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Clinical outcome and success rates of ACI for cartilage defects of the patella: a subgroup analysis from a controlled randomized clinical phase II trial (CODIS study)

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Aim

Cartilage defects of the patella are considered as a problematic entity. Purpose of the present study was to evaluate the outcome of patients treated with autologous chondrocyte implantation (ACI) for cartilage defects of the patella in comparison to patient with defects of the femoral condyles.

Patients and methods

73 patients with a follow-up of 5 years have been included in this subgroup analysis of the randomized controlled clinical trial (RCT). In dependence of defect location, patients were divided into two groups [patella defects (n = 45) and femoral condyle defects (n = 28)]. Clinical outcome was evaluated by the means of the KOOS score at baseline and 6 weeks, 3, 6, 12, 18, 24, 36, 48 and 60 months following ACI.

Results

“Responder rate” at 60 months (improvement from baseline of > 7 points in the KOOS score) in patients with patella defects was 86.2%. All scores showed a significant improvement from baseline. While overall KOOS score at 60 months was 81.9 (SD 18.6) points in femoral condyle defects, a mean of 82.6 (SD 14.0) was observed in patella defects (p = 0.2483).

Conclusion

ACI seems an appropriate surgical treatment for cartilage defects of the patella leading to a high success rate. In this study, the clinical outcome in patients with patellar defects was even better than the already excellent results in patients with defects of the femoral condyle even though the study included relatively large defect sizes for both groups (mean defect size 6.0 ± 1.7 and 5.4 ± 1.6 for femur and patella, respectively).

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Funding

This study was funded by CO.DON AG, Teltow, Germany.

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery and Traumatology, Freiburg University Hospital, Germany and OCM Clinic, OCM | Orthopädische Chirurgie München, Steinerstrass 6, 83069, Munich, Germany

    Philipp Niemeyer

  2. Joint and Spine Centre, Berlin, Germany

    Volker Laute

  3. Department of Orthopedic Surgery and Traumatology, St. Vinzenz-Hospital, Dinslaken, Germany

    Wolfgang Zinser

  4. Department of Orthopedic Surgery, Medical University Annastift Hanover, Hanover, Germany

    Christoph Becher

  5. Department of Orthopedic Surgery and Traumatology, Orthopedic Center Munich East, Munich, Germany

    Peter Diehl

  6. Traumatology and Reconstructive Surgery, DRK Hospital Luckenwalde, Luckenwalde, Germany

    Thomas Kolombe

  7. Department of Traumatology and Arthroscopic Surgery, Lubinus Clinicum Kiel, Kiel, Germany

    Jakob Fay

  8. Center for Hip, Knee and Foot Surgery, ATOS Clinic Heidelberg, Heidelberg, Germany

    Rainer Siebold

  9. Sporthopaedicum Straubing, Straubing, Germany

    Stefan Fickert

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  1. Philipp Niemeyer
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Correspondence to Philipp Niemeyer.

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Philipp Niemeyer has received speaker honorarium from CO.DON AG. All other authors declare that they have no conflict of interest.

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Niemeyer, P., Laute, V., Zinser, W. et al. Clinical outcome and success rates of ACI for cartilage defects of the patella: a subgroup analysis from a controlled randomized clinical phase II trial (CODIS study). Arch Orthop Trauma Surg 140, 717–725 (2020). https://doi.org/10.1007/s00402-019-03264-x

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