Skip to main content

Advertisement

SpringerLink
Log in

Comparison of two different matrix-based autologous chondrocyte transplantation systems: 1 year follow-up results

  • Original Article
  • Published:
European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

The treatment of full-thickness cartilage defects of the knee is a common problem in orthopaedic surgery. Autologous chondrocyte transplantation (ACT) is one of the few reliable treatment options of cartilage defects with good long-term outcomes. The improvement of ACT led to the matrix-based ACT (MACT). The purpose of the study was to compare two different commercially available MACT systems.

Methods

Eleven patients with a cartilage defect of the knee were treated with the MACI® system and another nine patients with the CaRes® implant. The patients were prospectively followed and re-examined after one year.

Results

One year after surgery all but one patient have significantly improved in their clinical outcome. Both types of MACT revealed similar results in terms of increase in level of activity, pain relief and knee function.

Conclusion

The study showed that MACT is a good therapeutic option for full-size defects of the femoral condyle. The MACI® implant seems to be easier to handle which is reflected by smaller incisions and a shorter operation time.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L. Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med. 1994;331(14):889–95.

    Article  PubMed  CAS  Google Scholar 

  2. Bentley G, Biant LC, Carrington RW, Akmal M, Goldberg A, Williams AM, et al. A prospective, randomised comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects in the knee. J Bone Joint Surg Br. 2003;85(2):223–30.

    Article  PubMed  CAS  Google Scholar 

  3. Horas U, Pelinkovic D, Herr G, Aigner T, Schnettler R. Autologous chondrocyte implantation and osteochondral cylinder transplantation in cartilage repair of the knee joint. A prospective, comparative trial. J Bone Joint Surg Am. 2003;85-A(2):185–92.

    PubMed  CAS  Google Scholar 

  4. Peterson L, Minas T, Brittberg M, Lindahl A. Treatment of osteochondritis dissecans of the knee with autologous chondrocyte transplantation: results at two to ten years. J Bone Joint Surg Am. 2003;85-A(Suppl 2):17–24.

    PubMed  Google Scholar 

  5. Gooding CR, Bartlett W, Bentley G, Skinner JA, Carrington R, Flanagan A. A prospective, randomised study comparing two techniques of autologous chondrocyte implantation for osteochondral defects in the knee: periosteum covered versus type I/III collagen covered. Knee. 2006;13(3):203–10.

    Article  PubMed  CAS  Google Scholar 

  6. Minas T. Autologous chondrocyte implantation for focal chondral defects of the knee. Clin Orthop Relat Res. 2001;391(Suppl):S349–61.

    Article  PubMed  Google Scholar 

  7. Peterson L, Minas T, Brittberg M, Nilsson A, Sjogren-Jansson E, Lindahl A. Two- to 9-year outcome after autologous chondrocyte transplantation of the knee. Clin Orthop Relat Res. 2000;374:212–34.

    Article  PubMed  Google Scholar 

  8. Bartlett W, Skinner JA, Gooding CR, Carrington RW, Flanagan AM, Briggs TW, et al. Autologous chondrocyte implantation versus matrix-induced autologous chondrocyte implantation for osteochondral defects of the knee: a prospective, randomised study. J Bone Joint Surg Br. 2005;87(5):640–5.

    Article  PubMed  CAS  Google Scholar 

  9. Ruano-Ravina A, Jato Diaz M. Autologous chondrocyte implantation: a systematic review. Osteoarthritis Cartilage. 2006;14(1):47–51.

    Article  PubMed  CAS  Google Scholar 

  10. Behrens P, Bosch U, Bruns J, Erggelet C, Esenwein SA, Gaissmaier C, et al. Indications and implementation of recommendations of the working group “tissue regeneration and tissue substitutes” for autologous chondrocyte transplantation (act). Z Orthop Ihre Grenzgeb. 2004;142(5):529–39.

    Article  PubMed  CAS  Google Scholar 

  11. Irrgang JJ, Anderson AF, Boland AL, Harner CD, Kurosaka M, Neyret P, et al. Development and validation of the international knee documentation committee subjective knee form. Am J Sports Med. 2001;29(5):600–13.

    PubMed  CAS  Google Scholar 

  12. Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985;198:43–9.

    PubMed  Google Scholar 

  13. ICRS. Cartilage evaluation package. In: package/ICRS evaluation.pdf. 2000. http://www.cartilage.org/Evaluation.

  14. Saris DB, Vanlauwe J, Victor J, Haspl M, Bohnsack M, Fortems Y, et al. Characterized chondrocyte implantation results in better structural repair when treating symptomatic cartilage defects of the knee in a randomized controlled trial versus microfracture. Am J Sports Med. 2008;36(2):235–46.

    Article  PubMed  Google Scholar 

  15. Selmi TA, Verdonk P, Chambat P, Dubrana F, Potel JF, Barnouin L, et al. Autologous chondrocyte implantation in a novel alginate–agarose hydrogel: outcome at two years. J Bone Joint Surg Br. 2008;90(5):597–604.

    Article  PubMed  CAS  Google Scholar 

  16. Maus U, Schneider U, Gravius S, Muller-Rath R, Mumme T, Miltner O, et al. Clinical results after three years use of matrix-associated act for the treatment of osteochondral defects of the knee. Z Orthop Unfall. 2008;146(1):31–7.

    Article  PubMed  CAS  Google Scholar 

  17. Behrens P, Bitter T, Kurz B, Russlies M. Matrix-associated autologous chondrocyte transplantation/implantation (mact/maci)–5 year follow-up. Knee. 2006;13(3):194–202.

    Article  PubMed  Google Scholar 

  18. Marcacci M, Zaffagnini S, Kon E, Visani A, Iacono F, Loreti I. Arthroscopic autologous chondrocyte transplantation: technical note. Knee Surg Sports Traumatol Arthrosc. 2002;10(3):154–9.

    Article  PubMed  CAS  Google Scholar 

  19. Nehrer S, Domayer S, Dorotka R, Schatz K, Bindreiter U, Kotz R. Three-year clinical outcome after chondrocyte transplantation using a hyaluronan matrix for cartilage repair. Eur J Radiol. 2006;57(1):3–8.

    Article  PubMed  CAS  Google Scholar 

  20. Steinwachs M, Kreuz PC. Autologous chondrocyte implantation in chondral defects of the knee with a type I/III collagen membrane: a prospective study with a 3 year follow-up. Arthroscopy. 2007;23(4):381–7.

    Article  PubMed  Google Scholar 

  21. Kon E, Gobbi A, Filardo G, Delcogliano M, Zaffagnini S, Marcacci M. Arthroscopic second-generation autologous chondrocyte implantation compared with microfracture for chondral lesions of the knee: prospective non-randomized study at 5 years. Am J Sports Med. 2009;37(1):33–41.

    Article  PubMed  Google Scholar 

  22. Concaro S, Nicklasson E, Ellowsson L, Lindahl A, Brittberg M, Gatenholm P. Effect of cell seeding concentration on the quality of tissue engineered constructs loaded with adult human articular chondrocytes. J Tissue Eng Regen Med. 2008;2(1):14–21.

    Article  PubMed  CAS  Google Scholar 

  23. Dowthwaite GP, Bishop JC, Redman SN, Khan IM, Rooney P, Evans DJ, et al. The surface of articular cartilage contains a progenitor cell population. J Cell Sci. 2004;117(Pt 6):889–97.

    Article  PubMed  CAS  Google Scholar 

  24. Gigante A, Bevilacqua C, Zara C, Travasi M, Chillemi C. Autologous chondrocyte implantation: cells phenotype and proliferation analysis. Knee Surg Sports Traumatol Arthrosc. 2001;9(4):254–8.

    Article  PubMed  CAS  Google Scholar 

  25. Gigante A, Bevilacqua C, Ricevuto A, Mattioli-Belmonte M, Greco F. Membrane-seeded autologous chondrocytes: cell viability and characterization at surgery. Knee Surg Sports Traumatol Arthrosc. 2007;15(1):88–92.

    Article  PubMed  Google Scholar 

  26. Brittberg M, Sjogren-Jansson E, Lindahl A, Peterson L. Influence of fibrin sealant (tisseel) on osteochondral defect repair in the rabbit knee. Biomaterials. 1997;18(3):235–42.

    Article  PubMed  CAS  Google Scholar 

  27. Gille J, Meisner U, Ehlers EM, Muller A, Russlies M, Behrens P. Migration pattern, morphology and viability of cells suspended in or sealed with fibrin glue: a histomorphologic study. Tissue Cell. 2005;37(5):339–48.

    Article  PubMed  CAS  Google Scholar 

  28. Marlovits S, Striessnig G, Kutscha-Lissberg F, Resinger C, Aldrian SM, Vecsei V, et al. Early postoperative adherence of matrix-induced autologous chondrocyte implantation for the treatment of full-thickness cartilage defects of the femoral condyle. Knee Surg Sports Traumatol Arthrosc. 2005;13(6):451–7.

    Article  PubMed  Google Scholar 

  29. Sha′ban M, Kim SH, Idrus RB, Khang G. Fibrin and poly (lactic-co-glycolic acid) hybrid scaffold promotes early chondrogenesis of articular chondrocytes: an in vitro study. J Orthop Surg. 2008;3:17.

    Article  Google Scholar 

  30. Ronga M, Grassi FA, Bulgheroni P. Arthroscopic autologous chondrocyte implantation for the treatment of a chondral defect in the tibial plateau of the knee. Arthroscopy. 2004;20(1):79–84.

    Article  PubMed  Google Scholar 

  31. Marcacci M, Kon E, Zaffagnini S, Filardo G, Delcogliano M, Neri MP, et al. Arthroscopic second generation autologous chondrocyte implantation. Knee Surg Sports Traumatol Arthrosc. 2007;15(5):610–9.

    Article  PubMed  Google Scholar 

  32. Wasiak J, Clar C, Villanueva E. Autologous cartilage implantation for full thickness articular cartilage defects of the knee. Cochrane Database Syst Rev. 2006;3:CD003323.

    Google Scholar 

Download references

Acknowledgments

The manuscript has been read and approved by all identified authors. The authors did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Trauma and Hand Surgery, Heinrich Heine University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany

    S. Flohé, M. Betsch, M. Wild & J. Windolf

  2. Department of Arthroscopic Surgery and Sports Traumatology, Sankt Josef Orthopaedic and Rheumatology Centre Wuppertal, Wuppertal, Germany

    K. Ruße

  3. Department of Surgery, St. Johannes-Hospital Varel, Varel, Germany

    M. Schulz

Authors
  1. S. Flohé
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Betsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. Ruße
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Wild
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Windolf
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. Schulz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Betsch.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Flohé, S., Betsch, M., Ruße, K. et al. Comparison of two different matrix-based autologous chondrocyte transplantation systems: 1 year follow-up results. Eur J Trauma Emerg Surg 37, 397–403 (2011). https://doi.org/10.1007/s00068-010-0057-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00068-010-0057-2

Keywords

Search

Navigation