Tags

Type your tag names separated by a space and hit enter

The incidence and clinical relevance of graft hypertrophy after matrix-based autologous chondrocyte implantation.
Am J Sports Med 2012; 40(1):68-74AJ

Abstract

BACKGROUND

Graft hypertrophy is the most common complication of periosteal autologous chondrocyte implantation (p-ACI).

PURPOSE

The aim of this prospective study was to analyze the development, the incidence rate, and the persistence of graft hypertrophy after matrix-based autologous chondrocyte implantation (mb-ACI) in the knee joint within a 2-year postoperative course.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

Between 2004 and 2007, a total of 41 patients with 44 isolated cartilage defects of the knee were treated with the mb-ACI technique. The mean age of the patients was 35.8 years (standard deviation [SD], 11.3 years), and the mean body mass index was 25.9 (SD, 4.2; range, 19-35.3). The cartilage defects were arthroscopically classified as Outerbridge grades III and IV. The mean area of the cartilage defect measured 6.14 cm(2) (SD, 2.3 cm(2)). Postoperative clinical and magnetic resonance imaging (MRI) examinations were conducted at 3, 6, 12, and 24 months to analyze the incidence and course of the graft.

RESULTS

Graft hypertrophy developed in 25% of the patients treated with mb-ACI within a postoperative course of 1 year; 16% of the patients developed hypertrophy grade 2, and 9% developed hypertrophy grade 1. Graft hypertrophy occurred primarily in the first 12 months and regressed in most cases within 2 years. The International Knee Documentation Committee (IKDC) and visual analog scale (VAS) scores improved during the postoperative follow-up time of 2 years. There was no difference between the clinical results regarding the IKDC and VAS pain scores and the presence of graft hypertrophy.

CONCLUSION

The mb-ACI technique does not lead to graft hypertrophy requiring treatment as opposed to classic p-ACI. The frequency of occurrence of graft hypertrophy after p-ACI and mb-ACI is comparable. Graft hypertrophy can be considered as a temporary excessive growth of regenerative cartilage tissue rather than a true graft hypertrophy. It is therefore usually not a persistent or systematic complication in the treatment of circumscribed cartilage defects with mb-ACI.

Authors+Show Affiliations

Department of Orthopaedic Surgery, University Hospital of Munich (LMU), Campus Groβhadern, Munich, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22031857

Citation

Pietschmann, Matthias F., et al. "The Incidence and Clinical Relevance of Graft Hypertrophy After Matrix-based Autologous Chondrocyte Implantation." The American Journal of Sports Medicine, vol. 40, no. 1, 2012, pp. 68-74.
Pietschmann MF, Niethammer TR, Horng A, et al. The incidence and clinical relevance of graft hypertrophy after matrix-based autologous chondrocyte implantation. Am J Sports Med. 2012;40(1):68-74.
Pietschmann, M. F., Niethammer, T. R., Horng, A., Gülecyüz, M. F., Feist-Pagenstert, I., Jansson, V., & Müller, P. E. (2012). The incidence and clinical relevance of graft hypertrophy after matrix-based autologous chondrocyte implantation. The American Journal of Sports Medicine, 40(1), pp. 68-74. doi:10.1177/0363546511424396.
Pietschmann MF, et al. The Incidence and Clinical Relevance of Graft Hypertrophy After Matrix-based Autologous Chondrocyte Implantation. Am J Sports Med. 2012;40(1):68-74. PubMed PMID: 22031857.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The incidence and clinical relevance of graft hypertrophy after matrix-based autologous chondrocyte implantation. AU - Pietschmann,Matthias F, AU - Niethammer,Thomas R, AU - Horng,Annie, AU - Gülecyüz,Mehmet F, AU - Feist-Pagenstert,Isa, AU - Jansson,Volkmar, AU - Müller,Peter E, Y1 - 2011/10/26/ PY - 2011/10/28/entrez PY - 2011/10/28/pubmed PY - 2012/4/28/medline SP - 68 EP - 74 JF - The American journal of sports medicine JO - Am J Sports Med VL - 40 IS - 1 N2 - BACKGROUND: Graft hypertrophy is the most common complication of periosteal autologous chondrocyte implantation (p-ACI). PURPOSE: The aim of this prospective study was to analyze the development, the incidence rate, and the persistence of graft hypertrophy after matrix-based autologous chondrocyte implantation (mb-ACI) in the knee joint within a 2-year postoperative course. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Between 2004 and 2007, a total of 41 patients with 44 isolated cartilage defects of the knee were treated with the mb-ACI technique. The mean age of the patients was 35.8 years (standard deviation [SD], 11.3 years), and the mean body mass index was 25.9 (SD, 4.2; range, 19-35.3). The cartilage defects were arthroscopically classified as Outerbridge grades III and IV. The mean area of the cartilage defect measured 6.14 cm(2) (SD, 2.3 cm(2)). Postoperative clinical and magnetic resonance imaging (MRI) examinations were conducted at 3, 6, 12, and 24 months to analyze the incidence and course of the graft. RESULTS: Graft hypertrophy developed in 25% of the patients treated with mb-ACI within a postoperative course of 1 year; 16% of the patients developed hypertrophy grade 2, and 9% developed hypertrophy grade 1. Graft hypertrophy occurred primarily in the first 12 months and regressed in most cases within 2 years. The International Knee Documentation Committee (IKDC) and visual analog scale (VAS) scores improved during the postoperative follow-up time of 2 years. There was no difference between the clinical results regarding the IKDC and VAS pain scores and the presence of graft hypertrophy. CONCLUSION: The mb-ACI technique does not lead to graft hypertrophy requiring treatment as opposed to classic p-ACI. The frequency of occurrence of graft hypertrophy after p-ACI and mb-ACI is comparable. Graft hypertrophy can be considered as a temporary excessive growth of regenerative cartilage tissue rather than a true graft hypertrophy. It is therefore usually not a persistent or systematic complication in the treatment of circumscribed cartilage defects with mb-ACI. SN - 1552-3365 UR - https://www.unboundmedicine.com/medline/citation/22031857/The_incidence_and_clinical_relevance_of_graft_hypertrophy_after_matrix_based_autologous_chondrocyte_implantation_ L2 - http://journals.sagepub.com/doi/full/10.1177/0363546511424396?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -