Injectable autologous chondrocyte transplantation for full thickness acetabular cartilage defects: early clinical results

Schroeder, J.; Hufeland, Martin; Schütz, Michael; Haas, Norbert; Perka, Carsten; Krueger, David R.

doi:10.1007/s00402-016-2510-0

Cited by 16 publications

(22 citation statements)

References 36 publications

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“…They monitored a significant improvement in the outcome scores at 16 months displayed in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and NAHS [ 16 ]. Schroeder et al reported significant improvement in the iHOT33, mHHS and subjective hip value (SHV) scores in 20 patients with an average defect size of 5.05 cm 2 at 12 months follow-up [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Schroeder et al also excluded patients with radiographic signs of dysplasia. Patients with radiographic signs of osteoarthritis ≥ 1° according to Kellgren and Lawrence were also excluded [ 17 ]. Körsmeier et al in comparison does not specify exclusion criteria [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…This demonstrates the limitation of the mHHS, which has been published previously [ 35 ]. Similar to Schroeder et al [ 17 ] the iHOT33 was used in our study, which has been developed and validated especially for FAI patients to evaluate patient’s symptoms, functional and sports limitation as well as social, emotional and occupational limitations [ 36 ]. Furthermore, we correlated the functional outcome results with the general health of the patient (EQ-5D) to evaluate possible influences on the results [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to the knee joint, only limited data has been published on arthroscopic or open autologous chondrocyte transplantation in the hip [ 14 – 17 ]. The main reasons for the limited use of ACI procedures on the hip are the restricted space during arthroscopy due to osseous and labral containment and the technically demanding procedure [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Arthroscopic autologous chondrocyte implantation in the hip for the treatment of full-thickness cartilage defects

Thier

Weiß

Fickert

2017

SICOT-J

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Purpose: Current literature indicates that the appropriate treatment of articular cartilage defects has significant influence on the postoperative outcome after hip arthroscopy. In the hip, arthroscopic treatment of cartilage defects is technically challenging, especially the autologous chondrocyte implantation/matrix-associated autologous chondrocyte implantation (ACI/MACI) procedures. The purpose of this prospective study was to introduce two injectable MACI products with self-adherent properties. Furthermore, we report short-term outcome and review the current literature. Methods: Full-thickness cartilage defects of 29 patients caused by the femoroacetabular impingement (FAI) were treated arthroscopically with an injectable MACI product in a two-step surgical procedure. The patient-related outcome was assessed with International Hip Outcome Tool (iHOT33), Euro-Quol group score (EQ-5D) and Non-Arthritic-Hip-Score (NAHS) at baseline, six weeks, six, 12 and 24 months. Results: Twenty-nine out of 46 patients (27 male/two female) with a mean age of 30.3 years (range 18–45 years) and an average defect size of 2.21 cm2 were available for follow-up after a mean of 19 months (range 6–24 months). All defects were located on the acetabulum International Cartilage Repair Society (ICRS) grade 3A–3D (nine 3A; eleven 3B; six 3C; three 3D). Twenty-six patients had associated labral pathology (23 repair 1–5 anchors; three partial trimming). Twenty-seven defects were caused by the FAI (20 CAM, six combined, one Pincer), two cases were of traumatic cause. An overall statistically significant improvement was observed for all assessment scores at an average follow-up of 19 months. Conclusion: In this study, we present short-term data of new arthroscopic injectable matrix-associated, autologous chondrocyte implants as a treatment option for full-thickness cartilage defects of the hip. All patient-administered assessment scores demonstrated an increase in activity level, quality of life and reduction of pain after a 19-month follow-up. Further randomized controlled trails (RCTs) with comparison of natural history, bone marrow stimulation techniques and MACI of the hip have to approve the results in long-term follow-up.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Arthroscopic autologous chondrocyte implantation in the hip for the treatment of full-thickness cartilage defects

Thier

Weiß

Fickert

2017

SICOT-J

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“…In 2 Fällen musste eine Rearthroskopie zur Lösung von Adhäsionen durchgeführt werden, wobei sich eine quantitativ und qualitativ gute Defektauffüllung zeigte. Aus einer weiteren Studie mit 20 konsekutiven Patienten bei vergleichbaren Indikationen und Knorpeldefekten (∅ Größe: 5,05 cm 2 , 2-6 cm 2 ) wurden ähnlich gute und statistisch signifikante Ergebnisse in den verwendeten Scores (mHHS, iHOT [international Hip Outcome Tool] und SHV [Sub-jective Hip Value]) 6-24 Monate nach injizierbarer ACT berichtet [70]. Es wurden keine altersabhängigen Ergebnisunterschiede gefunden.…”

Section: Bisherige Klinische Ergebnisse Nach Actunclassified

Biologische Rekonstruktion lokalisiert vollschichtiger Knorpelschäden des Hüftgelenks: Empfehlungen der Arbeitsgemeinschaft „Klinische Geweberegeneration“ der DGOU und des Hüftkomitees der AGA

et al. 2017

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Symptomatic pre-arthritic deformities such as femoroacetabular impingement (FAI) or hip dysplasia often lead to localised cartilage defects and subsequently to osteoarthritis. The present review of the working group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Trauma (DGOU) and the hip committee of the AGA (German speaking Society for Arthroscopy and Joint Surgery) provides an overview of current knowledge of the diagnosis and surgical treatment of cartilage defects, in order to infer appropriate therapy recommendations for the hip. Review of FAI and resultant cartilage damage in the hip as reported in published study findings in the literature and discussion of the advantages and disadvantages of different surgical procedures to preserve the joint. Most published studies on the surgical treatment of cartilage damage in the hip report defects caused by cam-type FAI at the acetabulum. Development of these defects can be prevented by timely elimination of the relevant deformities. At present, current full-thickness cartilage defects are mostly treated with bone marrow-stimulating techniques such as microfracture (MFx), with or without a biomaterial, and matrix-assisted autologous chondrocyte transplantation (MACT). Osteochondral autologous transplantation (OAT) is not the treatment of choice for isolated full-thickness chondral defects at the hip, because of the unfavourable risk-benefit profile. Due to the relatively short history of cartilage repair surgery on the hip, the studies available on these procedures have low levels of evidence. However, it is already becoming obvious that the experience gained with the same procedures on the knee can be applied to the hip as well. For example, limited healing and regeneration of chondral defects after MFx can also be observed at the hip joint. The cartilage surface of the acetabulum, where FAI-related chondral lesions appear, is considerably smaller than the weight-bearing cartilage surface of the knee joint. However, as in the knee joint, MACT is the therapy of choice for full-thickness cartilage defects of more than 1.5 - 2 cm. Minimally invasive types of MACT (e.g. injectable chondrocyte implants) should be preferred in the hip joint. In cases where a single-stage procedure is indicated or there are other compelling reasons for not performing a MACT, a bone marrow-stimulating technique in combination with a biomaterial covering is preferable to standard MFx. For treatment of lesions smaller than 1.5 - 2 cm the indication for a single-stage procedure is wider. As with defects in the knee, it is not possible to determine a definite upper age limit for joint-preserving surgery or MACT in the hip, as the chronological age of patients does not necessarily correlate with their biological age or the condition of their joints. Advanced osteoarthritis of the hip is a contraindication for any kind of hip-preserving surgery. Long-term observations and prospective randomised studies like those carried out for other joints are necessary.

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Hip Cartilage Restoration: Overview

Kamenaga

Haneda

Pascual‐Garrido

2021

Hip Arthroscopy and Hip Joint Preservation Surgery

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Injectable autologous chondrocyte transplantation for full thickness acetabular cartilage defects: early clinical results

Abstract: The injectable matrix associated ACT is a reliable procedure, yielding promising early results with a significant increase of all scores evaluated in patients with full thickness acetabular cartilage defects.

Cited by 16 publications

References 36 publications

Arthroscopic autologous chondrocyte implantation in the hip for the treatment of full-thickness cartilage defects

Arthroscopic autologous chondrocyte implantation in the hip for the treatment of full-thickness cartilage defects

Biologische Rekonstruktion lokalisiert vollschichtiger Knorpelschäden des Hüftgelenks: Empfehlungen der Arbeitsgemeinschaft „Klinische Geweberegeneration“ der DGOU und des Hüftkomitees der AGA

Hip Cartilage Restoration: Overview

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