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. 2018 Dec 4;5(4):386-392.
doi: 10.1093/jhps/hny043. eCollection 2018 Dec.

Injectable autologous chondrocyte implantation (ACI) in acetabular cartilage defects-three-year results

David R Krueger  1 , Markus Gesslein  2 , Michael Schuetz  1 , Carsten Perka  1 , Joerg H Schroeder  1
Affiliations

Injectable autologous chondrocyte implantation (ACI) in acetabular cartilage defects-three-year results

David R Krueger et al. J Hip Preserv Surg. .

Abstract

To evaluate the clinical outcome after arthroscopic matrix-associated injectable autologous chondrocyte implantation (ACI) in patients with large full-thickness acetabular cartilage defects. ACI was performed in young patients with full-thickness acetabular cartilage defects ≥2 cm2 in a two-step arthroscopic procedure. The patients were followed closely with clinical examinations and pre- and postoperative scores. The modified Harris Hip Score (mHHS), iHOT33 questionnaire (iHOT33) and the Subjective Hip Value (SHV) were surveyed. Demographic patient data was evaluated for influencing factors for the pre- and postoperative results. Thirty-two consecutive cases (4 female, 28 male, mean age 33 years) were included. The average defect size was 4.9 (range: 2-6) cm2. They were followed at 6, 12, 24 and 36 months postoperatively. Patients had improved significantly from 64 to 91 points (P < 0.001) in the mHHS, from 44% to 86% (P < 0.001) in the iHOT33 and from 54% to 87% (P < 0.001) in the SHV. No surgery related complications were noted. Cell cultivation failed in two cases (7%) and the patients decided for a repeated harvesting of cartilage cylinders followed by a successful ACI. Patients age and size of the cartilage defect showed no significant correlation with the pre- or postoperative results. Injectable ACI is a reliable procedure treating full-thickness acetabular cartilage defects leading to promising results 3 years postoperatively with a significant increase in all scores despite large acetabular cartilage defects in the weight-bearing zone.

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Figures

Fig. 1.
Fig. 1.
Arthroscopy of the central compartment of a left hip of a 26-year-old male patient. (A) MRI showing a large inverted ‘Oreo’ cookie sign [37]. (B) The diagnostic evaluation shows a large full-thickness acetabular cartilage flap with disruption of the chondrolabral transition zone. (C) The defect is debrided using a curette. (D) Contained cartilage defect after debridement of the unstable cartilage parts and refixation of the labrum. (E and F) Eight weeks after the initial hip arthroscopy the spheroids are inserted using the applicator.
Fig. 2.
Fig. 2.
Outcome measurement tools at the different follow-up times. *P < 0.05.
See this image and copyright information in PMC

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