Autologous chondrocyte implantation for joint preservation in patients with early osteoarthritis.
Young patients with early osteoarthritis wishing to remain functionally active have limited treatment options. Existing studies examining the use of autologous chondrocyte implantation (ACI) have included patients with early degenerative changes; however, none specifically investigated the outcome of ACI with this challenging problem. We prospectively followed 153 patients (155 knees) for up to 11 years after treatment with ACI for early-stage osteoarthritis. Patient pain and function was assessed using WOMAC, modified Cincinnati, SF-36, Knee Society score, and a satisfaction questionnaire. Mean patient age was 38.3 years. On average, 2.1 defects were treated per knee; the mean defect size was 4.9 cm2 and total area per knee was 10.4 cm2. Eight percent of joints were considered treatment failures that went on to arthroplasty and the remaining patients experienced 50% to 75% improvement in WOMAC subscales. Our data suggest that ACI in patients with early osteoarthritis results in clinically relevant reductions in pain and improvement in function. At 5 years postoperatively, 92% of patients were functioning well and were able to delay the need for joint replacement. Given the limited number of treatment options for this subset of patients, autologous chondrocyte implantation may offer improved quality of life for young osteoarthritic patients.


METHODS
Level IV, case series. See Guidelines for Authors for a complete description of levels of evidence.
Minas
Tom
T
Cartilage Repair Center, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA. tminas@partners.org
Gomoll
Andreas H
AH
Solhpour
Shahram
S
Rosenberger
Ralf
R
Probst
Christian
C
Bryant
Tim
T
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D017690:Cell Transplantation; D019902:Chondrocytes / Q000637:transplantation*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000601:surgery*; D010146:Pain / Q000503:physiopathology; D010147:Pain Measurement; D017060:Patient Satisfaction; D011446:Prospective Studies; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012086:Reoperation; D011795:Surveys and Questionnaires; D014182:Transplantation, Autologous; D017211:Treatment Failure; D055815:Young Adult