Abstract
Background
Recently, various types of engineered autologous chondrocyte implantation (ACI) have
been developed. Atelocollagen-associated ACI (A-ACI) is the only ACI procedure covered
by Japanese Health Insurance since 2013. The indications of the A-ACI are traumatic
cartilage defects and osteochondral dissecans (OCD) for knee joints.
Purpose
To evaluate midterm clinical results after A-ACI for the treatment for full-thickness
cartilage defects of the knee.
Methods
Thirteen consecutive patients who underwent A-ACI between 2014 and 2018 had been prospectively
enrolled in this study. There were 11 men and 2 women with a mean age of 34 years
at the time of surgery. The causes of the cartilage defect were trauma in 10 knees
and OCD in 3 knees. The total number of lesions was 15, which were comprised of the
medial femoral condyle in 5 knees, the lateral femoral condyle in 5 knees, and the
femoral trochlea in 5 knees. The mean size of the lesion was 5.3 cm2. Each knee was clinically and radiologically evaluated preoperatively and postoperatively.
Results
The mean Lysholm score improved significantly from 74.0 points to 94.0 points (p = 0.008)
and each subscale in Knee injury and Osteoarthritis Outcome Score improved significantly
(p < 0.001) at the mean final follow-up period of 51 months (range, 36–84 months).
The magnetic resonance observation of cartilage repair tissue 2.0 score at the mean
follow-up of 38 months was significantly higher than that at 2 months postoperatively
(p = 0.014). According to the International Cartilage Repair Society (ICRS) grading
scale, 3 knees were graded as normal, 3 knees as nearly normal, and 1 knee as severely
abnormal in second-look arthroscopic evaluation at a mean of 22 months (range, 8–41
months) after A-ACI.
Conclusion
The present study showed a significant subjective and objective clinical improvement
in the A-ACI for large cartilage defects of the knee at a mean follow-up of 51 months
(range, 36–84 months).
Keywords
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Article info
Publication history
Published online: January 09, 2023
Accepted:
December 5,
2022
Received in revised form:
November 30,
2022
Received:
May 12,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
