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Matrix based autologous chondrocyte implantation in children and adolescents: a match paired analysis in a follow-up over three years post-operation

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Abstract

Purpose

The aim of this study is the investigation of the clinical results after third generation autologous chondrocyte implantation in the knee in a follow-up over three years post-operation. Our primary focus is on the effects of this procedure on children and adolescent patients as there is a lack of knowledge regarding the clinical outcomes in children/adolescents in particular when compared with adults.

Methods

A total of 40 patients (43 defects) <20 years with cartilage defects of the knee were treated with third generation ACI (Novocart® 3D). These defects were caused by osteochondritis dissecans (n = 13), acute trauma (<12 months) (n = 9), old trauma (>12 months) (n = 5) or unknown pathology (n = 13). The mean defect size was 5.2 cm2. IKDC subjective score and VAS (at rest and during activity) were used for clinical evaluation after 6, 12, 24 and 36 months post-operatively. The results of these patients were compared with 40 matched adult patients. Match paired analysis was performed by numbers of treated defects, defect location and defect size. All cartilage defects were arthroscopically classified with IKDC grade III-IV. All adult patients in the control group were treated with matrix based autologous chondrocyte implantation.

Results

All patients showed significantly better clinical results compared with the pre-operative findings in the follow-up over three years. We observed significantly better results in the IKDC score and VAS during the whole postoperative follow-up in children and adolescents after six, 12, 24 and 36 months compared with the adult control group. The IKDC score improved from 46.5 preoperative to 77.5 (+31) after three years in children and adolescents. Similarly, significantly lower stress pain after six months and one, two and three years was found in this group.

Conclusion

This study showed that third generation autologous chondrocyte implantation is a suitable method for the treatment of full cartilage defects in children and adolescents.

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Acknowledgments

T.R.N., M.F.P., and P.E.M. are members of the working group “Tissue Regeneration” of the German Society for Orthopaedic and Trauma Surgery.

There was no financial support of this project. The authors have received nothing of value. This manuscript does not contain information about medical devices.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, University Hospital of Munich (LMU), Campus Grosshadern, Marchioninistr. 15, 81377, Munich, Germany

    Thomas Richard Niethammer, Martin Holzgruber, Mehmet Fatih Gülecyüz, Patrick Weber, Matthias Frank Pietschmann & Peter Ernst Müller

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  1. Thomas Richard Niethammer
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  2. Martin Holzgruber
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Correspondence to Thomas Richard Niethammer.

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Ethical approval

Institutional review board (IRB) approval was obtained from the ethical committee of the Ludwig Maximilian University (LMU) of Munich.

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Informed consent was obtained from all individual participants included in the study.

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Niethammer, T.R., Holzgruber, M., Gülecyüz, M.F. et al. Matrix based autologous chondrocyte implantation in children and adolescents: a match paired analysis in a follow-up over three years post-operation. International Orthopaedics (SICOT) 41, 343–350 (2017). https://doi.org/10.1007/s00264-016-3321-1

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  • DOI: https://doi.org/10.1007/s00264-016-3321-1

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