Patellofemoral Full-Thickness Chondral Defects Treated With Second-Generation Autologous Chondrocyte Implantation

Gobbi, Alberto; Kon, Elizaveta; Berruto, Massimo; Filardo, Giuseppe; Delcogliano, Marco; Boldrini, Lorenzo; Bathan, Lyndon; Marcacci, Maurilio

doi:10.1177/0363546509331419

Cited by 190 publications

(173 citation statements)

References 38 publications

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“…The IKDC scores of all our patients were within the 0 to 10th percentile measured on the instrument before surgery. When investigating the use of second-generation ACI in adults for full-thickness patellofemoral chondral defects, Gobbi et al [11] found that in the eight patients who had second-look arthroscopy and biopsies, the repaired surface was nearly normal with biopsy samples characterized as hyaline-like in appearance. Peterson et al [23] studied the durability of autologous chondrocyte transplantation of isolated cartilage defects on the femoral condyle or patella in the adult-aged group and concluded the technique is durable for 5 to 11 years.…”

Section: Discussionmentioning

confidence: 99%

“…ACI reportedly improves function in patients with full-thickness patellofemoral chondral defects [15]; in one article, chondroplasty increased the level of knee function in 86% of the patients at 2-year followup [14] and in another was associated with durable function for as long as 11 years [23]. Gobbi et al [11] reported improvements in the International Knee Documentation Committee (IKDC) subjective scores (46.09 to 77.06), Tegner-Lysholm (2.56 to 4.94), and EuroQol Visual Analog Scale (56.76 to 78.23) at 2 years using chondrocyte grafts but a decline of the IKDC subjective scores and Tegner-Lysholm scores in patients with multiple and patellar lesions from 2 to 5 years followup. Using arthroscopy, Brittberg et al [5] found transplants were level and had the same macroscopic appearance as the surrounding cartilage at 3 months posttransplant.…”

Section: Introductionmentioning

confidence: 99%

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Cell-based Therapy Improves Function in Adolescents and Young Adults With Patellar Osteochondritis Dissecans

Teo

Buhary

Tai

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Recent advances have been made in using chondrocytes and other cell-based therapy to treat cartilage defects in adults. However, it is unclear whether these advances should be extended to the adolescent and young adult-aged patients. Questions/purposes We assessed cell-based surgical therapy for patellar osteochondritis dissecans (OCD) in adolescents and young adults by (1) determining function with the International Knee Documentation Committee (IKDC) subjective and Lysholm-Gillquist scores; and (2) evaluating activity level using the Tegner-Lysholm scale. Methods We retrospectively reviewed 23 patients between 12 and 21 years of age (mean 16.8 years) treated for OCD lesions involving the patella from 2001 to 2008. Twenty patients had autologous chondrocyte implantation and three patients had cultured bone marrow stem cell implantation. There were 19 males and four females. We obtained preoperative CT scans to assess patella subluxation, tilt, and congruence angle to determine choice of treatment. We obtained IKDC subjective knee evaluation scores, Tegner-Lysholm activity levels, and LysholmGillquist knee scores preoperatively and at 6, 12, and 24 months postoperatively. Results Mean IKDC score, Tegner-Lysholm outcomes, and Lysholm-Gillquist scale improved from 45, 2.5, and 50, respectively, at surgery to 75, 4, and 70, respectively, at 24-month followup. Complications include periosteal hypertrophy observed in two patients. Conclusion Cell-based therapy was associated with shortterm improvement in function in adolescents and young adults with patellar

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cell-based Therapy Improves Function in Adolescents and Young Adults With Patellar Osteochondritis Dissecans

Teo

Buhary

Tai

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…The hyaluronic acid-based graft was considered to be ideal for this arthroscopic technique given the physical characteristics, and the clinical success that has been shown when using this scaffold in conjunction with both activated BMAC and ACI. 3,10 The clinical outcomes that have been achieved with the use of HA-BMAC in open cases of cartilage repair have been encouraging, and the arthroscopic technique presented here may be an important step in the advancement of this technology. Medium-to long-term follow-up data from this arthroscopic HA-BMAC procedure will need to be analyzed to confirm restoration of hyaline-like cartilage, and the achievement of successful clinical outcomes similar to that achieved by HA-BMAC implantation performed in an open manner.…”

Section: Discussionmentioning

confidence: 81%

“…Cell-based procedures such as autologous chondrocyte implantation (ACI) have been shown to better stimulate the production of hyaline-like repair tissue, and provide the patient with longer-lasting clinical improvement. 2,3 In addition, ACI in conjunction with a preseeded scaffold has been used arthroscopically, with encouraging success. 4,5 Although the success of marrow stimulation techniques is often related to lesion size and location, cell-based repair procedures have shown good clinical outcomes in cases of large, and even bipolar lesions.…”

mentioning

confidence: 99%

Dry Arthroscopic Single-Stage Cartilage Repair of the Knee Using a Hyaluronic Acid-Based Scaffold With Activated Bone Marrow-Derived Mesenchymal Stem Cells

Whyte

Gobbi

Sadlik

2016

Arthroscopy Techniques

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Cartilage lesions of the knee are a frequent finding; however, treatment options that are capable of restoring hyaline-like tissue are not routinely used. Cell-based technology such as autologous chondrocyte implantation may in some cases provide durable cartilage repair, but availability of this procedure is often restricted due to cost constraints. There have been promising outcomes reported with the use of scaffolds seeded with activated bone marrow aspirate concentrate in cases of chondral injury. There are clear advantages to cell-based cartilage repair techniques that are performed as a single-stage procedure, particularly when the repair technology can be used in a minimally invasive manner. We present an arthroscopic technique of cartilage repair using a hyaluronic acid-based scaffold associated with activated bone marrow aspirate concentrate. This technique is a cost-effective, minimally invasive, single-stage procedure that has the potential for routine use in a wide range of cartilage lesion types and locations.

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“…Their idea is good as Hyaff-11 has been used clinical in patients for some years with promising results [6,7] but still an osteochondral technique is lacking. The paper is focused on the implantation technique, but the way the authors use the demineralised bone for the support of the Hyaff-11 is interesting.…”

mentioning

confidence: 99%

… more bricks to the building of cartilage knowledge?

Brittberg

2009

Knee Surg Sports Traumatol Arthrosc

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This issue of the KSSTA journal contains a spicy basket of papers on cartilage repair and related problems. When I was asked to give an editorial about those papers, I used a nice sunny summer morning of one of my remaining vacation days to read them. It was a nice reading and I got new information useful for my practice. It is more than 20 years ago since our group in Gothenburg performed the first autologous chondrocyte implantation [1], the first generation ACI. Today, we have reached the third generation ACI with different scaffolds and cell-seeded carriers, but still we are only in the very beginning of knowing the secrets of cartilage and cartilage repair mechanisms. We need both experimental and clinical research contributing with bricks of knowledge of how and when to do our surgery, which lesions that need to be treated and traumatic versus osteoarthritis lesions and their different behaviours.William Mayo once said [2], ''reading papers is not the purpose of showing how much we know and what we are doing but it is an opportunity to learn''. I fully agree and those cartilage papers in this edition of the KSSTA journal are such good examples of a possible new learning. It does not say that what has been found is the final truth, but as always with critical reading, found information gives us the power to change our treatment habits a bit, stimulate us to new research etc.The papers in this edition can be divided into several categories, experimental studies, retrospective and prospective studies, review papers and single case stories.

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Patellofemoral Full-Thickness Chondral Defects Treated With Second-Generation Autologous Chondrocyte Implantation

Abstract: Hyaluronan-based scaffold seeded with autologous chondrocytes can be a viable treatment for patellofemoral chondral lesions.

Cited by 190 publications

References 38 publications

Cell-based Therapy Improves Function in Adolescents and Young Adults With Patellar Osteochondritis Dissecans

Cell-based Therapy Improves Function in Adolescents and Young Adults With Patellar Osteochondritis Dissecans

Dry Arthroscopic Single-Stage Cartilage Repair of the Knee Using a Hyaluronic Acid-Based Scaffold With Activated Bone Marrow-Derived Mesenchymal Stem Cells

… more bricks to the building of cartilage knowledge?

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