Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jan;3(1):13-9.
doi: 10.1177/1947603511415840.

What Patients Expect About Autologous Chondrocyte Implantation (ACI) for Treatment of Cartilage Defects at the Knee Joint

Affiliations

What Patients Expect About Autologous Chondrocyte Implantation (ACI) for Treatment of Cartilage Defects at the Knee Joint

Philipp Niemeyer et al. Cartilage. 2012 Jan.

Abstract

Objective: Although autologous chondrocyte implantation (ACI) has become an established surgical treatment for cartilage defects of the knee, little is known about what patients expect about this surgery.

Design: A total of 150 patients who underwent ACI for cartilage defects at the knee were assigned to the present study and asked about their expectations and estimation concerning the ACI procedure. Patients were asked to answer 4 questions of a web-based questionnaire concerning their expectations on clinical outcome and on factors they considered relevant for clinical outcome.

Results: A total of 118 (79%) returned questionnaires. Mean patient age was 32.6 years and mean defects size was 4.1 cm(2). A proportion of 70% (n = 83) of patients expected pain-free sports participation as a result of the ACI surgery, including 24 patients who expected to return to high-impact sports without any restrictions. Only 12.7% expected a reduction but persistence of pain during everyday activities. Concerning factors that influence outcome, the majority of the patients (55.1%) considered defect characteristics (i.e., size and location) most important for clinical outcome, whereas only a small proportion of patients considered rehabilitation (7.6%), cell quality (10.2%), or prior surgeries (4.2%) more relevant for final outcome.

Conclusion: The present study illustrates that expectations of ACI patients are demanding and quite high. The ACI technique seems generally considered to be able to restore pain-free sports participation. Patients do not seem to be aware of all factors of possible importance concerning clinical outcome.

Keywords: autologous chondrocyte implantation; cartilage defect; cartilage repair; cell transplantation; expectations.

PubMed Disclaimer

Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Minimal expectations of patients following ACI for isolated cartilage defects of the knee (n = 118)
Figure 2.
Figure 2.
Most important factors concerning clinical outcome following ACI according to the estimation of ACI patients (n = 118; blue columns: cannot be influenced by the patient; green columns: can be influenced by the patient; orange columns: issue related to the ACI technique and to the surgeon)

References

    1. Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L. Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med. 1994;331(14):889-95. - PubMed
    1. Cole BJ, Pascual-Garrido C, Grumet RC. Surgical management of articular cartilage defects in the knee. J Bone Joint Surg Am. 2009;91(7):1778-90. - PubMed
    1. Saris DB, Vanlauwe J, Victor J, Almqvist KF, Verdonk R, Bellemans J, et al. Treatment of symptomatic cartilage defects of the knee: characterized chondrocyte implantation results in better clinical outcome at 36 months in a randomized trial compared to microfracture. Am J Sports Med. 2009;37(Suppl 1):10S-9S. - PubMed
    1. Saris DB, Vanlauwe J, Victor J, Haspl M, Bohnsack M, Fortems Y, et al. Characterized chondrocyte implantation results in better structural repair when treating symptomatic cartilage defects of the knee in a randomized controlled trial versus microfracture. Am J Sports Med. 2008;36(2):235-46. - PubMed
    1. Basad E, Ishaque B, Bachmann G, Sturz H, Steinmeyer J. Matrix-induced autologous chondrocyte implantation versus microfracture in the treatment of cartilage defects of the knee: a 2-year randomised study. Knee Surg Sports Traumatol Arthrosc. 2010;18(4):519-27. - PubMed

LinkOut - more resources