Bone Marrow Edema in the Knee and Its Influence on Clinical Outcome After Matrix-Based Autologous Chondrocyte Implantation

Abstract

Midterm clinical results of the matrix-based third-generation ACI showed a substantial amount of BME over a 36-month follow-up, but this did not correlate with worse clinical outcome. Patients with femoral cartilage defects were more often affected than were those with patellar cartilage defects.

Revision surgery after third generation autologous chondrocyte implantation in the knee

“…Symptomatic defect-associated bone marrow edema were found in 8.4 % (n=3) of the cases. In a previous study, bone marrow edema after autologous chondrocyte implantation was analysed [13]. In this study, it was shown that bone marrow oedema appears in over 78 % of the cases.…”

“…All defects were treated with NOVACART®3D (TETEC AG, Reutlingen, Germany). The operation technique was performed as described in a previous study [13].…”

“…In regards to the postoperative rehabilitation, patients did a standardized protocol as described earlier [13]. After 24 hours of bed rest and drain removal, continuous passive motion device (CPM) was done and weight-bearing was limited to 20 kg for six weeks for femoral cartilage defects.…”

Treatment of failed cartilage repair: State of the Art

“…Preoperative subchondral bone oedema does not correlate with poor outcomes after ACI 38 52. However, a systematic review of the literature indicated a correlation between subchondral bone changes and the progression of knee osteoarthritis and the need for a total knee replacement 53…”

Knorpelschäden des patellofemoralen Gelenkabschnitts

“…Dieser Zusammenhang ließ sich im postoperativen Verlauf nach knorpelregenerativen Maßnahmen jedoch nicht nachweisen. Hier besteht keine Korrelation zwischen dem Auftreten und der Ausprägung von postoperativen Knochenmarködemen und dem postoperativen Outcome [12].…”