Clinical Orthopaedics and Related Research®

, Volume 471, Issue 4, pp 1152–1158

Cell-based Therapy Improves Function in Adolescents and Young Adults With Patellar Osteochondritis Dissecans

  • Bryon J. X. Teo
  • Kizher Buhary
  • Bee-Choo Tai
  • James H. Hui
Symposium: Osteochondritis Dissecans

Abstract

Background

Recent advances have been made in using chondrocytes and other cell-based therapy to treat cartilage defects in adults. However, it is unclear whether these advances should be extended to the adolescent and young adult-aged patients.

Questions/purposes

We assessed cell-based surgical therapy for patellar osteochondritis dissecans (OCD) in adolescents and young adults by (1) determining function with the International Knee Documentation Committee (IKDC) subjective and Lysholm-Gillquist scores; and (2) evaluating activity level using the Tegner-Lysholm scale.

Methods

We retrospectively reviewed 23 patients between 12 and 21 years of age (mean 16.8 years) treated for OCD lesions involving the patella from 2001 to 2008. Twenty patients had autologous chondrocyte implantation and three patients had cultured bone marrow stem cell implantation. There were 19 males and four females. We obtained preoperative CT scans to assess patella subluxation, tilt, and congruence angle to determine choice of treatment. We obtained IKDC subjective knee evaluation scores, Tegner-Lysholm activity levels, and Lysholm-Gillquist knee scores preoperatively and at 6, 12, and 24 months postoperatively.

Results

Mean IKDC score, Tegner-Lysholm outcomes, and Lysholm-Gillquist scale improved from 45, 2.5, and 50, respectively, at surgery to 75, 4, and 70, respectively, at 24-month followup. Complications include periosteal hypertrophy observed in two patients.

Conclusion

Cell-based therapy was associated with short-term improvement in function in adolescents and young adults with patellar OCD.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Copyright information

© The Association of Bone and Joint Surgeons® 2012

Authors and Affiliations

  • Bryon J. X. Teo
    • 1
  • Kizher Buhary
    • 2
  • Bee-Choo Tai
    • 3
  • James H. Hui
    • 4
  1. 1.Yong Loo Lin School of MedicineNational University of Singapore SingaporeSingapore
  2. 2.Duke-NUS Graduate Medical SchoolNational University of SingaporeSingaporeSingapore
  3. 3.Department of Epidemiology and Public Health, Yong Loo Lin School of MedicineNational University of Singapore SingaporeSingapore
  4. 4.Department of Orthopaedic Surgery, Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore

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