Autologous chondrocyte implant repairs knee cartilage damage

By Joene Hendry

DALLAS, Texas (Reuters Health) – Autologous cultured chondrocyte implantation (ACI) is a safe and durable treatment for certain articular cartilage lesions in the knee, according to study results presented here Wednesday during the American Academy of Orthopaedic Surgeons meeting in Dallas, Texas.

"ACI offers another treatment option for patients with larger symptomatic articular cartilage lesions of the distal femur," Dr. Jon E. Browne of the University of Missouri at Kansas City told Reuters Health.

Dr. Browne explained that the procedure requires the harvesting of chondrocytes from each patient that are then cultured and expanded in vitro over a three-week period. The cultured cells are then transplanted back into the patient's damaged cartilage, which is covered by a periosteum patch.

Dr. Browne and colleagues analyzed outcome data in the first 100 consecutive patients (65 male, 35 female) to undergo the procedure in the US. Patients had traumatic, full thickness lesions on the medial and/or lateral condyles or the trochlea of the knee. Eighty-five patients had single lesions averaging 4 square centimeters in size while the remaining 15 patients had multiple lesions as large as 9 square centimeters.

Dr. Browne presented data on 89 patients who completed self-assessment evaluations at baseline and annually for five years. The investigators report that 79% of the patients improved from a limited ability to perform daily activities at baseline to having no symptoms and participating in light work and sports at 5 years post-treatment. Self-assessment scores on a 10-division scale improved from a mean of 3.2 at baseline to 6.1 at 5 years.

There were 13 treatment failures in the series. Dr. Browne noted that 7 of the 13 were due to patient noncompliance, direct knee trauma from a postsurgery automobile accident, uncorrected ligament problems, and osteoarthritis.

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