Purpose: The clinical results after autologous chondrocyte implantation (ACI) with a collagen
membrane using sequential objective patient evaluation (clinical examination and magnetic
resonance imaging [MRI]) are inadequately reported. This prospective study was performed
to determine the results after ACI at different time intervals over a period of 36
months. Methods: Between 2000 and 2002, 63 patients (mean age, 34 years) with full-thickness chondral
lesions of the knee underwent an autologous chondrocyte implantation and were evaluated
preoperatively and at 6, 18, and 36 months after surgery. The chondrocyte suspension
within the defect was covered with a type I/III collagen membrane. Depending on the
localization of the defects (femoral condyles, trochlea, and retropatellar), the patients
were assigned to three different groups. Exclusion criteria were meniscal pathologies,
axial malpositioning, and ligament instabilities. Baseline clinical scores (modified
Cincinnati knee score and the International Cartilage Repair Society score) were determined
and compared with follow-up data by using the paired Wilcoxon test. Results: The ICRS and modified Cincinnati score showed significant improvement (P < .01) in all time intervals between preoperative and 6, 18, and 36 months after
surgery. There was no significant difference in the final outcome between different
defect localizations (P > .2). The Pearson coefficient of correlation between clinical and MRI scores was
0.73 and significant at the 0.01 level. There was no patient with a symptomatic graft
hypertrophy. Conclusions: ACI is an effective method in the treatment of isolated cartilage defects in the
knee. Graft hypertrophy can be avoided by using a collagen membrane. Significant improvement
(P < .001) occurs still between 18 and 36 months after surgery. Level of Evidence: Level IV, therapeutic case series.
Key Words
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Footnotes
The authors report no conflict of interest.
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© 2007 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
