The use of autologous chondrocyte implantation following and combined with anterior cruciate ligament reconstruction

Amin, A. A.; Bartlett, Will; Gooding, Christopher R.; Sood, Munish; Skinner, John; Carrington, Richard; Briggs, Timothy; Bentley, G.

doi:10.1007/s00264-005-0025-3

Cited by 43 publications

(34 citation statements)

References 25 publications

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“…Thirteen studies [17][18][19][20][21][22][23][24][25][26][27][28][29] (305 subjects; 305 knees) were analyzed (►Table 3). Although data were available on 305 subjects or knees with chondral defects, all variables analyzed had missing data, lowering the effective sample size.…”

Section: Resultsmentioning

confidence: 99%

Factors Influencing the Outcome of Autologous Chondrocyte Implantation: A Systematic Review

et al. 2012

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Autologous chondrocyte implantation (ACI) is an effective method of treatment of chondral defects of the knee. ACI outcomes are influenced by patient-, knee-, and lesion-specific factors. We compiled subject-level data from current studies on ACI and quantitatively analyzed this data set for associations between patient-, knee-, and lesion-specific factors and the outcome of ACI surgery. A systematic review of studies investigating ACI treatment outcomes in the knee was performed. Only studies that published subject-level data were included. Data on patient and lesion characteristics, as well as clinical outcome scores, were collected. Thirteen studies (305 defects) were included in this review. These studies showed that ACI treatment improves clinical outcomes in different patient populations. However, subject-specific variables such as patient age, gender, body mass index, duration of preoperative symptoms, as well as defect size and location were not associated with International Knee Documentation Committee score or visual analog scale score changes (p > 0.05 for all). Covariate analysis showed that patient age was related to symptom duration prior to surgery (p = 0.009). ACI surgery has been shown to improve outcomes in patients with chondral lesions of the knee. Despite evidence in the literature showing that multiple patient-, knee-, and lesion-specific factors may influence treatment outcomes, our review shows that these factors, solely, do not affect outcomes. However, together, they may synergistically affect outcomes.

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Section: Resultsmentioning

confidence: 99%

Factors Influencing the Outcome of Autologous Chondrocyte Implantation: A Systematic Review

et al. 2012

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“…8 While significant improvement in patient outcome has been reported using this method, 8,43,50,51,59,60 a number of technical challenges and issues relating to the hypertrophic growth of the periosteal patch 47,48 brought about the use of a biodegradable collagen membrane to contain the implanted chondrocytes, rather than periosteum. This second generation ACI method has also provided good clinical results, 1,3,27 though still failed to remove problems associated with suturing the cover such as the surgical complexity involved, the extensive micro-trauma that results, and cell leakage. Matrix-induced ACI (MACI) 4,6,20,24 has provided the third and current generation of ACI, and does not use a periosteal or collagen patch.…”

Section: Introductionmentioning

confidence: 99%

Factors Predictive of Outcome 5 Years After Matrix-Induced Autologous Chondrocyte Implantation in the Tibiofemoral Joint

et al. 2013

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This study outlined factors such as preoperative SF-36 scores, duration of knee symptoms, graft size, and postoperative course of weightbearing rehabilitation as pertinent variables involved in 5-year clinical and radiological outcomes and overall satisfaction. This information may allow orthopaedic surgeons to better screen their patients as good candidates for MACI, while allowing treating therapists to better individualize their preoperative preparatory and postoperative rehabilitation regimens for a best possible outcome.

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“…Development of techniques to repair damaged cartilage has been the subject of extensive research . However, long‐term outcomes have remained disappointing, so that development of functional engineered replacement tissues for cartilage remains an important avenue of investigation.…”

Section: Introductionmentioning

confidence: 99%

Improved MR‐based characterization of engineered cartilage using multiexponential T₂ relaxation and multivariate analysis

et al. 2012

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Noninvasive monitoring of tissue quality would be of substantial use in the development of cartilage tissue engineering strategies. Conventional MR parameters provide noninvasive measures of biophysical tissue properties and are sensitive to changes in matrix development, but do not cleanly distinguish between groups with different levels of matrix development. Furthermore, MR outcomes are nonspecific, with specific changes in matrix components resulting in changes in multiple MR parameters. To address these limitations, we present two new approaches for evaluation of tissue engineered constructs using MR, and apply them to immature and mature engineered cartilage after 1 week and 5 weeks of development, respectively. First, we applied multiexponential T2 analysis for quantification of matrix macromolecule-associated water compartments. Second, we applied multivariate support vector machine (SVM) analysis using multiple MR parameters to improve detection of degree of matrix development. Classification of samples based on individual MR parameters, T1, T2, km, or ADC, showed that the best classifiers were T1 and km, with classification accuracies of 85% and 84%, respectively. SVM analysis improved accuracy to 98% using the combination (km, ADC). These approaches were validated using biochemical and Fourier transform infrared imaging spectroscopy analyses, which showed increased proteoglycan and collagen with maturation. Monoexponential T2 values decreased with maturation, but without further specificity. Much more specific information was provided by multiexponential analysis. The T2 distribution in both immature and mature constructs was comparable to that of native cartilage. The analysis also showed that proteoglycan-bound water increased significantly during maturation, from a fraction of 0.05±0.01 to 0.07±0.01. In summary, multivariate SVM and multiexponential T2 analysis provide improved sensitivity to changes in matrix development and specificity to matrix composition in tissue engineered cartilage. These approaches show substantial potential for evaluation of engineered cartilage tissue as well as extension to other tissue engineering constructs.

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The use of autologous chondrocyte implantation following and combined with anterior cruciate ligament reconstruction

Cited by 43 publications

References 25 publications

Factors Influencing the Outcome of Autologous Chondrocyte Implantation: A Systematic Review

Factors Influencing the Outcome of Autologous Chondrocyte Implantation: A Systematic Review

Factors Predictive of Outcome 5 Years After Matrix-Induced Autologous Chondrocyte Implantation in the Tibiofemoral Joint

Improved MR‐based characterization of engineered cartilage using multiexponential T₂ relaxation and multivariate analysis

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The use of autologous chondrocyte implantation following and combined with anterior cruciate ligament reconstruction

Cited by 43 publications

References 25 publications

Factors Influencing the Outcome of Autologous Chondrocyte Implantation: A Systematic Review

Factors Influencing the Outcome of Autologous Chondrocyte Implantation: A Systematic Review

Factors Predictive of Outcome 5 Years After Matrix-Induced Autologous Chondrocyte Implantation in the Tibiofemoral Joint

Improved MR‐based characterization of engineered cartilage using multiexponential T2 relaxation and multivariate analysis

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Improved MR‐based characterization of engineered cartilage using multiexponential T₂ relaxation and multivariate analysis