title: Cell-based therapy improves function in adolescents and young adults with patellar osteochondritis dissecans.
abstract: BACKGROUND
  Recent advances have been made in using chondrocytes and other cell-based therapy to treat cartilage defects in adults. However, it is unclear whether these advances should be extended to the adolescent and young adult-aged patients.
  
  
  OBJECTIVE
  We assessed cell-based surgical therapy for patellar osteochondritis dissecans (OCD) in adolescents and young adults by (1) determining function with the International Knee Documentation Committee (IKDC) subjective and Lysholm-Gillquist scores; and (2) evaluating activity level using the Tegner-Lysholm scale.
  
  
  METHODS
  We retrospectively reviewed 23 patients between 12 and 21 years of age (mean 16.8 years) treated for OCD lesions involving the patella from 2001 to 2008. Twenty patients had autologous chondrocyte implantation and three patients had cultured bone marrow stem cell implantation. There were 19 males and four females. We obtained preoperative CT scans to assess patella subluxation, tilt, and congruence angle to determine choice of treatment. We obtained IKDC subjective knee evaluation scores, Tegner-Lysholm activity levels, and Lysholm-Gillquist knee scores preoperatively and at 6, 12, and 24 months postoperatively.
  
  
  RESULTS
  Mean IKDC score, Tegner-Lysholm outcomes, and Lysholm-Gillquist scale improved from 45, 2.5, and 50, respectively, at surgery to 75, 4, and 70, respectively, at 24-month followup. Complications include periosteal hypertrophy observed in two patients.
  
  
  CONCLUSIONS
  Cell-based therapy was associated with short-term improvement in function in adolescents and young adults with patellar OCD.
  
  
  METHODS
  Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Bryon J X
authors.initials: BJ
authors.lastname: Teo
authors.forename: Kizher
authors.initials: K
authors.lastname: Buhary
authors.forename: Bee-Choo
authors.initials: BC
authors.lastname: Tai
authors.forename: James H
authors.initials: JH
authors.lastname: Hui
mesh_terms: D000293:Adolescent; D016026:Bone Marrow Transplantation; D002358:Cartilage, Articular / Q000601:surgery*; D064987:Cell- and Tissue-Based Therapy / Q000379:methods*; D002648:Child; D019902:Chondrocytes / Q000637:transplantation*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D010008:Osteochondritis Dissecans / Q000601:surgery*; D010329:Patella; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult