|Beitragstitel||One-step autologous particulate cartilage for treatment of knee joint chondral and osteochondral lesions - preliminary prospective one-year data among 27 patients|
Chondral and osteochondral lesions at the knee present a frequent problem and adequate treatment remains a challenge. For large diameter cartilage lesions autologous chondrocyte implantation (ACI) is state of the art. Although showing good clinical and radiological results, ACI involves two operations and is rather complex and expensive. Furthermore, it is not available in every country. Autologous minced cartilage repair technique bypasses the need for in-vitro culturing of cartilage and avoids a necessary second operation. The aim of this study was to evaluate prospectively the short-term clinical and radiological results following treatment of chondral and osteochondral lesions by an autologous minced cartilage procedure at the knee joint.
From August 2015 to January 2016 a total of 27 consecutive patients with chondral /osteochondral lesions at the knee joint have been treated by a one-step autologous particulate cartilage procedure. All patients underwent pre- and postoperative (6 and 12 months) MRI for collection of AMADEUS und MOCART MRI scoring. Clinical analysis was by a numeric analogue scale (NAS) for pain (10 worst pain) and knee function (10 worst function) at 12 months postoperatively.
There were 12 female and 15 male subjects with a mean age of 28.7 years (range 16 - 51 years) at time of surgery. The duration of symptoms was 2.4 years on average. Average follow-up was 14.3 months. The average cartilage defect size encountered intraoperatively was 3.1 ± 1.6 cm2. The most common location was retropatellar (63%) followed by the lateral femoral condyle (18.5%). Osteochondral lesions were seen in 55.5%. There was a significant mean decrease in pain (NAS) from preoperatively 7.2 ± 1.9 to postoperatively 2.3 ± 2.0. Knee function (NAS) also showed significant improvement from preoperatively 7.2 ± 2.0 to postoperatively 3.0 ± 2.2. The AMADEUS score was on average 42 before the operation and the MOCART score was 41 after the operation at the 6 months follow-up visit. A total of 26 patients would undergo the same procedure again.
Particulate autologous cartilage may turn out as an adequate alternative to other cell-based cartilage reconstruction techniques showing good regenerate tissue quality and improvement of the clinical outcome scores in the short-term among this small cohort of patients. Longer follow-up and larger cohorts are required to clearly underline this procedure.