Richmond Bone and Joint Clinic, 15035 Southwest Freeway, Houston, TX 77478, USA.
Am J Sports Med. 2010 Feb;38(2):238-46. doi: 10.1177/0363546509348000.
Autologous chondrocyte implantation for full-thickness lesions of the distal femur has demonstrated good short- to midterm clinical improvement. However, long-term durability (>5 years) of autologous chondrocyte implantation has not been evaluated in US patients to date.
Patients who improve from baseline to early follow-up will sustain improvement at later follow-up.
Case series, Level of evidence, 4.
Cartilage Repair Registry patients with full-thickness distal femur lesions who were treated with autologous chondrocyte implantation before December 31, 1996 and had modified overall Cincinnati scores at baseline and 1- to 5-year follow-up scores were re-evaluated at 6- to 10-year follow-up. Autologous chondrocyte implantation durability was determined by comparing early (1-5 years) to long-term (6-10 years) outcomes. Adverse events and treatment failures were recorded. Results Seventy-two patients met eligibility criteria (at baseline: mean age, 37 years; mean lesion size, 5.2 cm(2); and overall condition score, 3.4 points [poor]). Eighty-seven percent of patients (47 of 54) who improved at the earlier follow-up period sustained a mean improvement in overall condition score of 3.8 points from baseline to the later follow-up period (P < .001). From baseline to 10-year follow-up (mean follow-up, 9.2 years), 69% improved, 17% failed, and 12.5% reported no change from baseline. Most failures (75% [9 of 12]) occurred at a mean follow-up of 2.5 years. Thirty patients (42%) had 42 operations after autologous chondrocyte implantation; 24 operations (57%) occurred in patients who met the study definition of failure.
Treatment with autologous chondrocyte implantation for large, symptomatic, full-thickness lesions of the distal femur can result in early improvement that is sustained at longer follow-up (up to 10 years) in the majority of patients.
自体软骨细胞移植治疗股骨远端全层病变，短期至中期临床疗效改善良好。然而，自体软骨细胞移植的长期（>5 年）耐久性尚未在美国患者中进行评估。
从基线到早期随访改善的患者将在后续随访中持续改善。
病例系列，证据水平，4 级。
软骨修复登记处患者有全层股骨远端病变谁接受自体软骨细胞移植治疗之前，1996 年 12 月 31 日和修改后的整体辛辛那提评分在基线和 1 到 5 年随访评分进行重新评估在 6 至 10 年的随访。自体软骨细胞移植的耐久性通过比较早期（1-5 年）和长期（6-10 年）的结果来确定。记录不良事件和治疗失败。结果：72 名患者符合入选标准（基线：平均年龄 37 岁；平均病变大小 5.2cm²；整体病情评分 3.4 分[差]）。87%（47/54）在早期随访期改善的患者从基线到后期随访期平均整体病情评分改善 3.8 分（P<.001）。从基线到 10 年随访（平均随访 9.2 年），69%的患者改善，17%的患者失败，12.5%的患者报告与基线相比无变化。大多数失败（75%[9/12]）发生在平均随访 2.5 年后。30 名患者（42%）在自体软骨细胞移植后接受了 42 次手术；24 次手术（57%）发生在符合研究失败定义的患者中。
自体软骨细胞移植治疗股骨远端大、症状性、全层病变可使大多数患者在早期获得改善，并在较长时间（长达 10 年）的随访中持续改善。
