Purpose
The purpose of this study was to evaluate the overall long-term improvement of autologous
chondrocyte implantation (ACI) treatment in terms of patient satisfaction, clinical
assessment, and magnetic resonance imaging (MRI) evaluation. Furthermore, we aimed
to assess the impact of independent variables on clinical outcomes and patient satisfaction.
Methods
We evaluated 23 patients (mean age, 30.5 ± 8.2 years) with full-thickness chondral
lesions of the distal femur who underwent first-generation ACI with periosteum between
1997 and 2004. The Lysholm score, Tegner activity score, subjective International
Knee Documentation Committee score, numeric rating scale score, and Short Form 36
score were used for clinical assessment preoperatively, at 1 year postoperatively,
and at 7 to 14 years (mean, 9.9 years) after surgery. MRI was performed to evaluate
the cartilage preoperatively and at final follow-up, by use of the Magnetic Resonance
Observation of Cartilage Repair Tissue (MOCART) score.
Results
ACI resulted in a substantial improvement in all clinical outcome parameters, even
as much as 14 years after implantation, although a small deterioration was noticed
between intermediate and final evaluations in some outcome parameters. Of the patients,
73.1% stated that they would undergo the operation again. Younger patients with a
shorter duration of preoperative symptoms and smaller defect sizes benefited most.
MRI findings confirmed complete defect filling in 52.3% of the patients at final follow-up.
Conclusions
Our long-term results confirm that first-generation ACI is an effective treatment
for large full-thickness chondral and osteochondral lesions of the knee joint. Younger
patients with a shorter duration of preoperative symptoms and smaller defect size
benefited most in our study.
Level of Evidence
Level IV, therapeutic case series.
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Article Info
Publication History
Published online: October 04, 2012
Accepted:
May 4,
2012
Received:
October 14,
2011
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
