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Knee Surgery, Sports Traumatology, Arthroscopy

Erschienen in:

01.09.2012 | Knee

Second-generation arthroscopic autologous chondrocyte implantation for the treatment of degenerative cartilage lesions

verfasst von: Giuseppe Filardo, Elizaveta Kon, Alessandro Di Martino, Silvio Patella, Giulio Altadonna, Federica Balboni, Laura Bragonzoni, Andrea Visani, Maurilio Marcacci

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 9/2012

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Abstract

Purpose

Degenerative cartilage lesions present a negative joint environment, which may have a negative effect on the process of cartilage regeneration. The aim of this study is to analyze the clinical outcome obtained with the treatment for isolated degenerative knee cartilage lesions by second-generation arthroscopic autologous chondrocyte implantation (ACI).

Methods

Fifty-eight consecutive patients affected by focal degenerative chondral lesions of the femoral condyles and trochlea were treated by second-generation arthroscopic ACI. The mean age at surgery was 34.7 ± 9.1 years and the average defect size was 2.3 ± 0.9 cm². The patients were prospectively evaluated with IKDC, EQ-VAS, and Tegner scores preoperatively, at 2 and 6 years.

Results

A statistically significant improvement was observed in all scores from the basal evaluation to the final follow-up. The IKDC subjective score improved from 39.3 ± 13.6 to 68.8 ± 22.7 and 68.5 ± 23.9 at the 2- and 6-year follow-ups, respectively, with a significant improvement (P < 0.0005) and stable results over time; the same trend was confirmed by the EQ-VAS and Tegner scores. The worst results were found in patients with a low physical activity level, women, and those having undergone previous surgery, whereas the symptom duration before surgery did not influence the final outcome. The failure rate was 18.5%.

Conclusions

Despite a significant improvement, the results were lower with respect to the outcome reported in different study populations, and the number of failures was markedly higher, too. Tissue-engineered cartilage implantation is a promising approach for the treatment of degenerative chondral lesions, but graft properties, besides mechanical and biochemical joint environment, have to be improved.

Level of evidence

Case series, Level IV.

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Titel: Second-generation arthroscopic autologous chondrocyte implantation for the treatment of degenerative cartilage lesions
verfasst von: Giuseppe Filardo
Elizaveta Kon
Alessandro Di Martino
Silvio Patella
Giulio Altadonna
Federica Balboni
Laura Bragonzoni
Andrea Visani
Maurilio Marcacci
Publikationsdatum: 01.09.2012
Verlag: Springer-Verlag
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 9/2012
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-011-1732-5

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