title: Repair of osteochondral lesions in the knee by chondrocyte implantation using the MACI® technique.
abstract: OBJECTIVE
  Matrix-associated autologous chondrocyte implantation (MACI(®)) is an innovative therapeutic option for the treatment of chondral and osteochondral lesions of the knee.
  
  
  METHODS
  Fifty-three patients (54 knees) with MRI-documented osteochondral lesions were treated with MACI(®). A clinical assessment was performed using VAS score, Lysholm score, and Tegner activity level after an average follow-up of 27 months (SD: 2.3). MRI scans were performed 12 and 24 months after surgery. Seventeen patients were reevaluated after an average time of 59 months (SD: 6.7) after surgery.
  
  
  RESULTS
  Two years after transplantation, Lysholm score increased from a preoperative mean value of 70 (SD: 13.4) to 95 (SD: 6.4); the average VAS score decreased from a preoperative value of 5.2 (SD: 2.9) to 1.9 (SD: 2.1). The difference with respect to Tegner activity level did not prove to be significant. At 1 year, MRI scans documented a completely repaired defect with slight subchondral bone abnormality in 38 cases (70%). Satisfying outcomes were confirmed on 17 patients who were reevaluated 5 years after surgery. At 60 months, MRI scans showed complete integration with the surrounding native cartilage without any sign of detachment or bone marrow edema in 15 cases (88%).
  
  
  CONCLUSIONS
  The MACI(®) technique is a safe and clinically effective procedure, which has been proven to be valuable in treating osteochondral defects even over the long term.
  
  
  METHODS
  Therapeutic study, Level III-2 (retrospective cohort study).
authors.affiliation: U.O.S.D. Chirurgia Articolare Mininvasiva (Minimally Invasive Articular Surgery), Istituto Ortopedico G. Pini, Milan, Italy. alberto.ventura@doctoral.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Ventura
authors.forename: Antonio
authors.initials: A
authors.lastname: Memeo
authors.forename: Enrico
authors.initials: E
authors.lastname: Borgo
authors.forename: Clara
authors.initials: C
authors.lastname: Terzaghi
authors.forename: Claudio
authors.initials: C
authors.lastname: Legnani
authors.forename: Walter
authors.initials: W
authors.lastname: Albisetti
mesh_terms: D000293:Adolescent; D000328:Adult; D001178:Arthroplasty / Q000379:methods*; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000293:injuries*; D019902:Chondrocytes / Q000637:transplantation*; D015331:Cohort Studies; D005500:Follow-Up Studies; D048091:Guided Tissue Regeneration / Q000379:methods*; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012189:Retrospective Studies; D054457:Tissue Scaffolds; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult