Autologous chondrocyte implantation for cartilage repair: monitoring its success by magnetic resonance imaging and histology.
Autologous chondrocyte implantation is being used increasingly for the treatment of cartilage defects. In spite of this, there has been a paucity of objective, standardised assessment of the outcome and quality of repair tissue formed. We have investigated patients treated with autologous chondrocyte implantation (ACI), some in conjunction with mosaicplasty, and developed objective, semiquantitative scoring schemes to monitor the repair tissue using MRI and histology. Results indicate repair tissue to be on average 2.5 mm thick. It was of varying morphology ranging from predominantly hyaline in 22% of biopsy specimens, mixed in 48%, through to predominantly fibrocartilage, in 30%, apparently improving with increasing time postgraft. Repair tissue was well integrated with the host tissue in all aspects viewed. MRI scans provide a useful assessment of properties of the whole graft area and adjacent tissue and is a noninvasive technique for long-term follow-up. It correlated with histology (P = 0.02) in patients treated with ACI alone.
Roberts
Sally
S
Centre for Spinal Studies, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Trust, Oswestry, Shropshire, UK. s.roberts@keele.ac.uk
McCall
Iain W
IW
Darby
Alan J
AJ
Menage
Janis
J
Evans
Helena
H
Harrison
Paul E
PE
Richardson
James B
JB
D000328:Adult; D000368:Aged; D002358:Cartilage, Articular / Q000033:anatomy & histology* / Q000737:chemistry / Q000166:cytology; D019902:Chondrocytes / Q000502:physiology / Q000637:transplantation*; D003094:Collagen / Q000032:analysis / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006025:Glycosaminoglycans / Q000032:analysis / Q000276:immunology; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014945:Wound Healing
D006025:Glycosaminoglycans; D003094:Collagen