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. 2017 Apr;8(2):131-138.
doi: 10.1177/1947603516653208. Epub 2016 Jul 7.

Intralesional Osteophyte Regrowth Following Autologous Chondrocyte Implantation after Previous Treatment with Marrow Stimulation Technique

Marco Kawamura Demange  1 , Tom Minas  2   3 , Arvind von Keudell  2   3 , Sonal Sodha  2 , Tim Bryant  2 , Andreas H Gomoll  2   3
Affiliations

Intralesional Osteophyte Regrowth Following Autologous Chondrocyte Implantation after Previous Treatment with Marrow Stimulation Technique

Marco Kawamura Demange et al. Cartilage. 2017 Apr.

Abstract

Objective Bone marrow stimulation surgeries are frequent in the treatment of cartilage lesions. Autologous chondrocyte implantation (ACI) may be performed after failed microfracture surgery. Alterations to subchondral bone as intralesional osteophytes are commonly seen after previous microfracture and removed during ACI. There have been no reports on potential recurrence. Our purpose was to evaluate the incidence of intralesional osteophyte development in 2 cohorts: existing intralesional osteophytes and without intralesional osteophytes at the time of ACI. Study Design We identified 87 patients (157 lesions) with intralesional osteophytes among a cohort of 497 ACI patients. Osteophyte regrowth was analyzed on magnetic resonance imaging and categorized as small or large (less or more than 50% of the cartilage thickness). Twenty patients (24 defects) without intralesional osteophytes at the time of ACI acted as control. Results Osteophyte regrowth was observed in 39.5% of lesions (34.4% of small osteophytes and 5.1% of large osteophytes). In subgroup analyses, regrowth was observed in 45.8% of periosteal-covered defects and in 18.9% of collagen membrane-covered defects. Large osteophyte regrowth occurred in less than 5% in either group. Periosteal defects showed a significantly higher incidence for regrowth of small osteophytes. In the control group, intralesional osteophytes developed in 16.7% of the lesions. Conclusions Even though intralesional osteophytes may regrow after removal during ACI, most of them are small. Small osteophyte regrowth occurs almost twice in periosteum-covered ACI. Large osteophytes occur only in 5% of patients. Intralesional osteophyte formation is not significantly different in preexisting intralesional osteophytes and control groups.

Keywords: autologous chondrocyte implantation; cartilage; knee; microfracture.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Intralesional osteophyte observed during surgery (top left), after osteophyte removal (top right), autologous chondrocyte implantation (ACI) covered with periosteal patch (pACI) (bottom left), and 1-year follow-up magnetic resonance imaging without intralesional osteophyte (bottom right).
Figure 2.
Figure 2.
Intralesional osteophyte observed during surgery (top left), after osteophyte removal (top right), autologous chondrocyte implantation (ACI) covered with collagen membrane (cACI) (bottom left), and 1-year follow-up magnetic resonance imaging without intralesional osteophyte (bottom right).
Figure 3.
Figure 3.
Intralesional osteophyte observed during surgery (top left), after osteophyte removal (top center), autologous chondrocyte implantation (ACI) covered with collagen membrane (cACI) (top right), and 1-year follow-up magnetic resonance imaging with small intralesional osteophyte (bottom row).
Figure 4.
Figure 4.
Intralesional osteophyte observed during surgery (top left), after osteophyte removal (top right), autologous chondrocyte implantation (ACI) covered with collagen-membrane (cACI) (bottom left), and 1-year follow-up magnetic resonance imaging with large intralesional osteophyte (bottom right).
Figure 5.
Figure 5.
Intralesional osteophyte (left) prior to removal. Note changes in the subchondral bone. Bone aspect after osteophyte removal (right) with high-speed bur.
See this image and copyright information in PMC

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