title: The role of autologous chondrocyte implantation in the treatment of symptomatic chondromalacia patellae.
abstract: OBJECTIVE
  Chondromalacia patella is a distinct clinical entity of abnormal softening of the articular cartilage of the patella, which results in chronic retropatellar pain. Its aetiology is still unclear but the process is thought to be a due to trauma to superficial chondrocytes resulting in a proteolytic enzymic breakdown of the matrix. Our aim was to assess the effectiveness of autologous chondrocyte implantation on patients with a proven symptomatic retropatellar lesion who had at least one failed conventional marrow-stimulating therapy.
  
  
  METHODS
  We performed chondrocyte implantation on 48 patients: 25 received autologous chondrocyte implantation with a type I/III membrane (ACI-C) method (Geistlich Biomaterials, Wolhusen, Switzerland), and 23 received the Matrix-assisted Chondrocyte Implantation (MACI) technique (Genzyme, Kastrup, Denmark).
  
  
  RESULTS
  Over a mean follow-up period of 40.3 months, there was a statistically significant improvement in subjective pain scoring using the visual analogue scale (VAS) and objective functional scores using the Modified Cincinnati Rating System (MCS) in both groups.
  
  
  CONCLUSIONS
  Chondromalacia patellae lesions responded well to chondrocyte implantation. Better results occurred with MACI than with ACI-C. Excellent and good results were achieved in 40% of ACI-C patients and 57% of MACI patients, but success of chondrocyte implantation was greater with medial/odd-facet lesions. Given that the MACI procedure is technically easier and less time consuming, we consider it to be useful for treating patients with symptomatic chondral defects secondary to chondromalacia patellae.
authors.affiliation: Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK. simonmacmull@hotmail.com
authors.forename: Simon
authors.initials: S
authors.lastname: Macmull
authors.forename: Parag K
authors.initials: PK
authors.lastname: Jaiswal
authors.forename: George
authors.initials: G
authors.lastname: Bentley
authors.forename: John A
authors.initials: JA
authors.lastname: Skinner
authors.forename: Richard W J
authors.initials: RW
authors.lastname: Carrington
authors.forename: Tim W R
authors.initials: TW
authors.lastname: Briggs
mesh_terms: D000293:Adolescent; D000328:Adult; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery; D017690:Cell Transplantation / Q000295:instrumentation / Q000379:methods; D019902:Chondrocytes / Q000637:transplantation*; D046789:Chondromalacia Patellae / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D010329:Patella / Q000473:pathology / Q000601:surgery*; D046788:Patellofemoral Pain Syndrome / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D011446:Prospective Studies; D020127:Recovery of Function; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D008567:Membranes, Artificial