Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Am J Sports Med. 2010 Jun;38(6):1117-24. doi: 10.1177/0363546509357915. Epub 2010 Feb 24.
The medium-term results of autologous chondrocyte implantation (ACI) have shown good to excellent outcomes for the majority of patients. However, no long-term results 10 to 20 years after the surgery have been reported.
Autologous chondrocyte implantation provides a durable solution to the treatment of full-thickness cartilage lesions of the knee, maintaining good clinical results even 10 to 20 years after implantation.
Case series; Level of evidence, 4.
In this uncontrolled study, questionnaires with the Lysholm, Tegner-Wallgren, Brittberg-Peterson, modified Cincinnati (Noyes), and Knee Injury and Osteoarthritis Outcome Score (KOOS) scores were sent to 341 patients. Preoperative Lysholm, Tegner-Wallgren, and Brittberg-Peterson scores were also retrieved when possible from patients' files. The patients were asked to grade their status during the past 10 years as better, worse, or unchanged. Finally, they were asked if they would do the operation again.
There were 224 of 341 patients who replied to our posted questionnaires and were assessed. The mean cartilage lesion size was 5.3 cm(2). Ten to 20 years after the implantation (mean, 12.8 years), 74% of the patients reported their status as better or the same as the previous years. There were 92% who were satisfied and would have the ACI again. The Lysholm, Tegner-Wallgren, and Brittberg-Peterson scores were improved compared with the preoperative values. The average Lysholm score improved from 60.3 preoperatively to 69.5 postoperatively, the Tegner from 7.2 to 8.2, and the Brittberg-Peterson from 59.4 to 40.9. At the final measurement, the KOOS score was on average 74.8 for pain, 63 for symptoms, 81 for activities of daily living (ADL), 41.5 for sports, and 49.3 for quality of life (QOL). The average Noyes score was 5.4. Patients with bipolar lesions had a worse final outcome than patients with multiple unipolar lesions. The presence of meniscal injuries before ACI or history of bone marrow procedures before the implantation did not appear to affect the final outcomes. The age at the time of the operation or the size of lesion did not seem to correlate with the final outcome.
Autologous chondrocyte implantation has emerged as an effective and durable solution for the treatment of large full-thickness cartilage and osteochondral lesions of the knee joint. Our study suggests that the clinical and functional outcomes remain high even 10 to 20 years after the implantation.
自体软骨细胞移植（ACI）的中期结果显示，大多数患者的疗效良好或优秀。然而，尚未有术后 10 到 20 年的长期结果报告。
自体软骨细胞移植为膝关节全层软骨损伤的治疗提供了持久的解决方案，即使在植入后 10 到 20 年，仍能保持良好的临床效果。
病例系列；证据水平，4 级。
在这项非对照研究中，我们向 341 名患者发送了包含 Lysholm、Tegner-Wallgren、Brittberg-Peterson、改良 Cincinnati（Noyes）和膝关节损伤和骨关节炎结果评分（KOOS）的问卷。当可能从患者的档案中获取术前 Lysholm、Tegner-Wallgren 和 Brittberg-Peterson 评分。患者被要求在过去 10 年中对自己的状况进行评级，分为更好、更差或不变。最后，他们被问到是否会再次接受手术。
我们共收到 341 名患者中的 224 名回复的问卷并进行了评估。平均软骨损伤面积为 5.3cm2。植入后 10 到 20 年（平均 12.8 年），74%的患者报告其状况与前几年相同或更好。92%的患者表示满意，并会再次接受 ACI。Lysholm、Tegner-Wallgren 和 Brittberg-Peterson 评分与术前相比有所改善。平均 Lysholm 评分从术前的 60.3 分提高到术后的 69.5 分，Tegner 从 7.2 分提高到 8.2 分，Brittberg-Peterson 从 59.4 分提高到 40.9 分。在最后一次测量时，KOOS 评分平均为疼痛 74.8 分，症状 63 分，日常生活活动（ADL）81 分，运动 41.5 分，生活质量（QOL）49.3 分。平均 Noyes 评分为 5.4。双极病变患者的最终结局比多极病变患者差。ACI 前半月板损伤或植入前骨髓手术史似乎不会影响最终结果。手术时的年龄或病变大小似乎与最终结果无关。
自体软骨细胞移植已成为治疗膝关节大的全层软骨和骨软骨损伤的有效且持久的方法。我们的研究表明，即使在植入后 10 到 20 年，临床和功能结果仍然很高。
