title: Second-generation arthroscopic autologous chondrocyte implantation for the treatment of degenerative cartilage lesions.
abstract: OBJECTIVE
  Degenerative cartilage lesions present a negative joint environment, which may have a negative effect on the process of cartilage regeneration. The aim of this study is to analyze the clinical outcome obtained with the treatment for isolated degenerative knee cartilage lesions by second-generation arthroscopic autologous chondrocyte implantation (ACI).
  
  
  METHODS
  Fifty-eight consecutive patients affected by focal degenerative chondral lesions of the femoral condyles and trochlea were treated by second-generation arthroscopic ACI. The mean age at surgery was 34.7 ± 9.1 years and the average defect size was 2.3 ± 0.9 cm(2). The patients were prospectively evaluated with IKDC, EQ-VAS, and Tegner scores preoperatively, at 2 and 6 years.
  
  
  RESULTS
  A statistically significant improvement was observed in all scores from the basal evaluation to the final follow-up. The IKDC subjective score improved from 39.3 ± 13.6 to 68.8 ± 22.7 and 68.5 ± 23.9 at the 2- and 6-year follow-ups, respectively, with a significant improvement (P < 0.0005) and stable results over time; the same trend was confirmed by the EQ-VAS and Tegner scores. The worst results were found in patients with a low physical activity level, women, and those having undergone previous surgery, whereas the symptom duration before surgery did not influence the final outcome. The failure rate was 18.5%.
  
  
  CONCLUSIONS
  Despite a significant improvement, the results were lower with respect to the outcome reported in different study populations, and the number of failures was markedly higher, too. Tissue-engineered cartilage implantation is a promising approach for the treatment of degenerative chondral lesions, but graft properties, besides mechanical and biochemical joint environment, have to be improved.
  
  
  METHODS
  Case series, Level IV.
authors: III Clinic - Biomechanics Laboratory, Rizzoli Orthopaedic Institute, Via Di Barbiano, 1/10, 40136 Bologna, Italy.
authors: Giuseppe
authors: G
authors: Filardo
authors: Elizaveta
authors: E
authors: Kon
authors: Alessandro
authors: A
authors: Di Martino
authors: Silvio
authors: S
authors: Patella
authors: Giulio
authors: G
authors: Altadonna
authors: Federica
authors: F
authors: Balboni
authors: Laura
authors: L
authors: Bragonzoni
authors: Andrea
authors: A
authors: Visani
authors: Maurilio
authors: M
authors: Marcacci
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000328:Adult; D001182:Arthroscopy; D002357:Cartilage Diseases / Q000628:therapy*; D002358:Cartilage, Articular / Q000601:surgery*; D019902:Chondrocytes / Q000637:transplantation*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D054457:Tissue Scaffolds; D014182:Transplantation, Autologous; D055815:Young Adult
chemical_list: D000276:Adjuvants, Immunologic; D006820:Hyaluronic Acid