A Systematic Review of Reporting of Rehabilitation in Articular-Cartilage-Repair Studies of Third-Generation Autologous Chondrocyte Implantation in the Knee

Abstract

Context: Autologous chondrocyte implantation (ACI) is a tissue-engineered surgical technique initially developed for articular cartilage repair of isolated chondral lesions of the knee. Third-generation techniques (ACI3) are now available that deliver autologous cultured chondrocytes into the defect using cell scaffolds. The successful outcomes of these techniques have some dependency on presurgical and postsurgical patient rehabilitation. Objectives: To determine if the standard of reporting for rehabilitation has improved in ACI3 studies; previous reviews in this field recommended describing the detail of this rehabilitation and patient compliance as integral elements. Evidence Acquisition: A computerized search was performed in March 2013. Criteria for inclusion were any studies that evaluated or described the process of ACI3 in the knee and subsequent rehabilitation. The modified Coleman Methodology Score (CMS) was used to rate the standard of reporting of rehabilitation and surgical procedures; review articles were also evaluated for quality using the Strength of Recommendation Taxonomy (SORT). Mean scores, odds ratios, 95% confidence intervals, and Mann-Whitney U statistics were calculated. Evidence Synthesis: An improvement in mean CMS was seen compared with previous reviews, but rehabilitation reporting scores were lower than their surgical equivalent; significant association was seen between studies with rehabilitator involvement and high scores in the individual CMS rehabilitation element. Predominant SORT scores of 2A indicated medium strength of recommendation. Conclusions:The CMS provides a general overview of methodological quality, but a more specialized tool to report on the quantitative and qualitative aspects of the rehabilitation process would help raise the standards. It is recommended that rehabilitation therapists be included as key members of research teams and be involved in the design, implementation, and reporting of future studies.

Exploring Cross-Curriculum Content of Undergraduate Musculoskeletal Therapy Courses Regarding Articular Cartilage; Implications of Surveying UK Healthcare Curriculum Providers

“…his understanding is the foundation for therapists working with ACR; a previous review detailed that the standard of studies for ACR were of a higher quality when a rehabilitation therapist was party to the authorship [18]. he demand on the availability of such therapists will increase as ACR procedures become common place in an NHS setting.…”

Koinzidenz und Therapie von Beinachsdeviationen bei degenerativen Knorpelschäden des Kniegelenks. Ergebnisse aus dem Deutschen KnorpelRegister DGOU

“…Auch wenn mit dieser einfachen Methode Regenerate zu erzeugen sind, so sind für deren Einsatz Limitierungen (Defektdurchmesser) gegeben, und die Ergebnisse nach solchen Operationen verschlechtern sich innerhalb eines mittelfristigen (5-jährigen) Nachbeobachtungszeitraums [28]. Daher gelten heute zellbasierte Verfahren als Methode der Wahl für die Behandlung umschriebener Knorpelschäden [29][30][31][32][33]. Zudem gibt es Hinweise darauf, dass andere Verfahren wie die AMIC möglicherweise in den nächsten Jahren zunehmend Verbreitung erlangen könnten [34,35].…”

Scaffold-free tissue engineering for injured joint surface restoration

“…With the advancement of cell-based technologies, many of the recent tissue engineering approaches have taken advantage of scaffolds made of either synthetic (Vunjak-Novakovic et al 1999 ; Andriano et al 1999 ; Guo et al 1989 ; Masuda et al 2003 ) or natural polymers (Lee et al 2001 ; Homminga et al 1993 ; Brun et al 1999 ; Lahiji et al 2000 ; Shimomura et al 2014 ) as the supporting biomaterials, providing an appropriate three-dimensional (3D) environment for cells to optimize their proliferation and chondrogenic differentiation (De Bari et al 2004 ), and effectively delivering cells into cartilage defects (Bright and Hambly 2014 ; Gobbi et al 2009 ). This technique is robust and easy for surgeons to handle, and was reported to significantly improve the healing of cartilage defects.…”