2023 ISAKOS Biennial Congress ePoster
Patients with Longer Time Between Cartilage Biopsy and Second-stage Autologous Chondrocyte Implantation Have Worse Clinical Outcomes
Jairo Triana, BS, New York, NY UNITED STATES
Naina Rao, BS UNITED STATES
Zachary I Li, BA, New York UNITED STATES
Ariana Lott, MD, Princeton, NJ UNITED STATES
Nicole Danielle Rynecki, MD, New York, NY UNITED STATES
Guillem Gonzalez-Lomas, MD, New York, NY UNITED STATES
Michael J Alaia, MD, New York, New York UNITED STATES
Eric Jason Strauss, MD
Laith M. Jazrawi, MD, New York, NY UNITED STATES
Kirk Anthony Campbell, MD, New York, NY UNITED STATES
NYU Langone Health Department of Orthopedic Surgery, New York, New York, UNITED STATES
FDA Status Not Applicable
Summary
Subjects with a longer time elapsed between biopsy to graft implantation report higher pain and lower clinical outcomes scores; time progression is associated with an increase in cartilage lesion size.
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Abstract
Purpose
To evaluate time elapsed from cartilage biopsy surgery to second-stage autologous chondrocyte implantation and its influence on clinical outcomes, return to sport (RTS), and return to work (RTW).
Methods
A retrospective review was conducted of patients who underwent autologous chondrocyte implantation (ACI) and matrix-associated autologous chondrocyte implantation (MACI) from 2012 to 2020 with a minimum 2-year clinical follow-up. RTS status, RTW, and patient reported outcomes after surgery were collected including: Visual Analog Scale (VAS) for pain, satisfaction, and Knee Injury and Osteoarthritis Outcome Score (KOOS). Time delay was calculated as the time elapsed between cartilage biopsy and implantation. Patients were separated into short-interval (<12 weeks) and long-interval (>12 weeks) cohorts. The number of high-grade lesions and the size of lesions were analyzed at time of biopsy and implantation.
Results
Forty-five patients (60% female) with a mean age of 28.3 ± 8.2 were included. Twenty-six patients (57.8%) returned to sport. Patients that did not return to sport had significantly higher VAS pain and lower KOOS subscores. Of the 35 patients employed before surgery, all returned to at least a lower level of work function. There was a total of 59 high-grade lesions at implantation with the mean area of lesion increasing from 2.4 cm2 to 3.5 cm2 from biopsy to implantation. When compared to the short-interval group, subjects in the long-interval group had significantly higher VAS pain and lower KOOS symptom, pain, and sport sub-scores. For every week increase in time to implantation, defect surface area increased by 0.013 cm2 (p= 0.006).
Conclusion
Patients with cartilage defects undergoing ACI or MACI with longer time elapsed between biopsy and implantation report significantly worse clinical outcomes and higher pain levels after surgery than patients with a shorter time between the two stages. Time is predictive of progression of cartilage defect size.