TITLE

Autologous Chondrocyte Implantation

AUTHOR(S)
Harris, Joshua D.; Siston, Robert A.; Xueliang Pan; Flanigan, David C.
PUB. DATE
September 2010
SOURCE
Journal of Bone & Joint Surgery, American Volume;Sep2010, Vol. 92-A Issue 12, p2220
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: The purpose of the present study was to determine (1) whether the current literature supports the choice of using autologous chondrocyte implantation over other cartilage procedures with regard to clinical outcome, magnetic resonance imaging, arthroscopic assessment, and durability of treatment, (2) whether the current literature supports the use of a specific generation of autologous chondrocyte implantation, and (3) whether there are patient-specific and defect- specific factors that influence outcomes after autologous chondrocyte implantation in comparison with other cartilage repair or restoration procedures. Methods: We conducted a systematic review of multiple databases in which we evaluated Level-I and II studies comparing autologous chondrocyte implantation with another cartilage repair or restoration technique as well as comparative intergenerational studies of autologous chondrocyte implantation. The methodological quality of studies was evaluated with use of Delphi list and modified Coleman methodology scores. Effect size analysis was performed for all outcome measures. Results: Thirteen studies (917 subjects) were included. Study methodological quality improved with later publication dates. The mean modified Coleman methodology score was 54 (of 100). Patients underwent autologous chondrocyte implantation (n = 604), microfracture (n = 271), orosteochondral autograft(n = 42). All surgical techniques demonstrated improvement in comparison with the preoperative status. Three of seven studies showed better clinical outcomes after autologous chondrocyte implantation in comparison with microfracture after one to three years of follow-up, whereas one study showed better outcomes two years after microfracture and three other studies showed no difference in these treatments after one to five years. Clinical outcomes after microfracture deteriorated after eighteen to twenty-four months (in three of seven studies). Autologous chondrocyte implantation and osteochondral autograft demonstrated equivalent short-term clinical outcomes, although there was more rapid improvement after osteochondral autograft (two studies). Although outcomes were equivalent between first and second-generation autologous chondrocyte implantation and between open and arthroscopic autologous chondrocyte implantation, complication rates were higher with open, periosteal-cover, first-generation autologous chondrocyte implantation (four studies). Younger patients with a shorter preoperative duration of symptoms and fewer prior surgical procedures had the best outcomes after both autologous chondrocyte implantation and microfracture. A defect size of >4cm³ was the only factor predictive of better outcomes when autologous chondrocyte implantation was compared with a non-autologous chondrocyte implantation surgical technique. Conclusions: Cartilage repair or restoration in the knee provides short-term success with microfracture, autologous chondrocyte implantation, or osteochondral autograft. There are patient-specific and defect-specific factors that influence clinical outcomes. Level of Evidence: Therapeutic Level II. See Instructions to Authors for a complete description of levels of evidence.
ACCESSION #
53906212

 

Related Articles

  • Autologous Osteochondral Transplantation for Treating Patellar Chondral Injuries. Astur, Diego Costa; Arliani, Gustavo Gonçalves; Binz, Mario; Astur, Nelson; Kaleka, Camila Cohen; Amaro, Joicemar Tarouco; Pochini, Alberto; Cohen, Moises // Journal of Bone & Joint Surgery, American Volume;5/21/2014, Vol. 96 Issue 10, p816 

    Background: The patella is the largest human sesamoid bone and often sustains chondral injury. There is no consensus on how to treat a full-thickness, symptomatic articular cartilage injury of the patella. We analyzed the clinical and functional outcomes of patients with symptomatic...

  • Aortic autograft dilatation and impaired distensibility in Ross patients, assessed with MRI .  // Cardiology in the Young;May2005 Supplement 2, Vol. 15 Issue S2, p7 

    The article presents a study to investigate the degree of dilatation and its effect on aortic root distensibility in autograft replacement (Ross) patients with magnetic resonance imaging, with comparison to volunteers. Despite the overall good clinical results of the Ross procedure, the presence...

  • The incidence of Chiari malformation in nonsyndromic, single suture craniosynostosis. Leikola, Junnu; Koljonen, Virve; Valanne, Leena; Hukki, Jyri // Child's Nervous System;Jun2010, Vol. 26 Issue 6, p771 

    This study was designed to determine the incidence of Chiari malformation (CM) in nonsyndromic single suture craniosynostosis (N-SSSC). A retrospective analysis of brain magnetic resonance imaging (MRI) studies of children undergoing craniofacial surgery during 1 January, 2004–31 March,...

  • Juvenile Chondrocytes May Facilitate Disc Repair. Kim, Anne J.; Adkisson, H. Davis; Wendland, Michael; Seyedin, Mitchell; Berven, Sigurd; Lotz, Jeffrey C. // Open Tissue Engineering & Regenerative Medicine Journal;2010, Vol. 3, p28 

    Cell transplantation for disc regeneration is a theoretically-attractive alternative to more invasive surgical procedures to treat discogenic pain. Several cell types have been tried in pre-clinical models for this indication, each with relative merits and limitations. Recently, human...

  • Cartilage repair approach and treatment characteristics across the knee joint: a European survey. Salzmann, Gian; Niemeyer, P.; Steinwachs, M.; Kreuz, P.; Südkamp, N.; Mayr, H. // Archives of Orthopaedic & Trauma Surgery;Mar2011, Vol. 131 Issue 3, p283 

    Introduction: To describe indication, approach and treatment modalities for the management of knee cartilage lesions among a selected European population. Methods: An electronic questionnaire covering general and specific items concerning cartilage repair at the knee joint was designed and...

  • Measurement of the graft angles for the anterior cruciate ligament reconstruction with transtibial technique using postoperative magnetic resonance imaging in comparative study. Ahn, Jin; Lee, Sang; Yoo, Jae; Ha, Hae; Ahn, Jin Hwan; Lee, Sang Hak; Yoo, Jae Chul; Ha, Hae Chan // Knee Surgery, Sports Traumatology, Arthroscopy;Nov2007, Vol. 15 Issue 11, p1293 

    The aims of this study were to quantify the angle and placement of an anterior cruciate ligament (ACL) grafted with a single incision ACL reconstruction technique using postoperative magnetic resonance imaging (MRI), and to compare the results with those with a native ACL. Between February 1996...

  • Are Dropped Osteoarticular Bone Fragments Safely Reimplantable in Vivo? Bruce, Benjamin; Sheibani-Rad, Shahin; Appleyard, Deborah; Calfee, Ryan P.; Reinert, Steven E.; Chapin, Kimberle C.; DiGiovanni, Christopher W. // Journal of Bone & Joint Surgery, American Volume;3/2/2011, Vol. 93-A Issue 5, p430 

    Background: There are limited data detailing the appropriate management of nondisposable autologous osteoarticular fragments that have been contaminated by the operating room floor. The goal of the present study was to perform a comprehensive, three-phase investigation to establish an...

  • Articular Cartilage Injury and Autologous Chondrocyte Implantation. Wroble, Randall R. // Physician & Sportsmedicine;Nov2000, Vol. 28 Issue 11, p43 

    Focuses on articular cartilage injury and autologous chondrocyte implantation. Composition and structure of the articular cartilage; Response to injury; Implantation procedure; Chondrocyte proliferation; Indications for implantation.

  • A longitudinal study of the effect of sex and age on rate of change in knee cartilage volume in adults. Flavia Cicuttini // Rheumatology;Feb2007, Vol. 46 Issue 2, p273 

    Objective. To describe the association between sex, age and rate of change in knee cartilage volume in adults.Methods. A total of 325 subjects (mean age 45 yrs, range 26–61) was measured at baseline and ∼2 yrs later. Knee cartilage volume and bone size were determined...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics