Matrix-Associated Autologous Chondrocyte Implantation Is an Effective Treatment at Midterm Follow-up in Adolescents and Young Adults

Abstract

Background: Autologous chondrocyte implantation (ACI) is an established method for treating cartilage defects in the knee of adult patients. However, less is known about its effectiveness in adolescents. Hypothesis: Third-generation matrix-associated ACI (MACI) using spheroids (co.don chondrosphere/Spherox) is an effective and safe treatment for articular cartilage defects in adolescents aged 15 to 17 years, with outcomes comparable with those for young adults aged 18 to 34 years. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 71 patients (29 adolescents, 42 young adults) who had undergone ACI using spheroids were evaluated retrospectively in this multicenter study. For adolescents, the mean defect size was 4.6 ± 2.4 cm 2 , and the follow-up range was 3.5 to 8.0 years (mean, 63.3 months). For young adults, the mean defect size was 4.7 ± 1.2 cm 2 , and the follow-up range was 3.8 to 4.3 years (mean, 48.4 months). At the follow-up assessment, outcomes were assessed by using validated questionnaires (Knee injury and Osteoarthritis Outcome Score [KOOS], International Knee Documentation Committee [IKDC] subjective knee evaluation form and current health assessment form, and modified Lysholm score), the magnetic resonance observation of cartilage repair tissue (MOCART) score, and if relevant, time to treatment failure. Safety was assessed by the treatment failure rate. Results: No significant difference between the 2 study groups was found for KOOS, IKDC, or MOCART scores, with all patients achieving high functional values. A significant difference was found in the modified Lysholm score, favoring the young adult group over the adolescent group (22.3 ± 1.9 vs 21.0 ± 2.4, respectively; P = .0123). There were no differences between the rates of treatment failure, with 3% in the adolescent group and 5% in the young adult group. Conclusion: Third-generation MACI using spheroids is a safe and effective treatment for large cartilage defects of the knee in adolescents at midterm follow-up. Outcomes are comparable with those for young adults after ACI.

Three-dimensional, Scaffold-Free, Autologous Chondrocyte Transplantation: A Systematic Review

“…The search included 10 studies 11 , 12 , 14 , 15 , 19 , 20 , 29 , 33 , 34 , 36 that fulfilled the inclusion criteria: 2 randomized controlled trials, 15 , 19 7 case series, 11 , 12 , 19 , 20 , 33 , 34 , 36 and 1 cohort study. 14 Of the 10 studies, 6 studies addressed ACT3D of articular cartilage defects in the knee joint, 11 , 14 , 15 , 29 , 33 , 34 and 4 publications investigated the outcome of ACT3D therapy in affected hip joints. 12 , 19 , 20 , 36 The mean defect size of the treated lesions ranged from 2 to 6 cm 2 .…”

“… 33 , 34 ACT3D further proved to be a suitable therapy for children and adolescents with chondral defects. 14 …”

“…33,34 ACT3D further proved to be a suitable therapy for children and adolescents with chondral defects. 14 In 2020, Niemeyer et al 29 published the 4-year outcomes of their European Medicines Agency (EMA)-driven, prospective, phase II study addressing the dose-dependent safety and efficacy of Chondrosphere. The study did not reveal any statistically significant differences between different concentrations of spheroids in the dose range of 10 to 70 spheroids/cm 2 .…”

“…Hoburg (2019) adults 14 92.9 ± 7.9 (n ¼ 30) Siebold (2018) 34 77.7 ± 14.6 (n ¼ 30) Siebold (2016) 33 79.0 ± 18.0 (n ¼ 31) Fickert (2012) 11 82. 34 84.2 ± 5.6 (n ¼ 30) Siebold (2016) 33 63.0 ± 18.8 (n ¼ 31) Fickert (2012) 11 64.0 (n ¼ 37) Weighted average 73.5 (n ¼ 147) KOOS (overall) Hoburg (2020) 15,28 83.2 ± 14.9 (n ¼ 48) Niemeyer (2020) 5,27,29 77.…”

Overexpression of Long Non-Coding RNA AP001505.9 Inhibits Dedifferentiation in Human Hyaline Chondrocyte

“…Autologous chondrocyte implantation (ACI) is an effective method for the treatment of chronic articular cartilage defect in recent years, which may aid in rehabilitation of patients with cartilage defects. ACI technology was first established in 1994 and has been developed to the third generation, namely matrix-associated ACI (MACI) (12).…”