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Early resumption of physical activities leads to inferior clinical outcomes after matrix-based autologous chondrocyte implantation in the knee.

Abstract

PURPOSE

Matrix-based autologous chondrocyte implantation is a well-established operation procedure for full cartilage defects. When to resume physical activity after matrix-based autologous chondrocyte implantation is controversial. Our hypothesis was that early resumption of physical activity leads to a worse clinical outcome after matrix-based autologous chondrocyte implantation in the knee two years post-operatively. Physical activity is defined as any kind of impact sport.

METHODS

Forty-four patients with cartilage defects of the knee were treated with matrix-based autologous chondrocyte implantation (Novocart3D). All patients were assessed preoperatively and after a period of 24 months with the University of California Los Angeles (UCLA) Activity score. The return to physical activities or sports after matrix-based autologous chondrocyte implantation was documented. Patients were evaluated using the International Knee Documentation Committee Knee Examination Form and visual analogue scale for pain after 6, 12 and 24 months.

RESULTS

Fifty-five percent showed an unchanged level of physical activity in the UCLA Activity score post-operatively. About 35% showed a lower level and 10% a higher level of physical activity. The average return to physical activities or sports after matrix-based autologous chondrocyte implantation procedure was 10.2 months. Patients with a later return of sports after 12 months showed significantly better clinical results after two years. In particular, patients who started practicing impact sport after 12 months post-operatively showed significantly better results.

CONCLUSION

Resuming physical activity including impact sports without waiting at least 12 months after the operation leads to inferior outcomes up to 24 months after matrix-based autologous chondrocyte implantation.

LEVEL OF EVIDENCE

Level IV.

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  • Authors+Show Affiliations

    ,

    Department of Orthopaedic Surgery, University Hospital of Munich (LMU), Campus Grosshadern, Marchioninistr. 15, 81377, Munich, Germany, thomas.niethammer@med.uni-muenchen.de.

    , , , , ,

    Source

    MeSH

    Adult
    Athletic Injuries
    Cartilage Diseases
    Cartilage, Articular
    Chondrocytes
    Female
    Humans
    Knee Injuries
    Knee Joint
    Male
    Middle Aged
    Motor Activity
    Orthopedic Procedures
    Postoperative Care
    Recovery of Function
    Transplantation, Autologous
    Young Adult

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    23839208

    Citation

    Niethammer, Thomas R., et al. "Early Resumption of Physical Activities Leads to Inferior Clinical Outcomes After Matrix-based Autologous Chondrocyte Implantation in the Knee." Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, vol. 22, no. 6, 2014, pp. 1345-52.
    Niethammer TR, Müller PE, Safi E, et al. Early resumption of physical activities leads to inferior clinical outcomes after matrix-based autologous chondrocyte implantation in the knee. Knee Surg Sports Traumatol Arthrosc. 2014;22(6):1345-52.
    Niethammer, T. R., Müller, P. E., Safi, E., Ficklscherer, A., Roβbach, B. P., Jansson, V., & Pietschmann, M. F. (2014). Early resumption of physical activities leads to inferior clinical outcomes after matrix-based autologous chondrocyte implantation in the knee. Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, 22(6), pp. 1345-52. doi:10.1007/s00167-013-2583-z.
    Niethammer TR, et al. Early Resumption of Physical Activities Leads to Inferior Clinical Outcomes After Matrix-based Autologous Chondrocyte Implantation in the Knee. Knee Surg Sports Traumatol Arthrosc. 2014;22(6):1345-52. PubMed PMID: 23839208.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Early resumption of physical activities leads to inferior clinical outcomes after matrix-based autologous chondrocyte implantation in the knee. AU - Niethammer,Thomas R, AU - Müller,Peter E, AU - Safi,Elem, AU - Ficklscherer,Andreas, AU - Roβbach,Björn P, AU - Jansson,Volkmar, AU - Pietschmann,Matthias F, Y1 - 2013/07/10/ PY - 2013/02/16/received PY - 2013/06/24/accepted PY - 2013/7/11/entrez PY - 2013/7/11/pubmed PY - 2014/11/17/medline SP - 1345 EP - 52 JF - Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA JO - Knee Surg Sports Traumatol Arthrosc VL - 22 IS - 6 N2 - PURPOSE: Matrix-based autologous chondrocyte implantation is a well-established operation procedure for full cartilage defects. When to resume physical activity after matrix-based autologous chondrocyte implantation is controversial. Our hypothesis was that early resumption of physical activity leads to a worse clinical outcome after matrix-based autologous chondrocyte implantation in the knee two years post-operatively. Physical activity is defined as any kind of impact sport. METHODS: Forty-four patients with cartilage defects of the knee were treated with matrix-based autologous chondrocyte implantation (Novocart3D). All patients were assessed preoperatively and after a period of 24 months with the University of California Los Angeles (UCLA) Activity score. The return to physical activities or sports after matrix-based autologous chondrocyte implantation was documented. Patients were evaluated using the International Knee Documentation Committee Knee Examination Form and visual analogue scale for pain after 6, 12 and 24 months. RESULTS: Fifty-five percent showed an unchanged level of physical activity in the UCLA Activity score post-operatively. About 35% showed a lower level and 10% a higher level of physical activity. The average return to physical activities or sports after matrix-based autologous chondrocyte implantation procedure was 10.2 months. Patients with a later return of sports after 12 months showed significantly better clinical results after two years. In particular, patients who started practicing impact sport after 12 months post-operatively showed significantly better results. CONCLUSION: Resuming physical activity including impact sports without waiting at least 12 months after the operation leads to inferior outcomes up to 24 months after matrix-based autologous chondrocyte implantation. LEVEL OF EVIDENCE: Level IV. SN - 1433-7347 UR - https://www.unboundmedicine.com/medline/citation/23839208/Early_resumption_of_physical_activities_leads_to_inferior_clinical_outcomes_after_matrix_based_autologous_chondrocyte_implantation_in_the_knee_ L2 - https://dx.doi.org/10.1007/s00167-013-2583-z DB - PRIME DP - Unbound Medicine ER -