title: Minimum ten-year results of a prospective randomised study of autologous chondrocyte implantation versus mosaicplasty for symptomatic articular cartilage lesions of the knee.
abstract: Autologous chondrocyte implantation (ACI) and mosaicplasty are methods of treating symptomatic articular cartilage defects in the knee. This study represents the first long-term randomised comparison of the two techniques in 100 patients at a minimum follow-up of ten years. The mean age of the patients at the time of surgery was 31.3 years (16 to 49); the mean duration of symptoms pre-operatively was 7.2 years (9 months to 20 years). The lesions were large with the mean size for the ACI group being 440.9 mm(2) (100 to 1050) and the mosaicplasty group being 399.6 mm(2) (100 to 2000). Patients had a mean of 1.5 previous operations (0 to 4) to the articular cartilage defect. Patients were assessed using the modified Cincinnati knee score and the Stanmore-Bentley Functional Rating system. The number of patients whose repair had failed at ten years was ten of 58 (17%) in the ACI group and 23 of 42 (55%) in the mosaicplasty group (p < 0.001). The functional outcome of those patients with a surviving graft was significantly better in patients who underwent ACI compared with mosaicplasty (p = 0.02).
authors.affiliation: Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK.
authors.forename: G
authors.initials: G
authors.lastname: Bentley
authors.forename: L C
authors.initials: LC
authors.lastname: Biant
authors.forename: S
authors.initials: S
authors.lastname: Vijayan
authors.forename: S
authors.initials: S
authors.lastname: Macmull
authors.forename: J A
authors.initials: JA
authors.lastname: Skinner
authors.forename: R W J
authors.initials: RW
authors.lastname: Carrington
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000379:methods; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery*; D018929:Cell Culture Techniques; D019902:Chondrocytes / Q000637:transplantation*; D003646:Debridement / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010008:Osteochondritis Dissecans / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery; D011446:Prospective Studies; D020127:Recovery of Function; D012086:Reoperation / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult