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Outcomes of autologous chondrocyte implantation in a diverse patient population.
Am J Sports Med 2009; 37(7):1344-50AJ

Abstract

BACKGROUND

Autologous chondrocyte implantation is indicated as a second-line treatment of large, irregularly shaped chondral defects after failure of first-line surgical intervention. This study examines the clinical results of a patient cohort undergoing autologous chondrocyte implantation and elucidates factors associated with subjective improvement after implantation.

HYPOTHESIS

Autologous chondrocyte implantation will result in long-term functional and symptomatic improvement.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

The cohort included 137 subjects (140 knees) who underwent autologous chondrocyte implantation of the knee. Mean defect size per patient was 5.2 +/- 3.5 cm(2) (range, 0.8-26.6 cm(2)). Patients averaged 30.3 +/- 9.1 years of age (range, 13.9-49.9 years) and were followed for 4.3 +/- 1.8 years (range, 2.0-9.7 years). Outcomes were assessed via clinical assessment and established outcome scales, including the Lysholm scale, International Knee Documentation Committee scale, and Short Form-12.

RESULTS

A significant improvement after surgery was observed in all outcome assessments including the Lysholm (41 to 69; P < .001) and International Knee Documentation Committee (34 to 64; P < .001) scales. Subjectively, 75% of patients indicated they were completely or mostly satisfied with the outcome and 83% would have the procedure again. Preoperatively, 32% of patients had a Tegner score of 6 or greater, compared with 82% before injury and 65% at most recent follow-up. Multivariate analysis identified age (P < .021) and receiving workers' compensation (P < .018) as independent predictors of follow-up Lysholm score. Twenty-one patients (16%) required debridement of the autologous chondrocyte implantation site secondary to persistent symptoms, whereas 9 knees (6.4%) clinically failed and underwent a revision procedure.

CONCLUSION

Autologous chondrocyte implantation is a viable treatment option for chondral defects of the knee, resulting in durable functional and symptomatic improvement. Age and workers' compensation status are independent predictors of outcome.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

19286911

Citation

McNickle, Allison G., et al. "Outcomes of Autologous Chondrocyte Implantation in a Diverse Patient Population." The American Journal of Sports Medicine, vol. 37, no. 7, 2009, pp. 1344-50.
McNickle AG, L'Heureux DR, Yanke AB, et al. Outcomes of autologous chondrocyte implantation in a diverse patient population. Am J Sports Med. 2009;37(7):1344-50.
McNickle, A. G., L'Heureux, D. R., Yanke, A. B., & Cole, B. J. (2009). Outcomes of autologous chondrocyte implantation in a diverse patient population. The American Journal of Sports Medicine, 37(7), pp. 1344-50. doi:10.1177/0363546509332258.
McNickle AG, et al. Outcomes of Autologous Chondrocyte Implantation in a Diverse Patient Population. Am J Sports Med. 2009;37(7):1344-50. PubMed PMID: 19286911.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of autologous chondrocyte implantation in a diverse patient population. AU - McNickle,Allison G, AU - L'Heureux,Daniel R, AU - Yanke,Adam B, AU - Cole,Brian J, Y1 - 2009/03/13/ PY - 2009/3/17/entrez PY - 2009/3/17/pubmed PY - 2009/10/21/medline SP - 1344 EP - 50 JF - The American journal of sports medicine JO - Am J Sports Med VL - 37 IS - 7 N2 - BACKGROUND: Autologous chondrocyte implantation is indicated as a second-line treatment of large, irregularly shaped chondral defects after failure of first-line surgical intervention. This study examines the clinical results of a patient cohort undergoing autologous chondrocyte implantation and elucidates factors associated with subjective improvement after implantation. HYPOTHESIS: Autologous chondrocyte implantation will result in long-term functional and symptomatic improvement. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: The cohort included 137 subjects (140 knees) who underwent autologous chondrocyte implantation of the knee. Mean defect size per patient was 5.2 +/- 3.5 cm(2) (range, 0.8-26.6 cm(2)). Patients averaged 30.3 +/- 9.1 years of age (range, 13.9-49.9 years) and were followed for 4.3 +/- 1.8 years (range, 2.0-9.7 years). Outcomes were assessed via clinical assessment and established outcome scales, including the Lysholm scale, International Knee Documentation Committee scale, and Short Form-12. RESULTS: A significant improvement after surgery was observed in all outcome assessments including the Lysholm (41 to 69; P < .001) and International Knee Documentation Committee (34 to 64; P < .001) scales. Subjectively, 75% of patients indicated they were completely or mostly satisfied with the outcome and 83% would have the procedure again. Preoperatively, 32% of patients had a Tegner score of 6 or greater, compared with 82% before injury and 65% at most recent follow-up. Multivariate analysis identified age (P < .021) and receiving workers' compensation (P < .018) as independent predictors of follow-up Lysholm score. Twenty-one patients (16%) required debridement of the autologous chondrocyte implantation site secondary to persistent symptoms, whereas 9 knees (6.4%) clinically failed and underwent a revision procedure. CONCLUSION: Autologous chondrocyte implantation is a viable treatment option for chondral defects of the knee, resulting in durable functional and symptomatic improvement. Age and workers' compensation status are independent predictors of outcome. SN - 1552-3365 UR - https://www.unboundmedicine.com/medline/citation/19286911/Outcomes_of_autologous_chondrocyte_implantation_in_a_diverse_patient_population_ L2 - http://journals.sagepub.com/doi/full/10.1177/0363546509332258?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -