title: Outcome of combined autologous chondrocyte implantation and anterior cruciate ligament reconstruction.
abstract: BACKGROUND
  Instability of the knee joint, after anterior cruciate ligament (ACL) injury, is contraindication to osteochondral defect repair. This prospective study is to investigate the role of combined autologous chondrocyte implantation (ACI) with ACL reconstruction.
  
  
  METHODS
  Three independent groups of patients with previous ACL injuries undergoing ACI were identified and prospectively followed up. The first group had ACI in combination with ACL reconstruction (combined group); the 2(nd) group consisted of individuals who had an ACI procedure having had a previously successful ACL reconstruction (ACL first group); and the third group included patients who had an ACI procedure to a clinically stable knee with documented nonreconstructed ACL disruption (No ACL group). Their outcomes were assessed using the modified cincinnati rating system, the Bentley functional (BF) rating system (BF) and a visual analog scale (VAS).
  
  
  RESULTS
  At a mean followup of 64.24 months for the ACL first group, 63 months for combined group and 78.33 months for the No ACL group; 60% of ACL first patients, 72.73% of combined group and 83.33% of the No ACL group felt their outcome was better following surgery. There was no significant difference demonstrated in BF and VAS between the combined and ACL first groups. Results revealed a significant affect of osteochondral defect size on outcome measures.
  
  
  CONCLUSIONS
  The study confirms that ACI in combination with ACL reconstruction is a viable option with similar outcomes as those patients who have had the procedures staged.
authors.affiliation: Joint Reconstruction Unit, Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, HA7 4LP, United Kingdom.
authors.forename: Baljinder S
authors.initials: BS
authors.lastname: Dhinsa
authors.affiliation: Joint Reconstruction Unit, Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, HA7 4LP, United Kingdom.
authors.forename: Syed Z
authors.initials: SZ
authors.lastname: Nawaz
authors.affiliation: Joint Reconstruction Unit, Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, HA7 4LP, United Kingdom.
authors.forename: Kieran R
authors.initials: KR
authors.lastname: Gallagher
authors.affiliation: Joint Reconstruction Unit, Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, HA7 4LP, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Skinner
authors.affiliation: Joint Reconstruction Unit, Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, HA7 4LP, United Kingdom.
authors.forename: Tim
authors.initials: T
authors.lastname: Briggs
authors.affiliation: Joint Reconstruction Unit, Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, HA7 4LP, United Kingdom.
authors.forename: George
authors.initials: G
authors.lastname: Bentley
keywords: Anterior cruciate ligament; autologous; autologous chondrocyte; chondrocyte; chondrocytes; knee; osteochondral defect