Centre for Arthroscopy and Sports Medicine, Orthopedic Hospital Markgroeningen, Kurt-Lindemann-Weg 10, 71706, Markgroeningen, Germany.
Department of Orthopedics and Traumatology, Paracelsus Medical Private University, Clinic Nuremberg, Breslauer Straße 201, 90471, Nuremberg, Germany.
Arch Orthop Trauma Surg. 2019 Nov;139(11):1607-1615. doi: 10.1007/s00402-019-03243-2. Epub 2019 Jul 30.
To clinically evaluate an arthroscopic autologous chondrocyte implantation (ACI) technique with an in situ crosslinking matrix for the treatment of full thickness cartilage defects of the knee and to present histological results of a graft cartilage biopsy obtained after 1.5 years.
Fifteen cases of arthroscopic autologous chondrocyte implantation in the knee performed between November 2011 and October 2012 were included in the study. Medical charts and operational reports were screened and the patients were contacted after 0.8 ± 0.3 years (0.4-1.3) and 4.3 ± 0.3 years (4.0-4.8) to asses subjective IKDC and re-operation. The Tegner activity scale was collected at the second follow-up time point. Subjective IKDC response rates were assessed at both follow-up time points.
The first and second follow-up was completed by all 15 patients (100%). The subjective IKDC scores showed a significant improvement (pre-operative 44.5 ± 15.9, first follow-up 71.1 ± 15.9, p < 0.001, second follow-up 72.6 ± 17.3, p < 0.001). The overall response rate was 66.7% (n = 10) at follow-up one and two. There were no significant differences in pre-injury (4, range 1-9) and follow-up two (4, range 2-7) Tegner activity scales (p = n.s.). Two patients required re-operation in the index knee, not related to the ACI procedure. No complication related to the ACI or the implantation technique occurred. The histological results showed excellent cartilage regeneration.
Arthroscopic ACI using an in situ crosslinking matrix is a safe and reliable treatment option for full-thickness cartilage defects of the knee.
临床评估关节镜下自体软骨细胞移植（ACI）技术与原位交联基质联合治疗膝关节全层软骨缺损，并展示 1.5 年后获得的移植物软骨活检的组织学结果。
研究纳入了 2011 年 11 月至 2012 年 10 月期间进行的 15 例膝关节关节镜下自体软骨细胞移植病例。筛选病历和手术报告，并在 0.8±0.3 年（0.4-1.3）和 4.3±0.3 年（4.0-4.8）后联系患者，以评估主观 IKDC 和再次手术情况。在第二次随访时收集 Tegner 活动量表。在两次随访时评估主观 IKDC 反应率。
15 例患者均完成了首次和第二次随访（100%）。主观 IKDC 评分显示出显著改善（术前 44.5±15.9，第一次随访 71.1±15.9，p<0.001，第二次随访 72.6±17.3，p<0.001）。首次和第二次随访的总体反应率分别为 66.7%（n=10）。术前（4，范围 1-9）和第二次随访（4，范围 2-7）Tegner 活动量表无显著差异（p=n.s.）。两名患者在索引膝关节需要再次手术，但与 ACI 手术无关。未发生与 ACI 或植入技术相关的并发症。组织学结果显示出良好的软骨再生。
关节镜下使用原位交联基质的 ACI 是治疗膝关节全层软骨缺损的一种安全可靠的选择。
