Repair of Extensive Articular Cartilage Defects in Horses by Autologous Chondrocyte Transplantation

Background Limited information exists about the treatment of full-thickness articular cartilage lesions of the knee in adolescent athletes. Purpose To evaluate the functional outcome and athletic activity after articular cartilage repair in the knees of adolescent athletes. Study Design Case series; Level of evidence, 4. Methods Twenty adolescent athletes with full-thickness articular cartilage lesions of the knee were treated with autologous chondrocyte transplantation. Functional outcome was evaluated by subjective patient outcome rating, knee activity scores, and level of athletic participation. Results At a mean of 47 months after autologous chondrocyte transplantation, 96% of adolescents reported good or excellent results with significant increases in postoperative Tegner activity scores and Lysholm scores. Ninety-six percent returned to high-impact sports and 60% to an athletic level equal or higher than that before knee injury. Return to preinjury sports correlated with shorter preoperative symptoms and a lower number of prior operations. All adolescents with preoperative symptoms ≤12 months returned to preinjury-level athletics, compared to 33% with preoperative intervals longer than 12 months. Conclusion Treatment of full-thickness articular injuries of the knee in adolescent athletes with autologous chondrocyte transplantation yields a high rate of functional success at a mean follow-up of 47 months. The rate of return to demanding athletic activities is higher in cases in which the preoperative duration of symptoms is 12 months or less.

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Three-dimensional, Scaffold-Free, Autologous Chondrocyte Transplantation: A Systematic Review

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120951152 ◽

2020 ◽

Vol 8 (9) ◽

pp. 232596712095115

Author(s):

Moritz Riedl ◽

Gianluca Vadalà ◽

Rocco Papalia ◽

Vincenco Denaro

Keyword(s):

Systematic Review ◽

Case Series ◽

Autologous Chondrocyte Transplantation ◽

Systematic Evaluation ◽

Cartilage Defects ◽

Chondrocyte Transplantation ◽

Hip Joints ◽

Randomized Controlled ◽

Randomized Controlled Studies ◽

Autologous Chondrocyte

Background: A 3-dimensional, scaffold-free, and completely autologous form of chondrocyte transplantation (ACT3D) has been developed and applied in clinical practice in the past decade to overcome disadvantages of previous-generation procedures. Purpose: To document and analyze the available literature on the results of ACT3D in the treatment of articular chondral lesions in the knee and hip joints. Study Design: Systematic review; Level of evidence, 4. Methods: All studies published in English addressing ACT3D were identified and included those that fulfilled the following criteria: (1) level 1 through 4 evidence, (2) measures of radiological or functional/clinical outcome, and (3) outcome related to cartilage lesions of the knee and hip joints. Results: A total of 10 studies were selected: 2 randomized controlled trials, 1 cohort study, and 7 case series. The studies revealed significant increases in patients’ subjective quality of life, satisfaction, pain reduction, and improvement in joint function at short- to medium-term follow-up. Magnetic resonance imaging-assisted examination and second-look arthroscopy showed a hyaline-like repair tissue with a high degree of defect filling and integration. Conclusion: ACT3D shows promising results in the therapy of articular cartilage defects in the knee as well as in the hip, but well-designed, long-term studies are lacking. ACT3D might have relevant advantages over common matrix-associated autologous chondrocyte transplantation products, but systematic evaluation and randomized controlled studies are crucial to verify the potential of this tissue-engineered approach.

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