubMedCrossRef
3.
Zurück zum Zitat Bentley G, Biant LC, Vijayan S, Macmull S, Skinner JA, Carrington RW (2012) Minimum ten-year results of a prospective randomised study of autologous chondrocyte implantation versus mosaicplasty for symptomatic articular cartilage lesions of the knee. J Bone Joint Surg Br 94(4):504–509PubMedCrossRef Bentley G, Biant LC, Vijayan S, Macmull S, Skinner JA, Carrington RW (2012) Minimum ten-year results of a prospective randomised study of autologous chondrocyte implantation versus mosaicplasty for symptomatic articular cartilage lesions of the knee. J Bone Joint Surg Br 94(4):504–509PubMedCrossRef
4.
Zurück zum Zitat Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L (1994) Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med 331(14):889–895PubMedCrossRef Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L (1994) Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med 331(14):889–895PubMedCrossRef
5.
Zurück zum Zitat Browne JE, Anderson AF, Arciero R, Mandelbaum B, Moseley JB Jr, Micheli LJ, Fu F, Erggelet C (2005) Clinical outcome of autologous chondrocyte implantation at 5 years in US subjects. Clin Orthop Relat Res 436:237–245PubMedCrossRef Browne JE, Anderson AF, Arciero R, Mandelbaum B, Moseley JB Jr, Micheli LJ, Fu F, Erggelet C (2005) Clinical outcome of autologous chondrocyte implantation at 5 years in US subjects. Clin Orthop Relat Res 436:237–245PubMedCrossRef
6.
Zurück zum Zitat Buckwalter JA (1995) Activity vs. rest in the treatment of bone, soft tissue and joint injuries. Iowa Orthop J 15:29–42PubMedCentralPubMed Buckwalter JA (1995) Activity vs. rest in the treatment of bone, soft tissue and joint injuries. Iowa Orthop J 15:29–42PubMedCentralPubMed
7.
Zurück zum Zitat Buckwalter JA, Mankin HJ, Grodzinsky AJ (2005) Articular cartilage and osteoarthritis. Instr Course Lect 54:465–480PubMed Buckwalter JA, Mankin HJ, Grodzinsky AJ (2005) Articular cartilage and osteoarthritis. Instr Course Lect 54:465–480PubMed
8.
Zurück zum Zitat Ebert JR, Fallon M, Zheng MH, Wood DJ, Ackland TR (2012) A randomized trial comparing accelerated and traditional approaches to postoperative weightbearing rehabilitation after matrix-induced autologous chondrocyte implantation: findings at 5 years. Am J Sports Med 40(7):1527–1537PubMedCrossRef Ebert JR, Fallon M, Zheng MH, Wood DJ, Ackland TR (2012) A randomized trial comparing accelerated and traditional approaches to postoperative weightbearing rehabilitation after matrix-induced autologous chondrocyte implantation: findings at 5 years. Am J Sports Med 40(7):1527–1537PubMedCrossRef
9.
Zurück zum Zitat Ebert JR, Robertson WB, Woodhouse J, Fallon M, Zheng MH, Ackland T, Wood DJ (2011) Clinical and magnetic resonance imaging-based outcomes to 5 years after matrix-induced autologous chondrocyte implantation to address articular cartilage defects in the knee. Am J Sports Med 39(4):753–763PubMedCrossRef Ebert JR, Robertson WB, Woodhouse J, Fallon M, Zheng MH, Ackland T, Wood DJ (2011) Clinical and magnetic resonance imaging-based outcomes to 5 years after matrix-induced autologous chondrocyte implantation to address articular cartilage defects in the knee. Am J Sports Med 39(4):753–763PubMedCrossRef
10.
Zurück zum Zitat Faul F, Erdfelder E, Lang AG, Buchner A (2007) G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 39(2):175–191PubMedCrossRef Faul F, Erdfelder E, Lang AG, Buchner A (2007) G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 39(2):175–191PubMedCrossRef
11.
Zurück zum Zitat Filardo G, Kon E, Di Martino A, Patella S, Altadonna G, Balboni F, Bragonzoni L, Visani A, Marcacci M (2012) Second-generation arthroscopic autologous chondrocyte implantation for the treatment of degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 20(9):1704–1713PubMedCrossRef Filardo G, Kon E, Di Martino A, Patella S, Altadonna G, Balboni F, Bragonzoni L, Visani A, Marcacci M (2012) Second-generation arthroscopic autologous chondrocyte implantation for the treatment of degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 20(9):1704–1713PubMedCrossRef
12.
Zurück zum Zitat Gilbert JE (1998) Current treatment options for the restoration of articular cartilage. Am J Knee Surg 11(1):42–46PubMed Gilbert JE (1998) Current treatment options for the restoration of articular cartilage. Am J Knee Surg 11(1):42–46PubMed
13.
Zurück zum Zitat Gomoll AH, Farr J, Gillogly SD, Kercher J, Minas T (2010) Surgical management of articular cartilage defects of the knee. J Bone Joint Surg Am 92(14):2470–2490PubMed Gomoll AH, Farr J, Gillogly SD, Kercher J, Minas T (2010) Surgical management of articular cartilage defects of the knee. J Bone Joint Surg Am 92(14):2470–2490PubMed
14.
Zurück zum Zitat Hambly K, Bobic V, Wondrasch B, Van Assche D, Marlovits S (2006) Autologous chondrocyte implantation postoperative care and rehabilitation: science and practice. Am J Sports Med 34(6):1020–1038PubMedCrossRef Hambly K, Bobic V, Wondrasch B, Van Assche D, Marlovits S (2006) Autologous chondrocyte implantation postoperative care and rehabilitation: science and practice. Am J Sports Med 34(6):1020–1038PubMedCrossRef
15.
Zurück zum Zitat Hangody L, Fules P (2003) Autologous osteochondral mosaicplasty for the treatment of full-thickness defects of weight-bearing joints: ten years of experimental and clinical experience. J Bone Joint Surg Am. 85-A Suppl 2: 25–32 Hangody L, Fules P (2003) Autologous osteochondral mosaicplasty for the treatment of full-thickness defects of weight-bearing joints: ten years of experimental and clinical experience. J Bone Joint Surg Am. 85-A Suppl 2: 25–32
16.
Zurück zum Zitat Harris JD, Siston RA, Pan X, Flanigan DC (2010) Autologous chondrocyte implantation: a systematic review. J Bone Joint Surg Am 92(12):2220–2233PubMedCrossRef Harris JD, Siston RA, Pan X, Flanigan DC (2010) Autologous chondrocyte implantation: a systematic review. J Bone Joint Surg Am 92(12):2220–2233PubMedCrossRef
17.
Zurück zum Zitat Hirschmuller A, Baur H, Braun S, Kreuz PC, Sudkamp NP, Niemeyer P (2011) Rehabilitation after autologous chondrocyte implantation for isolated cartilage defects of the knee. Am J Sports Med 39(12):2686–2696PubMedCrossRef Hirschmuller A, Baur H, Braun S, Kreuz PC, Sudkamp NP, Niemeyer P (2011) Rehabilitation after autologous chondrocyte implantation for isolated cartilage defects of the knee. Am J Sports Med 39(12):2686–2696PubMedCrossRef
18.
Zurück zum Zitat Hunziker EB (2002) Articular cartilage repair: basic science and clinical progress. A review of the current status and prospects. Osteoarthritis Cartilage 10(6):432–463PubMedCrossRef Hunziker EB (2002) Articular cartilage repair: basic science and clinical progress. A review of the current status and prospects. Osteoarthritis Cartilage 10(6):432–463PubMedCrossRef
19.
Zurück zum Zitat Imade S, Kumahashi N, Kuwata S, Iwasa J, Uchio Y (2012) Effectiveness and limitations of autologous osteochondral grafting for the treatment of articular cartilage defects in the knee. Knee Surg Sports Traumatol Arthrosc 20(1):160–165PubMedCrossRef Imade S, Kumahashi N, Kuwata S, Iwasa J, Uchio Y (2012) Effectiveness and limitations of autologous osteochondral grafting for the treatment of articular cartilage defects in the knee. Knee Surg Sports Traumatol Arthrosc 20(1):160–165PubMedCrossRef
20.
Zurück zum Zitat Jones DG, Peterson L (2006) Autologous chondrocyte implantation. J Bone Joint Surg Am 88(11):2502–2520PubMed Jones DG, Peterson L (2006) Autologous chondrocyte implantation. J Bone Joint Surg Am 88(11):2502–2520PubMed
21.
Zurück zum Zitat Kreuz PC, Muller S, Erggelet C, von Keudell A, Tischer T, Kaps C, Niemeyer P, Hirschmuller A (2012) Is gender influencing the biomechanical results after autologous chondrocyte implantation? Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-012-2280-3 PubMed Kreuz PC, Muller S, Erggelet C, von Keudell A, Tischer T, Kaps C, Niemeyer P, Hirschmuller A (2012) Is gender influencing the biomechanical results after autologous chondrocyte implantation? Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-012-2280-3 PubMed
22.
Zurück zum Zitat Kreuz PC, Steinwachs M, Erggelet C, Lahm A, Henle P, Niemeyer P (2006) Mosaicplasty with autogenous talar autograft for osteochondral lesions of the talus after failed primary arthroscopic management: a prospective study with a 4-year follow-up. Am J Sports Med 34(1):55–63PubMedCrossRef Kreuz PC, Steinwachs M, Erggelet C, Lahm A, Henle P, Niemeyer P (2006) Mosaicplasty with autogenous talar autograft for osteochondral lesions of the talus after failed primary arthroscopic management: a prospective study with a 4-year follow-up. Am J Sports Med 34(1):55–63PubMedCrossRef
23.
Zurück zum Zitat Krishnan SP, Skinner JA, Bartlett W, Carrington RW, Flanagan AM, Briggs TW, Bentley G (2006) Who is the ideal candidate for autologous chondrocyte implantation? J Bone Joint Surg Br 88(1):61–64PubMedCrossRef Krishnan SP, Skinner JA, Bartlett W, Carrington RW, Flanagan AM, Briggs TW, Bentley G (2006) Who is the ideal candidate for autologous chondrocyte implantation? J Bone Joint Surg Br 88(1):61–64PubMedCrossRef
24.
Zurück zum Zitat Macmull S, Parratt MT, Bentley G, Skinner JA, Carrington RW, Morris T, Briggs TW (2011) Autologous chondrocyte implantation in the adolescent knee. Am J Sports Med 39(8):1723–1730PubMedCrossRef Macmull S, Parratt MT, Bentley G, Skinner JA, Carrington RW, Morris T, Briggs TW (2011) Autologous chondrocyte implantation in the adolescent knee. Am J Sports Med 39(8):1723–1730PubMedCrossRef
25.
Zurück zum Zitat McNickle AG, L’Heureux DR, Yanke AB, Cole BJ (2009) Outcomes of autologous chondrocyte implantation in a diverse patient population. Am J Sports Med 37(7):1344–1350PubMedCrossRef McNickle AG, L’Heureux DR, Yanke AB, Cole BJ (2009) Outcomes of autologous chondrocyte implantation in a diverse patient population. Am J Sports Med 37(7):1344–1350PubMedCrossRef
26.
Zurück zum Zitat Minas T, Peterson L (1999) Advanced techniques in autologous chondrocyte transplantation. Clin Sports Med 18(1):13–44, v-vi Minas T, Peterson L (1999) Advanced techniques in autologous chondrocyte transplantation. Clin Sports Med 18(1):13–44, v-vi
27.
Zurück zum Zitat Mithofer K, Peterson L, Mandelbaum BR, Minas T (2005) Articular cartilage repair in soccer players with autologous chondrocyte transplantation: functional outcome and return to competition. Am J Sports Med 33(11):1639–1646PubMedCrossRef Mithofer K, Peterson L, Mandelbaum BR, Minas T (2005) Articular cartilage repair in soccer players with autologous chondrocyte transplantation: functional outcome and return to competition. Am J Sports Med 33(11):1639–1646PubMedCrossRef
28.
Zurück zum Zitat Naal FD, Impellizzeri FM, Leunig M (2009) Which is the best activity rating scale for patients undergoing total joint arthroplasty? Clin Orthop Relat Res 467(4):958–965PubMedCentralPubMedCrossRef Naal FD, Impellizzeri FM, Leunig M (2009) Which is the best activity rating scale for patients undergoing total joint arthroplasty? Clin Orthop Relat Res 467(4):958–965PubMedCentralPubMedCrossRef
29.
Zurück zum Zitat Nho SJ, Pensak MJ, Seigerman DA, Cole BJ (2010) Rehabilitation after autologous chondrocyte implantation in athletes. Clin Sports Med. 29(2):267–282, viii Nho SJ, Pensak MJ, Seigerman DA, Cole BJ (2010) Rehabilitation after autologous chondrocyte implantation in athletes. Clin Sports Med. 29(2):267–282, viii
30.
Zurück zum Zitat Niemeyer P, Pestka JM, Kreuz PC, Erggelet C, Schmal H, Suedkamp NP, Steinwachs M (2008) Characteristic complications after autologous chondrocyte implantation for cartilage defects of the knee joint. Am J Sports Med 36(11):2091–2099PubMedCrossRef Niemeyer P, Pestka JM, Kreuz PC, Erggelet C, Schmal H, Suedkamp NP, Steinwachs M (2008) Characteristic complications after autologous chondrocyte implantation for cartilage defects of the knee joint. Am J Sports Med 36(11):2091–2099PubMedCrossRef
31.
Zurück zum Zitat Outerbridge RE (1961) The etiology of chondromalacia patellae. J Bone Joint Surg Br. 43-B: 752–757 Outerbridge RE (1961) The etiology of chondromalacia patellae. J Bone Joint Surg Br. 43-B: 752–757
32.
Zurück zum Zitat Peterson L, Vasiliadis HS, Brittberg M, Lindahl A (2010) Autologous chondrocyte implantation: a long-term follow-up. Am J Sports Med 38(6):1117–1124PubMedCrossRef Peterson L, Vasiliadis HS, Brittberg M, Lindahl A (2010) Autologous chondrocyte implantation: a long-term follow-up. Am J Sports Med 38(6):1117–1124PubMedCrossRef
33.
Zurück zum Zitat Pietschmann MF, Horng A, Niethammer T, Pagenstert I, Sievers B, Jansson V, Glaser C, Muller PE (2009) Cell quality affects clinical outcome after MACI procedure for cartilage injury of the knee. Knee Surg Sports Traumatol Arthrosc 17(11):1305–1311PubMedCrossRef Pietschmann MF, Horng A, Niethammer T, Pagenstert I, Sievers B, Jansson V, Glaser C, Muller PE (2009) Cell quality affects clinical outcome after MACI procedure for cartilage injury of the knee. Knee Surg Sports Traumatol Arthrosc 17(11):1305–1311PubMedCrossRef
34.
Zurück zum Zitat Salzmann GM, Sah B, Sudkamp NP, Niemeyer P (2013) Reoperative characteristics after microfracture of knee cartilage lesions in 454 patients. Knee Surg Sports Traumatol Arthrosc 21(2):365–371PubMedCrossRef Salzmann GM, Sah B, Sudkamp NP, Niemeyer P (2013) Reoperative characteristics after microfracture of knee cartilage lesions in 454 patients. Knee Surg Sports Traumatol Arthrosc 21(2):365–371PubMedCrossRef
35.
Zurück zum Zitat Saris DB, Vanlauwe J, Victor J, Haspl M, Bohnsack M, Fortems Y, Vandekerckhove B, Almqvist KF, Claes T, Handelberg F, Lagae K, van der Bauwhede J, Vandenneucker H, Yang KG, Jelic M, Verdonk R, Veulemans N, Bellemans J, Luyten FP (2008) 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 36(2):235–246PubMedCrossRef Saris DB, Vanlauwe J, Victor J, Haspl M, Bohnsack M, Fortems Y, Vandekerckhove B, Almqvist KF, Claes T, Handelberg F, Lagae K, van der Bauwhede J, Vandenneucker H, Yang KG, Jelic M, Verdonk R, Veulemans N, Bellemans J, Luyten FP (2008) 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 36(2):235–246PubMedCrossRef
36.
Zurück zum Zitat Smith GD, Taylor J, Almqvist KF, Erggelet C, Knutsen G, Garcia Portabella M, Smith T, Richardson JB (2005) Arthroscopic assessment of cartilage repair: a validation study of 2 scoring systems. Arthroscopy 21(12):1462–1467PubMedCrossRef Smith GD, Taylor J, Almqvist KF, Erggelet C, Knutsen G, Garcia Portabella M, Smith T, Richardson JB (2005) Arthroscopic assessment of cartilage repair: a validation study of 2 scoring systems. Arthroscopy 21(12):1462–1467PubMedCrossRef
37.
Zurück zum Zitat Steadman JR, Briggs KK, Rodrigo JJ, Kocher MS, Gill TJ, Rodkey WG (2003) Outcomes of microfracture for traumatic chondral defects of the knee: average 11-year follow-up. Arthroscopy 19(5):477–484PubMedCrossRef Steadman JR, Briggs KK, Rodrigo JJ, Kocher MS, Gill TJ, Rodkey WG (2003) Outcomes of microfracture for traumatic chondral defects of the knee: average 11-year follow-up. Arthroscopy 19(5):477–484PubMedCrossRef
38.
Zurück zum Zitat Vanlauwe J, Saris DB, Victor J, Almqvist KF, Bellemans J, Luyten FP, Tig/Act, Group EXTS (2011) Five-year outcome of characterized chondrocyte implantation versus microfracture for symptomatic cartilage defects of the knee: early treatment matters. Am J Sports Med 39(12):2566–2574PubMedCrossRef Vanlauwe J, Saris DB, Victor J, Almqvist KF, Bellemans J, Luyten FP, Tig/Act, Group EXTS (2011) Five-year outcome of characterized chondrocyte implantation versus microfracture for symptomatic cartilage defects of the knee: early treatment matters. Am J Sports Med 39(12):2566–2574PubMedCrossRef
39.
Zurück zum Zitat Vasiliadis HS, Lindahl A, Georgoulis AD, Peterson L (2011) Malalignment and cartilage lesions in the patellofemoral joint treated with autologous chondrocyte implantation. Knee Surg Sports Traumatol Arthrosc 19(3):452–457PubMedCrossRef Vasiliadis HS, Lindahl A, Georgoulis AD, Peterson L (2011) Malalignment and cartilage lesions in the patellofemoral joint treated with autologous chondrocyte implantation. Knee Surg Sports Traumatol Arthrosc 19(3):452–457PubMedCrossRef
40.
Zurück zum Zitat Ventura A, Memeo A, Borgo E, Terzaghi C, Legnani C, Albisetti W (2012) Repair of osteochondral lesions in the knee by chondrocyte implantation using the MACI(R) technique. Knee Surg Sports Traumatol Arthrosc 20(1):121–126PubMedCrossRef Ventura A, Memeo A, Borgo E, Terzaghi C, Legnani C, Albisetti W (2012) Repair of osteochondral lesions in the knee by chondrocyte implantation using the MACI(R) technique. Knee Surg Sports Traumatol Arthrosc 20(1):121–126PubMedCrossRef
41.
Zurück zum Zitat Wondrasch B, Zak L, Welsch GH, Marlovits S (2009) Effect of accelerated weightbearing after matrix-associated autologous chondrocyte implantation on the femoral condyle on radiographic and clinical outcome after 2 years: a prospective, randomized controlled pilot study. Am J Sports Med 37(Suppl 1):88S–96SPubMedCrossRef Wondrasch B, Zak L, Welsch GH, Marlovits S (2009) Effect of accelerated weightbearing after matrix-associated autologous chondrocyte implantation on the femoral condyle on radiographic and clinical outcome after 2 years: a prospective, randomized controlled pilot study. Am J Sports Med 37(Suppl 1):88S–96SPubMedCrossRef
42.
Zurück zum Zitat Zeifang F, Oberle D, Nierhoff C, Richter W, Moradi B, Schmitt H (2010) Autologous chondrocyte implantation using the original periosteum-cover technique versus matrix-associated autologous chondrocyte implantation: a randomized clinical trial. Am J Sports Med 38(5):924–933PubMedCrossRef Zeifang F, Oberle D, Nierhoff C, Richter W, Moradi B, Schmitt H (2010) Autologous chondrocyte implantation using the original periosteum-cover technique versus matrix-associated autologous chondrocyte implantation: a randomized clinical trial. Am J Sports Med 38(5):924–933PubMedCrossRef
Metadaten
Titel
Early resumption of physical activities leads to inferior clinical outcomes after matrix-based autologous chondrocyte implantation in the knee
verfasst von
Thomas R. Niethammer
Peter E. Müller
Elem Safi
Andreas Ficklscherer
Björn P. Roßbach
Volkmar Jansson
Matthias F. Pietschmann
Publikationsdatum
01.06.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 6/2014
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2583-z

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