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Feasibility of arthroscopic 3-dimensional, purely autologous chondrocyte transplantation for chondral defects of the hip: a case series

  • Arthroscopy and Sports Medicine
  • Published:
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Abstract

Introduction

The purpose of this retrospective study was to describe technical aspects of arthroscopic, purely autologous chondrocyte transplantation of the hip and to report short-term data of the postoperative outcome in a consecutive series of patients.

Materials and methods

We retrospectively analyzed six patients with a full-thickness chondral defect of the hip joint. The defect was treated with an arthroscopically applicable 3-dimensional purely autologous chondrocyte transplant product (chondrosphere®; co.don® AG, Berlin, Germany) in a two-step surgical procedure. Patient-administered scores were assessed at baseline (day before transplantation) and at 6 weeks, 3, 6 and 12 months.

Results

Six out of six initially included patients (five males, one female) with a median age of 32.5 years and an average defect size of 3.5 cm2 were available for follow-up after a mean of 11.2 months. Five acetabular and one femoral defect were treated. An overall statistically significant improvement was observed for all assessment scores (NHS, mHHS and SF 36).

Conclusion

In this study, we displayed the feasibility and technical aspects of arthroscopic matrix-associated, purely autologous chondrocyte transplantation as a treatment option for full-thickness cartilage defects of the hip. The patient-administered assessment scores demonstrated an increase in activity level and quality of life after a 1-year follow-up.

Level of evidence

Level IV, retrospective study.

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References

  1. Allen D, Beaule PE, Ramadan O, Doucette S (2009) Prevalence of associated deformities and hip pain in patients with cam-type femoroacetabular impingement. J Bone Jt Surg Br 91:589–594

    Article  CAS  Google Scholar 

  2. Anderer U, Libera J (2002) In vitro engineering of human autogenous cartilage. J Bone Miner Res 17(8):1420–1429

    Article  PubMed  Google Scholar 

  3. Anderson LA, Peters CL, Park BB, Stoddard GJ, Erickson JA, Crim JR (2009) Acetabular cartilage delamination in femoroacetabular impingement. Risk factors and magnetic resonance imaging diagnosis. J Bone Jt Surg Am 91(2):305–313. doi:10.2106/JBJS.G.01198

    Article  Google Scholar 

  4. Beck M, Kalhor M, Leunig M, Ganz R (2005) Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Jt Surg Br 87:1012–1018

    Article  CAS  Google Scholar 

  5. Beck M, Leunig M, Parvizi J, Boutier V, Wyss D, Ganz R (2004) Anterior femoroacetabular impingement: part II. Midterm results of surgical treatment. Clin Orthop Relat Res 418:67–73

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  7. Bentley G, Biant LC, Vijayan S, Macmull S, Skinner JA, Carrington RW (2012) Minimum 10-year results of a prospective randomised study of autologous chondrocyte implantation vs. mosaicplasty for symptomatic articular cartilage lesions of the knee. J Bone Jt Surg Br 94(4):504–509

    Article  CAS  Google Scholar 

  8. Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L (1994) Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med 331:889–895

    Article  CAS  PubMed  Google Scholar 

  9. Byrd JW, Jones KS (2000) Prospective analysis of hip arthroscopy with 2-year follow-up. Arthroscopy 16:578–587

    Article  CAS  PubMed  Google Scholar 

  10. Byrd JW, Jones KS (2009) Arthroscopic femoroplasty in the management of cam-type femoroacetabular impingement. Clin Orthop Relat Res 467(3):739–746

    Article  PubMed Central  PubMed  Google Scholar 

  11. Byrd JW, Jones KS (2004) Microfracture for grade IV chondral lesions of the hip. Arthroscopy 20:e41

    Article  Google Scholar 

  12. Byrd JW, Jones KS (2002) Osteoarthritis caused by an inverted acetabular labrum: radiographic diagnosis and arthroscopic treatment. Arthroscopy 18:741–747

    Article  PubMed  Google Scholar 

  13. Byrd JW, Jones KS (2010) Prospective analysis of hip arthroscopy with 10-year followup. Clin Orthop Relat Res 468(3):741–746 Epub 2009 Apr 21

    Article  PubMed Central  PubMed  Google Scholar 

  14. Byrd JW, Jones KS (2004) Traumatic rupture of the ligamentum teres as a source of hip pain. Arthroscopy 20(4):385–391

    Article  PubMed  Google Scholar 

  15. Christensen CP, Althausen PL, Mittleman MA, Lee JA, McCarthy JC (2003) The nonarthritic hip score: reliable and validated. Clin Orthop Relat Res 406:75–83

    Article  PubMed  Google Scholar 

  16. Crawford JR, Villar RN (2005) Current concepts in the management of femoroacetabular impingement. J Bone Jt Surg Br 87:1459–1462

    Article  CAS  Google Scholar 

  17. Crawford K, Philippon MJ, Sekiya JK, Rodkey WG, Steadman JR (2006) Microfracture of the hip in athletes. Clin Sports Med 25:327–335

    Article  PubMed  Google Scholar 

  18. Eijer H, Leunig M, Mahomed MN, Ganz R (2001) Crosstable lateral radiograph for screening of anterior femoral head–neck offset in patients with femoroacetabular impingement. Hip Int 11:37–41

    Google Scholar 

  19. Espinosa N, Rothenfluh DA, Beck M, Ganz R, Leunig M (2006) Treatment of femoro-acetabular impingement: preliminary results of labral refixation. J Bone Jt Surg Am 88:925–935

    Article  Google Scholar 

  20. Farjo LA, Glick JM, Sampson TG (1999) Hip arthroscopy for acetabular labral tears. Arthroscopy 15:132–137

    Article  CAS  PubMed  Google Scholar 

  21. Ferguson SJ, Bryant JT, Ganz R, Ito K (2000) The acetabular labrum seal: a poroelastic finite element model. Clin Biomech (Bristol, Avon) 15:463–468

    Article  CAS  Google Scholar 

  22. Ferguson SJ, Bryant JT, Ganz R, Ito K (2000) The influence of the acetabular labrum on hip joint cartilage consolidation: a poroelastic finite element model. J Biomech 33(953–960):11

    Google Scholar 

  23. Ferguson SJ, Bryant JT, Ganz R, Ito K (2003) An in vitro investigation of the acetabular labral seal in hip joint mechanics. J Biomech 36:171–178

    Article  CAS  PubMed  Google Scholar 

  24. Ferguson SJ, Bryant JT, Ito K (2001) The material properties of the bovine acetabular labrum. J Orthop Res 19(887–896):13

    Google Scholar 

  25. Fontana A, Bistolfi A, Crova M, Rosso F, Massazza G (2012) Arthroscopic treatment of hip chondral defects: autologous chondrocyte transplantation vs. simple debridement––a pilot study. Arthroscopy 28(3):322–329

    Article  PubMed  Google Scholar 

  26. Ganz R, Leunig M, Leunig-Ganz K, Harris WH (2008) The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res 466:264–272

    Article  PubMed Central  PubMed  Google Scholar 

  27. Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA (2003) Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res 417:1–9

    Google Scholar 

  28. Gedouin JE, May O, Bonin N, Nogier A, Boyer T, Sadri H, Villar RN, Laude F, French Arthroscopy Society (2010) Assessment of arthroscopic management of femoroacetabular impingement. A prospective multicenter study. Orthop Traumatol Surg Res 96(8 Suppl):S59–S67

    Article  PubMed  Google Scholar 

  29. Gille J, Schuseil E, Wimmer J, Gellissen J, Schulz AP, Behrens P (2010) Mid-term results of autologous matrix-induced chondrogenesis for treatment of focal cartilage defects in the knee. Knee Surg Sports Traumatol Arthrosc 18(11):1456–1464 Epub 2010 Feb 2

    Article  CAS  PubMed  Google Scholar 

  30. Giori NJ, Trousdale RT (2003) Acetabular retroversion is associated with osteoarthritis of the hip. Clin Orthop Relat Res 417:263–269

    PubMed  Google Scholar 

  31. Haddo O, Mahroof S, Higgs D, David L, Pringle J, Bayliss M, Cannon SR, Briggs TW (2004) The use of chondrogide membrane in autologous chondrocyte implantation. Knee 11(1):51–55

    Article  PubMed  Google Scholar 

  32. Libera J, Ruhnau K, Baum P, Lüthi U, Schreyer T, Meyer U et al (2009) Cartilage engineering. Springer Verlag, Berlin

    Google Scholar 

  33. Libera J, Luethi U, Alasevic OJ (2006) co.don chondrosphere® (co. don® AG): autologous matrix-induced engineered cartilage transplantation. In: Zanasi S, Brittberg M, Maracacci M (eds) Basic science, clinical repair and reconstruction of articular cartilage defects: current status and prospects, vol 1. Timeo Editore, Bologna, pp 591–600

    Google Scholar 

  34. Horas U, Schnettler R, Pelinkovic D, Herr G, Aigner T (2000) Osteochondral transplantation vs. autogenous chondrocyte transplantation. A prospective comparative clinical study. Chirurg 71(9):1090–1097

    Article  CAS  PubMed  Google Scholar 

  35. Insall J (1974) The Pridie debridement operation for osteoarthritis of the knee. Clin Orthop Relat Res 101:61–67

    PubMed  Google Scholar 

  36. Knutsen G, Drogset JO, Engebretsen L, Grøntvedt T, Isaksen V, Ludvigsen TC, Roberts S, Solheim E, Strand T, Johansen O (2007) A randomized trial comparing autologous chondrocyte implantation with microfracture. Findings at 5 years. J Bone Jt Surg Am 89(10):2105–2112

    Article  Google Scholar 

  37. Larson CM, Giveans MR, Stone RM (2012) Arthroscopic debridement versus refixation of the acetabular labrum associated with femoroacetabular impingement: mean 3.5-year follow-up. Am J Sports Med 40(5):1015–1021

  38. Leunig M, Beaulé PE, Ganz R (2009) The concept of femoroacetabular impingement: current status and future perspectives. Clin Orthop Relat Res 467(3):616–622

    Article  PubMed Central  PubMed  Google Scholar 

  39. Leunig M, Casillas MM, Hamlet M, Hersche O, Nötzli H, Slongo T, Ganz R (2000) Slipped capital femoral epiphysis: early mechanical damage to the acetabular cartilage by a prominent femoral metaphysis. Acta Orthop Scand 71:370–375

    Article  CAS  PubMed  Google Scholar 

  40. Lienert JJ, Rodkey WG, Steadman JR, Philippon MJ, Sekiya JK (2005) Microfracture techniques in hip arthroscopy. Oper Tech Orthop 15:267–272

    Article  Google Scholar 

  41. McCarthy JC, Lee JA (2004) Arthroscopic intervention in early hip disease. Clin Orthop Relat Res 429:157–162

    Article  PubMed  Google Scholar 

  42. Meyer DC, Beck M, Ellis T, Ganz R, Leunig M (2006) Comparison of six radiographic projections to assess femoral head/neck asphericity. Clin Orthop Relat Res 445:181–185

    PubMed  Google Scholar 

  43. Nötzli HP, Wyss TF, Stöcklin CH, Schmid MR, Treiber K, Hodler J (2002) The contour of the femoral head–neck junction as a predictor for the risk of anterior impingement. J Bone Jt Surg Br 84:556–560

    Article  Google Scholar 

  44. Philippon MJ, Schenker ML, Briggs KK, Maxwell RB (2008) Can microfracture produce repair tissue in acetabular chondral defects? Arthroscopy 24(1):46–50

    Article  PubMed  Google Scholar 

  45. Potter BK, Freedman BA, Andersen RC, Bojescul JA, Kuklo TR, Murphy KP (2005) Correlation of short form-36 and disability status with outcomes of arthroscopic acetabular labral debridement. Am J Sports Med 33(6):864–870

    Article  PubMed  Google Scholar 

  46. Reynolds D, Lucas J, Klaue K (1999) Retroversion of the acetabulum: a cause of hip pain. J Bone Jt Surg [Br] 81-B:281–288

    Article  Google Scholar 

  47. Saris DB, Vanlauwe J, Victor J, Almqvist KF, Verdonk R, Bellemans J, Luyten FP (2009) Treatment of symptomatic cartilage defects of the knee: characterized chondrocyte implantation results in better clinical outcome at 36 months in a randomized trial compared to microfracture. Am J Sports Med 37(Suppl 1):10S–19S Epub 2009 Oct 21

    Article  PubMed  Google Scholar 

  48. Singh PJ, O‘Donnell JM (2010) The outcome of hip arthroscopy in Australian football league players: a review of 27 hips. Arthroscopy 26(6):743–749

    Article  PubMed  Google Scholar 

  49. Stafford GH, Bunn JR, Villar RN (2011) Arthroscopic repair of delaminated acetabular articular cartilage using fibrin adhesive. Results at 1–3 years. Hip Int 21(6):744–750. doi:10.5301/HIP.2011.8843

    Article  PubMed  Google Scholar 

  50. Steadman JR, Rodkey WG, Briggs KK (2002) Microfracture to treat full-thickness chondral defects: surgical technique, rehabilitation, and outcomes. J Knee Surg 15:170–176

    PubMed  Google Scholar 

  51. Streich NA, Gotterbarm T, Barié A, Schmitt H (2009) Prognostic value of chondral defects on the outcome after arthroscopic treatment of acetabular labral tears. Knee Surg Sports Traumatol Arthrosc 17(10):1257–1263

    Article  PubMed  Google Scholar 

  52. Tannast M, Goricki D, Beck M, Murphy SB, Siebenrock KA (2008) Hip damage occurs at the zone of femoroacetabular impingement. Clin Orthop Relat Res 466:273–280

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  53. Tannast M, Siebenrock KA, Anderson SE (2007) Femoroacetabular impingement: radiographic diagnosis––what the radiologist should know. AJR Am J Roentgenol 188:1540–1552

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors received no financial support for the research and/or authorship of this article.

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Authors and Affiliations

  1. Orthopaedic and Trauma Surgery Center, University Medical Centre Mannheim, University of Heidelberg, Theodor Kutzer Ufer 1–3, 68167, Mannheim, Germany

    S. Fickert, T. Schattenberg, M. Niks & S. Thier

  2. Medical Faculty Mannheim, Institute of Biostatistics, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany

    C. Weiss

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  1. S. Fickert
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  2. T. Schattenberg
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Correspondence to S. Thier.

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Fickert, S., Schattenberg, T., Niks, M. et al. Feasibility of arthroscopic 3-dimensional, purely autologous chondrocyte transplantation for chondral defects of the hip: a case series. Arch Orthop Trauma Surg 134, 971–978 (2014). https://doi.org/10.1007/s00402-014-1997-5

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  • DOI: https://doi.org/10.1007/s00402-014-1997-5

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