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Arthroscopic matrix-associated, injectable autologous chondrocyte transplantation of the hip: significant improvement in patient-related outcome and good transplant quality in MRI assessment

  • Henriette Bretschneider
  • Siegfried Trattnig
  • Stefan Landgraeber
  • Albrecht Hartmann
  • Klaus-Peter GüntherEmail author
  • Michael Dienst
  • Jörg Schröder
  • Stefan Fickert
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Abstract

Purpose

Acetabular chondral lesions are common in patients with FAI. For large full-thickness cartilage defects, arthroscopic matrix-associated autologous chondrocyte transplantation (MACT) using an injectable in situ crosslinking product is an option. Aim of the study was to evaluate clinical and MRI results 12 months after MACT of acetabular cartilage defects in FAI patients.

Methods

We report data on 21 patients with a focal cartilage defect of the hip [2.97 ± 1.44 cm2 (mean ± SD)] caused by FAI treated with an arthroscopically conducted MACT combined with FAI surgery. The results were assessed with patient-reported outcome measures (iHOT33, EQ-5D) pre- as well as post-operatively and by MRI using MOCART scoring system 6 and 12 months post-operatively.

Results

The iHOT33 score improved from 52.9 ± 21.14 (mean ± SD) pre-operative to 81.08 ± 22.04 (mean ± SD; p = 0.0012) 12 months post-operatively. The lower the pre-operative iHOT33 score and the larger the defect size, the greater the observed improvement compared to pre-operative scores at 12 months. Patients showed a significant improvement in EQ-5D-5L index value (p = 0.0015) and EQ-5D VAS (p = 0.0006). MRI analysis after 12 months revealed a complete integration of the transplant in 16 of 20 patients.

Conclusions

Injectable MACT is a promising minimally invasive treatment option for full-thickness cartilage defects of the hip caused by FAI. A significant improvement in symptoms and function associated with an increase in quality of life was detected in patients treated with injectable MACT combined with FAI surgery. This is of considerable clinical relevance, since, in addition to the elimination of the mechanical cause, MACT allows the successful therapy of consequential cartilage damage.

Level of evidence

Level 4, case series.

Keywords

Hip arthroscopy Matrix-associated autologous chondrocyte transplantation MACT Cartilage defect 

Notes

Funding

This study was funded by TETEC Tissue Engineering Technologies AG, Reutlingen, Germany.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved according to the local institutional review board (#EK 48022014) and has been registered by ClinicalTrials.gov (NCT02179346).

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019

Authors and Affiliations

  • Henriette Bretschneider
    • 1
  • Siegfried Trattnig
    • 2
    • 3
  • Stefan Landgraeber
    • 4
  • Albrecht Hartmann
    • 1
  • Klaus-Peter Günther
    • 1
    Email author
  • Michael Dienst
    • 5
  • Jörg Schröder
    • 6
  • Stefan Fickert
    • 7
    • 8
  1. 1.University Centre for Orthopaedics and Trauma Surgery, University Hospital Carl Gustav Carus at Technische Universität DresdenDresdenGermany
  2. 2.Department of Biomedical Imaging and Image Guided Therapy, High Field MR CenterMedical University of ViennaViennaAustria
  3. 3.Christian Doppler Laboratory for Clinical Molecular MR ImagingViennaAustria
  4. 4.Department of Orthopaedics and Trauma SurgeryUniversity of Duisburg-EssenEssenGermany
  5. 5.Orthopedic Surgery München, OCM Clinic GmbHMunichGermany
  6. 6.Center for Musculoskeletal Surgery, Campus Virchow-KlinikumCharité-Universitätsmedizin BerlinBerlinGermany
  7. 7.Medical Faculty Mannheim, University Medical Centre MannheimUniversity of HeidelbergMannheimGermany
  8. 8.Sporthopaedicum Straubing Berlin RegensburgStraubingGermany

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