Background: Studies that compare the effectiveness of different cartilage repair treatments are needed to update treatment algorithms.
Hypothesis: Autologous chondrocyte implantation provides greater improvement in overall condition score than does debridement at a minimum of 3 years' follow-up.
Study Design: Cohort study; Level of evidence, 3.
Methods: Cohorts for debridement and autologous chondrocyte implantation each included 58 Cartilage Repair Registry patients who met study criteria. A retrospective analysis was performed on prospectively collected baseline and follow-up data.
Results: Patients in the autologous chondrocyte implantation and debridement groups had similar demographics and chondral lesions at baseline. However, more autologous chondrocyte implantation patients failed a previous debridement or marrow stimulation procedure than did debridement patients. Follow-up outcome assessments were completed by 54 autologous chondrocyte implantation patients and 42 debridement patients. Eighty-one percent of the autologous chondrocyte implantation patients and 60% of the debridement patients reported median improvements of 5 points and 2 points, respectively, in the overall condition score. Autologous chondrocyte implantation patients also reported greater improvements in the median pain and swelling scores than did debridement patients. The treatment failure rate was the same for both autologous chondrocyte implantation and debridement patients. Eighteen autologous chondrocyte implantation patients and 1 debridement patient had at least 1 subsequent operation.
Conclusion: Although patients treated with debridement for symptomatic, large, focal, chondral defects of the distal femur had some functional improvement at follow-up, patients who received autologous chondrocyte implantations obtained higher levels of knee function and had greater relief from pain and swelling at 3 years.
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http://dx.doi.org/10.1177/0363546505275148 | DOI Listing |
Am J Sports Med
January 2025
Department of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.
Background: Osteochondral allograft transplantation (OCA) is well established as a viable chondral restoration procedure for the treatment of symptomatic, focal chondral defects of the knee. The efficacy of secondary OCA in the setting of failed index cartilage repair or restoration is poorly understood.
Purpose: To evaluate radiographic and clinical outcomes, failures, and reoperations after OCA after failed index cartilage repair or restoration of the knee.
Arthrosc Sports Med Rehabil
December 2024
Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, San Francisco, California, U.S.A.
Purpose: To evaluate the relationship between preoperative whole-joint imaging evaluation of the knee with patient-reported outcome (PRO) measures after cartilage restoration surgery (mosaicplasty, osteochondral allograft transplantation, matrix autologous chondrocyte implantation).
Methods: We retrospectively evaluated patients who underwent knee articular cartilage restoration at our institution from 2014 to 2020. The patients' knee magnetic resonance imaging (MRI) was evaluated with the Whole-Organ Magnetic Resonance Imaging Score (WORMS) and semiquantitative synovial inflammation imaging biomarkers of the preoperative MRI.
Pharmaceutics
December 2024
Laboratorio RAMSES, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano, 1/10, 40136 Bologna, Italy.
The treatment of articular cartilage damage has always represented a problem of considerable practical interest for orthopedics. Over the years, many surgical techniques have been proposed to induce the growth of repairing tissue and limit degeneration. In 1994, the turning point occurred: implanted autologous cells paved the way for a new treatment option based more on regeneration than repair.
View Article and Find Full Text PDFInt J Mol Sci
December 2024
Biomedical Engineering Program, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut 1107 2020, Lebanon.
The limited self-repair capacity of cartilage due to its avascular and aneural nature leads to minimal regenerative ability. Autologous chondrocyte transplantation (ACT) is a popular treatment for cartilage defects but faces challenges due to chondrocyte dedifferentiation in later passages, which results in undesirable fibroblastic phenotypes. A promising treatment for cartilage injuries and diseases involves tissue engineering using cells (e.
View Article and Find Full Text PDFAm J Sports Med
January 2025
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA.
Background: Failure of primary cartilage restoration procedures of the knee that proceed to necessitating revision cartilage procedures represent a challenging clinical scenario with variable outcomes reported in previous literature.
Purpose: To perform a systematic review and meta-analysis of clinical outcomes and adverse events after revision cartilage restoration procedures of the knee for failed primary cartilage procedures.
Study Design: Systematic review and meta-analysis; Level of evidence, 4.
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