J Korean Orthop Assoc.  2008 Apr;43(2):193-199. 10.4055/jkoa.2008.43.2.193.

The Results of Autologous Chondrocyte Implantation with a Concomitant Injury

• Jeong BO
• Yoon KH
• Bae DK
• Moon JS
• Song SJ

• KMID: 2106439
• DOI: http://doi.org/10.4055/jkoa.2008.43.2.193

Abstract

PURPOSE: To evaluate the results of autologous chondrocyte implantation with a concomitant injury.
MATERIALS AND METHODS
Sixty-seven chondral defects (39 cases, 36 patients), which were treated with autologous chondrocyte implantation, were analyzed with a minimum follow-up of 2 years. The cases were divided into the following five groups: 4 cases of a single chondral defect (group I), 3 cases of multiple chondral defects (group II), 5 cases of osteochondritis dissecans (group III), 9 cases of a single chondral defect with a concomitant injury (group IV), and 18 cases of multiple chondral defects with a concomitant injury (group V). The clinical outcomes were evaluated using the International Knee Documentation Committee (IKDC) subjective and objective scores and the International Cartilage Repair Society (ICRS) functional evaluation system. Arthroscopic examinations were performed on 12 cases and 21 chondral defects.
RESULTS
The mean IKDC subjective score was 39.8 preoperatively, which improved to 64.1 postoperatively, and the IKDC objective score was C in 54% and D in 46%, which improved to A in 74%, B in 23% and C in 3%. The ICRS functional evaluation system was III in 82% of cases, and IV in 18% preoperatively, which improved to I in 15% and II in 85%, postoperatively. At the arthroscopic evaluation, the results of the ICRS system were I in 9%, II in 67%, and III in 24%. There was no significant difference between the single chondral defect and chondral defects with a concomitant injury.
CONCLUSION
In the treatment of the multiple chondral defects with a concomitant injury, autologous chondrocyte implantation produced similar excellent clinical results to those of a single chondral defect.

Keyword

Knee; Chondral defect; Autologous chondrocyte implantation

MeSH Terms

Cartilage
Chondrocytes
Follow-Up Studies
Knee
Osteochondritis Dissecans

Figure

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  Fig. 1 (A) A 47 years old woman had a varus alignment, anterior cruciate ligament deficiency, and chondral defect in the patella and medial femoral condyle. (B) Autologous chondrocyte implantation to the patella and medial femoral condyle were performed. (C) Open wedge valgus high tibial osteotomy and anterior cruciate ligament reconstruction using a bone-patella-bone allograft were performed with autologous chondrocyte implantation. Second look arthroscopy at 1 year 6 months postoperatively shows hypertrophied cartilage with good integration with the surrounding tissue and smooth surface in the medial femoral condyle (D) and patella (E).

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  Fig. 2 (A) A 32-year-old male underwent arthroscopic total lateral meniscectomy 7 years ago. He had a chondral defect in the lateral femoral condyle and an anterior cruciate ligament deficiency. (B) Lateral meniscus transplantation using meniscal allograft was performed using key hole technique and autologous chondrocyte implantation in lateral femoral condyle and anterior cruciate ligament reconstruction using an allo bone-patella-bone graft was performed. Second look arthroscopy at 1 year 6 months after surgery shows an almost normal cartilage with complete integration with surrounding tissue and smooth surface (C) and well healed transplanted lateral meniscus (D).

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