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Second-generation arthroscopic autologous chondrocyte implantation for the treatment of degenerative cartilage lesions

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Degenerative cartilage lesions present a negative joint environment, which may have a negative effect on the process of cartilage regeneration. The aim of this study is to analyze the clinical outcome obtained with the treatment for isolated degenerative knee cartilage lesions by second-generation arthroscopic autologous chondrocyte implantation (ACI).

Methods

Fifty-eight consecutive patients affected by focal degenerative chondral lesions of the femoral condyles and trochlea were treated by second-generation arthroscopic ACI. The mean age at surgery was 34.7 ± 9.1 years and the average defect size was 2.3 ± 0.9 cm2. The patients were prospectively evaluated with IKDC, EQ-VAS, and Tegner scores preoperatively, at 2 and 6 years.

Results

A statistically significant improvement was observed in all scores from the basal evaluation to the final follow-up. The IKDC subjective score improved from 39.3 ± 13.6 to 68.8 ± 22.7 and 68.5 ± 23.9 at the 2- and 6-year follow-ups, respectively, with a significant improvement (P < 0.0005) and stable results over time; the same trend was confirmed by the EQ-VAS and Tegner scores. The worst results were found in patients with a low physical activity level, women, and those having undergone previous surgery, whereas the symptom duration before surgery did not influence the final outcome. The failure rate was 18.5%.

Conclusions

Despite a significant improvement, the results were lower with respect to the outcome reported in different study populations, and the number of failures was markedly higher, too. Tissue-engineered cartilage implantation is a promising approach for the treatment of degenerative chondral lesions, but graft properties, besides mechanical and biochemical joint environment, have to be improved.

Level of evidence

Case series, Level IV.

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Acknowledgments

The following authors were acknowledged for their assistance in this work: L. D’Orazio, B. Di Matteo, F. Perdisa, S. Bassini, A. Montaperto: III Clinic—Biomechanics Laboratory, Rizzoli Orthopaedic Institute, Bologna, Italy. E. Pignotti, K. Smith: Task Force, Rizzoli Orthopaedic Institute, Bologna, Italy. This work was partially supported by the project Regione Emilia Romagna Programma di Ricerca Regione-Universita’ 2007-2009 (Regenerative Medicine in Osteoarticular Disease).

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All authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. III Clinic—Biomechanics Laboratory, Rizzoli Orthopaedic Institute, Via Di Barbiano, 1/10, 40136, Bologna, Italy

    Giuseppe Filardo, Elizaveta Kon, Alessandro Di Martino, Silvio Patella, Giulio Altadonna, Federica Balboni, Laura Bragonzoni, Andrea Visani & Maurilio Marcacci

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  1. Giuseppe Filardo
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  2. Elizaveta Kon
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Correspondence to Elizaveta Kon.

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Filardo, G., Kon, E., Di Martino, A. et al. Second-generation arthroscopic autologous chondrocyte implantation for the treatment of degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 20, 1704–1713 (2012). https://doi.org/10.1007/s00167-011-1732-5

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  • DOI: https://doi.org/10.1007/s00167-011-1732-5

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