2015 ISAKOS Biennial Congress ePoster #1501

Second-Look Arthroscopy After All-Arthroscopic Autologous Chondrocyte Implantation With 3-Dimensional Spheroides at the Knee

Rainer Siebold, Prof. Dr. med., Heidelberg GERMANY
Francis Hizon Fernandez, MD, Quezon City, Metro Manila PHILIPPINES
Georgios Karidakis, MD, PhD, Athens GREECE
ATOS Hospital Heidelberg, Heidelberg, GERMANY

FDA Status Not Applicable

Summary: Convincing second-look results after all-arthroscopic autologous chondrocyte implantation at the knee in 43 lesions

Abstract:

Purpose

To report clinical and second-look results after all-arthroscopic autologous chondroctye implantation (ACI) for articular cartilage repair at the knee joint.

Methods

A second-look arthroscopy after all-arthroscopic 3-dimensional ACI using matrix associated spheroides was performed in 33 patients with 43 full size articular cartilage defects of the knee. The average time from ACI to second look arthroscopy was 13.1 ± 11.6 months (6-72). Outcome was assessed clinically and by subjective outcome scores. The arthroscopic aspect of the regenerated ACI was rated according to the ICRS-Cartilage Repair Assessment (CRA).

Results

The ICRS-CRA was rated “normal” or “nearly normal” in 90.7 % (39/43) and “abnormal” in 9.3 % of all 43 ACI´s. The subjective score of the International Knee Documentation Committee (IKDC) significantly increased from 49 ± 13.2 preoperatively to 61.5 ± 12.6 at f/u (p=0.02). A significant improvement (p<.05) was observed for the Lysholm score and the Knee Injury and Osteoarthritis Outcome (KOOS) subscales for pain, activites of daily living and sport and recreation function. Concomitant surgery such as high tibial osteotomy, anterior cruciate ligament reconstruction and meniscal surgery was necessary in 66.7% of all patients.

Conclusion

At second-look arthroscopy more than 90% of all patients showed a (very) good cartilage regeneration after all-arthroscopic 3-dimensional ACI using spheroides. Most patients were (very) satisfied with the clinical result and all subjective scores increased significantly compared to preoperatively. However, the high number of concomitant surgeries reflexes the complex etiology and treatment of cartilage lesions. Thus a strict indication and treatment plan is necessary to avoid clinical failures.