Collagen-covered autologous chondrocyte implantation for osteochondritis dissecans of the knee: two- to seven-year results.
We prospectively studied the clinical, arthroscopic and histological results of collagen-covered autologous chondrocyte implantation (ACI-C) in patients with symptomatic osteochondritis dissecans of the knee. The study included 37 patients who were evaluated at a mean follow-up of 4.08 years. Clinical results showed a mean improvement in the modified Cincinnati score from 46.1 to 68.4. Excellent and good clinical results were seen in 82.1% of those with juvenile-onset osteochondritis dissecans but in only 44.4% of those with adult-onset disease. Arthroscopy at one year revealed International Cartilage Repair Society grades of 1 or 2 in 21 of 24 patients (87.5%). Of 23 biopsies, 11 (47.8%) showed either a hyaline-like or a mixture of hyaline-like and fibrocartilage, 12 (52.2%) showed fibrocartilage. The age at the time of ACI-C determined the clinical outcome for juvenile-onset disease (p = 0.05), whereas the size of the defect was the major determinant of outcome in adult-onset disease (p = 0.01).
Krishnan
S P
SP
Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK. shibupkrishnan@yahoo.co.in
Skinner
J A
JA
Carrington
R W J
RW
Flanagan
A M
AM
Briggs
T W R
TW
Bentley
G
G
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000375:Aging / Q000502:physiology; D000704:Analysis of Variance; D001182:Arthroscopy / Q000379:methods; D002358:Cartilage, Articular / Q000473:pathology / Q000601:surgery; D002648:Child; D019902:Chondrocytes / Q000637:transplantation*; D003094:Collagen / Q000627:therapeutic use*; D006801:Humans; D007719:Knee Joint / Q000473:pathology / Q000601:surgery*; D010008:Osteochondritis Dissecans / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D003094:Collagen