Matrix-Associated Autologous Chondrocyte Implantation Is an Effective Treatment at Midterm Follow-up in Adolescents and Young Adults

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background:

Autologous chondrocyte implantation (ACI) is an established method for treating cartilage defects in the knee of adult patients. However, less is known about its effectiveness in adolescents.

Hypothesis:

Third-generation matrix-associated ACI (MACI) using spheroids (co.don chondrosphere/Spherox) is an effective and safe treatment for articular cartilage defects in adolescents aged 15 to 17 years, with outcomes comparable with those for young adults aged 18 to 34 years.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A total of 71 patients (29 adolescents, 42 young adults) who had undergone ACI using spheroids were evaluated retrospectively in this multicenter study. For adolescents, the mean defect size was 4.6 ± 2.4 cm ², and the follow-up range was 3.5 to 8.0 years (mean, 63.3 months). For young adults, the mean defect size was 4.7 ± 1.2 cm ², and the follow-up range was 3.8 to 4.3 years (mean, 48.4 months). At the follow-up assessment, outcomes were assessed by using validated questionnaires (Knee injury and Osteoarthritis Outcome Score [KOOS], International Knee Documentation Committee [IKDC] subjective knee evaluation form and current health assessment form, and modified Lysholm score), the magnetic resonance observation of cartilage repair tissue (MOCART) score, and if relevant, time to treatment failure. Safety was assessed by the treatment failure rate.

Results:

No significant difference between the 2 study groups was found for KOOS, IKDC, or MOCART scores, with all patients achieving high functional values. A significant difference was found in the modified Lysholm score, favoring the young adult group over the adolescent group (22.3 ± 1.9 vs 21.0 ± 2.4, respectively; P = .0123). There were no differences between the rates of treatment failure, with 3% in the adolescent group and 5% in the young adult group.

Conclusion:

Third-generation MACI using spheroids is a safe and effective treatment for large cartilage defects of the knee in adolescents at midterm follow-up. Outcomes are comparable with those for young adults after ACI.

Related collections

Most cited references 1

Record: found
Abstract: found
Article: not found

The International Knee Documentation Committee Subjective Knee Evaluation Form: normative data.

James J. Irrgang, William S Kocher, Graham Mann … (2005)

The International Knee Documentation Committee Subjective Knee Evaluation Form may be used to measure symptoms, function, and sports activity for people with a variety of knee disorders, including ligamentous and meniscal injuries, osteoarthritis, and patellofemoral dysfunction. To date, normative data have not been established for this valid, reliable, and responsive outcomes instrument. To provide clinicians and researchers with normative data to facilitate the interpretation of results on the International Knee Documentation Committee Subjective Knee Evaluation Form. Cross-sectional survey. The Subjective Knee Evaluation Form was mailed to 600 people in each of 8 age/gender categories (18-24 years, 25-34 years, 35-50 years, and 51-65 years for both male subjects and female subjects). Participants were drawn from a panel of 550 000 households (1 300 000 subjects) representative of noninstitutionalized persons in the United States and were matched to data from the United States Census Bureau on geographical region, market size, income, and household size. Complete data were available for 5246 knees. Twenty-eight percent of respondents reported an injury, weakness, or other problem with one or both knees. Normative data were determined for respondents as a whole and for the subset of respondents with no history of knee problems. Mean scores were determined for men aged 18 to 24 years (89 +/- 18), 25 to 34 years (89 +/- 16), 35 to 50 years (85 +/- 19), and 51 to 55 years (77 +/- 23); mean scores were also determined for women aged 18 to 24 years (86 +/- 19), 25 to 34 years (86 +/- 19), 35 to 50 years (80 +/- 23), and 51 to 65 years (71 +/- 26). Scores were higher for the subset of respondents with no history of current or prior knee problems. Scores on the International Knee Documentation Committee Subjective Knee Evaluation Form vary by age, gender, and history of knee problems. The normative data collected in this article will allow clinicians to interpret how patients with knee injuries are functioning relative to their age- and gender-matched peers and will enable researchers to determine the clinical outcomes of treatment.

0 comments Cited 118 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): Orthop J Sports Med

Journal ID (iso-abbrev): Orthop J Sports Med

Journal ID (publisher-id): OJS

Journal ID (hwp): spojs

Title: Orthopaedic Journal of Sports Medicine

Publisher: SAGE Publications (Sage CA: Los Angeles, CA )

ISSN (Electronic): 2325-9671

Publication date (Electronic): 25 April 2019

Publication date Collection: April 2019

Volume: 7

Issue: 4

Electronic Location Identifier: 2325967119841077

Affiliations

[† ]Gelenk- und Wirbelsaeulen-Zentrum Steglitz, Berlin, Germany.

[‡ ]Orthopaedie in Essen, Essen, Germany.

[§ ]Facharztklinik Essen, Essen, Germany.

[∥ ]Center for Hip, Knee and Foot Surgery, ATOS Hospital Heidelberg, Heidelberg, Germany.

[¶ ]Department of Anatomy and Cell Biology, University of Heidelberg, Heidelberg, Germany.

[# ]Orthopaedische Chirurgie München, Munich, Germany.

[** ]Sporthopaedicum Straubing, Straubing, Germany.

[†† ]University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.

[‡‡ ]Sankt Marien-Hospital Buer, Gelsenkirchen, Germany.

[10-2325967119841077] Investigation performed at Multicenter Study in Germany.

Author notes

[*] [* ]Arnd Hoburg, MD, Gelenk- und Wirbelsaeulen-Zentrum Steglitz, Kieler Strasse 1, 12163 Berlin, Germany (email: hoburg@ 123456gwz-steglitz.de ).

Article

Publisher ID: 10.1177_2325967119841077

DOI: 10.1177/2325967119841077

PMC ID: 6484242

PubMed ID: 31041335

SO-VID: a7225f54-9bad-4cdb-9349-fe1283f064e8

License:

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License ( http://www.creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

History

Custom metadata

edited-state corrected-proof

Keywords: aci,maci,autologous chondrocyte implantation,adolescents,outcome,co.don chondrosphere,spherox

Data availability:

Keywords: aci, maci, autologous chondrocyte implantation, adolescents, outcome, co.don chondrosphere, spherox

Matrix-Associated Autologous Chondrocyte Implantation Is an Effective Treatment at Midterm Follow-up in Adolescents and Young Adults

Read this article at