Articular cartilage defects of the distal femur in children and adolescents: treatment with autologous chondrocyte implantation.

Purpose: Procedures aimed at biologically repairing cartilage injuries may have the greatest potential benefit in young patients because of their long-life expectancy and high-functional demands. Most cartilage-repair studies focus on older patient populations. This study assesses the outcomes of patients who were treated with autologous chondrocyte implantation before the age of 18.

Study Design: This is a Registry-based, multicenter, observational, cohort study of 37 patients from whom follow-up data was prospectively collected. Patient-rated assessments of overall condition, pain, and swelling were measured using modified, 10-point scales of the Cincinnati Knee Rating System.

Results: Mean age was 16 years (11-17); 22 boys and 15 girls. Twenty-three patients underwent at least 1 cartilage repair procedure before the cartilage harvest, including 11 who had a marrow stimulation procedure. Fourteen patients were diagnosed with osteochondritis dessicans lesions. Thirty-five patients had single defects (mean size, 5.4 cm). Thirty-two patients completed self-evaluations at a minimum of 2 years after implantation (mean follow-up = 4.3 years). The mean change in scale scores measuring overall condition, pain, and swelling were 3.8, 4.1, and 3.4 points, respectively. One patient had an implantation that failed.

Conclusions: Results highlight significant clinical improvements from baseline to follow-up for 32 patients who submitted follow-up data, including 28 patients who reported a minimum 1-point improvement in the overall condition score.

Clinical Relevance: These results suggest that autologous chondrocyte implantation may be an effective option for children and adolescents with large symptomatic chondral lesions of the distal femur.