title: Ten-year clinical and radiographic outcomes after autologous chondrocyte implantation of femoral condyles.
abstract: OBJECTIVE
  This prospective study assessed the 10-year clinical outcomes of periosteum autologous chondrocyte implantation (ACI) due to cartilage lesions of the femoral condyles.
  
  
  METHODS
  Thirty-three of 45 patients (3 failures, 7 non-responders, 2 others) were available for clinical and radiographic evaluation at 2, 5, and 10 years. Patients were categorized into groups with focal cartilage lesions, osteochondritis dissecans (OCD), and cartilage lesions with simultaneous ACL reconstruction (ACL). Seven patients in the overall series required an arthroscopic re-intervention (3 ACI related, 4 ACI unrelated).
  
  
  RESULTS
  Subjective knee scores and activity scores were significantly improved at 2 years toward their pre-operative levels and then remained stable up to 10 years; however, patients did not reach their pre-injury activity levels. Upon 10-year examination, using the IKDC knee examination form, there were 15 normal, 11 nearly normal, 5 abnormal, and 2 severely abnormal knees. Radiographic evidence of osteoarthritis was found in 45% of patients (5 focal lesions, 2 OCD, and 8 ACL).
  
  
  CONCLUSIONS
  ACI provided safe and stable performance of operated knees over 10 years with a significant improvement toward pre-operative levels. Patients restrained from high-impact knee joint activities, post-surgery, and their knee radiographs demonstrated a high incidence of knee OA in trauma-related lesions. Optimal long-term performance is expected in localized, low-impact cartilage lesions of young patients.
  
  
  METHODS
  Case series, Level IV.
authors.affiliation: Department of Orthopaedic Surgery, University Medical Centre Ljubljana, Zaloška ulica 9, 1000, Ljubljana, Slovenia.
authors.forename: David
authors.initials: D
authors.lastname: Martinčič
authors.forename: Damjan
authors.initials: D
authors.lastname: Radosavljevič
authors.forename: Matej
authors.initials: M
authors.lastname: Drobnič
mesh_terms: D000293:Adolescent; D000328:Adult; D002356:Cartilage / Q000637:transplantation; D002357:Cartilage Diseases / Q000175:diagnosis / Q000601:surgery*; D002358:Cartilage, Articular / Q000601:surgery; D019902:Chondrocytes / Q000637:transplantation*; D005260:Female; D005269:Femur / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery; D010521:Periosteum / Q000637:transplantation; D011446:Prospective Studies; D019651:Plastic Surgery Procedures; D014182:Transplantation, Autologous