Skip to main content
SpringerLink
Log in

Sequential outcome following autologous chondrocyte implantation of the knee: A six-year follow-up

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

This prospective six-year longitudinal study reviews the clinical outcome of patients undergoing autologous chondrocyte implantation (ACI) and a porcine type I/III collagen membrane cover for deep chondral defects of the knee. We present 57 patients (31 male, 26 female) with a mean age of 31.6 years (range 15–51 years) that have undergone ACI since July 1998. The mean size of the defect was 3.14 cm2 (range 1.0–7.0 cm2). All patients were assessed annually using seven independent validated clinical rating scores with the data analysed using ANOVA. ACI using a porcine type I/III collagen membrane cover produced statistically significant improvements (p < 0.001), maintained for up to six years, in knee symptoms compared to pre-operative levels. This study provides evidence of the medium-term benefit achieved by transplanting autologous chondrocytes to osteochondral defects.

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

Chart 1
Chart 2
Chart 3
Chart 4
Chart 5

Similar content being viewed by others

References

  1. Mankin HJ, Mow VC, Buckwalter JA (2005) Articular cartilage structure, composition and function. In: Buckwalter JA, Einhorn TA, Simon WH (ed) Orthopaedic Basic Science AAOS, pp 444–467

  2. Gray ML, Pizzanelli AM, Grodzinsky AJ, Lee RC (1988) Mechanical and physiochemical determinants of the chondrocyte biosynthetic response. J Orthop Res 6:777–792

    Article  CAS  PubMed  Google Scholar 

  3. Larsson T, Aspden RM, Heinegard D (1991) Effects of mechanical load on cartilage matrix biosynthesis in vitro. Matrix 11:388–394

    CAS  PubMed  Google Scholar 

  4. Steadman JR, Briggs KK, Rodrigo JJ, Kocher MS, Gill TJ, Rodkey WG (2003) Outcomes of microfracture for traumatic chondral defects of the knee: average 11-year follow-up. Arthroscopy 19:477–484

    Article  PubMed  Google Scholar 

  5. Brittberg M, Peterson L, Sjogren-Jansson E, Tallheden T, Lindahl A (2003) Articular cartilage engineering with autologous chondrocyte transplantation. A review of recent developments. J Bone Joint Surg Am 85-A(Suppl 3):109–115

    PubMed  Google Scholar 

  6. Peterson L, Minas T, Brittberg M, Nilsson A, Sjogren-Jansson E, Lindahl A (2000) Two- to 9-year outcome after autologous chondrocyte transplantation of the knee. Clin Orthop Relat Res 212–234

  7. 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 11:51–55

    Article  PubMed  Google Scholar 

  8. Bentley G, Minas T (2000) Treating joint damage in young people. BMJ 320:1585–1588

    Article  CAS  PubMed  Google Scholar 

  9. Briggs TW, Mahroof S, David LA, Flannelly J, Pringle J, Bayliss M (2003) Histological evaluation of chondral defects after autologous chondrocyte implantation of the knee. J Bone Joint Surg Br 85:1077–1083

    Article  CAS  PubMed  Google Scholar 

  10. Bartlett W, Skinner JA, Gooding CR, Carrington RW, Flanagan AM, Briggs TW, Bentley G (2005) Autologous chondrocyte implantation versus matrix-induced autologous chondrocyte implantation for osteochondral defects of the knee: a prospective, randomised study. J Bone Joint Surg Br 87:640–645

    Article  CAS  PubMed  Google Scholar 

  11. Noyes FR, Barber-Westin SD (1997) Arthroscopic-assisted allograft anterior cruciate ligament reconstruction in patients with symptomatic arthrosis. Arthroscopy 13:24–32

    Article  CAS  PubMed  Google Scholar 

  12. Wewers ME, Lowe NK (1990) A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health 13:227–236

    Article  CAS  PubMed  Google Scholar 

  13. Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10:150–154

    Article  CAS  PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  15. Peterson L, Brittberg M, Kiviranta I, Akerlund EL, Lindahl A (2002) Autologous chondrocyte transplantation. Biomechanics and long-term durability. Am J Sports Med 30:2–12

    PubMed  Google Scholar 

  16. Krishnan SP, Skinner JA, Bartlett W, Carrington RW, Flanagan AM, Briggs TW, Bentley G (2006) Who is the ideal candidate for autologous chondrocyte implantation? J Bone Joint Surg Br 88:61–64

    Article  CAS  PubMed  Google Scholar 

  17. Bartlett W, Gooding CR, Carrington RW, Skinner JA, Briggs TW, Bentley G (2005) Autologous chondrocyte implantation at the knee using a bilayer collagen membrane with bone graft. A preliminary report. J Bone Joint Surg Br 87:330–332

    Article  CAS  PubMed  Google Scholar 

  18. Bentley G, Biant LC, Carrington RW, Akmal M, Goldberg A, Williams AM, Skinner JA, Pringle J (2003) A prospective, randomised comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects in the knee. J Bone Joint Surg Br 85:223–230

    Article  CAS  PubMed  Google Scholar 

  19. Jakobsen RB, Engebretsen L, Slauterbeck JR (2005) An analysis of the quality of cartilage repair studies. J Bone Joint Surg Am 87:2232–2239

    Article  PubMed  Google Scholar 

  20. Henderson IJ, Tuy B, Connell D, Oakes B, Hettwer WH (2003) Prospective clinical study of autologous chondrocyte implantation and correlation with MRI at three and 12 months. J Bone Joint Surg Br 85:1060–1066

    Article  CAS  PubMed  Google Scholar 

  21. 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 

  22. Horas U, Pelinkovic D, Herr G, Aigner T, Schnettler R (2003) Autologous chondrocyte implantation and osteochondral cylinder transplantation in cartilage repair of the knee joint. A prospective, comparative trial. J Bone Joint Surg Am 85-A:185–192

    CAS  PubMed  Google Scholar 

  23. Knutsen G, Engebretsen L, Ludvigsen TC, Drogset JO, Grontvedt T, Solheim E, Strand T, Roberts S, Isaksen V, Johansen O (2004) Autologous chondrocyte implantation compared with microfracture in the knee. A randomized trial. J Bone Joint Surg Am 86-A:455–464

    PubMed  Google Scholar 

  24. Browne JE, Anderson AF, Arciero R, Mandelbaum B, Moseley JB, Jr, Micheli LJ, Fu F, Erggelet C (2005) Clinical outcome of autologous chondrocyte implantation at 5 years in US subjects. Clin Orthop Relat Res 237–245

  25. Gooding CR, Bartlett W, Bentley G, Skinner JA, Carrington R, Flanagan A (2006) 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 13:203–210

    Article  CAS  PubMed  Google Scholar 

  26. Steinwachs M, Kreuz PC (2007) 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 23:381–387

    Article  PubMed  Google Scholar 

  27. Saris DB, Vanlauwe J, Victor J, Haspl M, Bohnsack M, Fortems Y, Vandekerckhove B, Almqvist KF, Claes T, Handelberg F, Lagae K, van der BJ, Vandenneucker H, Yang KG, Jelic M, Verdonk R, Veulemans N, Bellemans J, Luyten FP (2008) 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 36:235–246

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Royal National Orthopaedic Hospital, Stanmore, UK

    Benedict A. Rogers, Lee A. David & Tim W. R. Briggs

  2. 38 Woodham Waye, Woking, Surrey, GU21 5SJ, UK

    Benedict A. Rogers

Authors
  1. Benedict A. Rogers
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lee A. David
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tim W. R. Briggs
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Benedict A. Rogers.

Additional information

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rogers, B.A., David, L.A. & Briggs, T.W.R. Sequential outcome following autologous chondrocyte implantation of the knee: A six-year follow-up. International Orthopaedics (SICOT) 34, 959–964 (2010). https://doi.org/10.1007/s00264-009-0842-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-009-0842-x

Keywords

Search

Navigation