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Comparative Study
. 2021 Apr;12(2):155-161.
doi: 10.1177/1947603519833136. Epub 2019 Mar 22.

Clinical Outcomes after Revision of Autologous Chondrocyte Implantation to Osteochondral Allograft Transplantation for Large Chondral Defects: A Comparative Matched-Group Analysis

Gergo Merkely  1   2 , Takahiro Ogura  1   3 , Jakob Ackermann  1 , Alexandre Barbieri Mestriner  1   4 , Andreas H Gomoll  1   5
Affiliations
Comparative Study

Clinical Outcomes after Revision of Autologous Chondrocyte Implantation to Osteochondral Allograft Transplantation for Large Chondral Defects: A Comparative Matched-Group Analysis

Gergo Merkely et al. Cartilage. 2021 Apr.

Abstract

Objective: Osteochondral allograft transplantation (OCA) is a well-established procedure for patients with symptomatic cartilage defects in the knee. Revision to OCA after prior failed cartilage repair has shown similar clinical outcomes as primary OCA; however, most of the failed procedures were arthroscopic procedures for smaller defects. There is no literature investigating the clinical outcomes after OCA for prior failed autologous chondrocyte implantation (ACI) for the treatment of large chondral defects of the knee. The purpose of this study was therefore to determine clinical outcomes of patients undergoing revision to OCA after prior failed ACI as compared with a matched cohort of patients undergoing OCA as a primary cartilage repair procedure (primary OCA).

Design: In this review of prospectively collected data, we analyzed data from 26 patients with at least 2 years follow-up. Thirteen patients who underwent revision to OCA after prior failed ACI by a single surgeon were compared with a matched group of patients who underwent primary OCA. The patients were matched per age, gender, body mass index, and defect size. Patient-reported outcomes, reoperations, and survival rates were compared between groups.

Results: There were no significant differences in patient-reported clinical outcome scores between the groups at final follow-up. Moreover, there was no significant difference in reoperation rates and survival rates between the groups.

Conclusion: The present study demonstrates that revision to OCA is a viable treatment option with favorable functional outcomes and similar reoperation and survival rate as primary OCA even for revision of large chondral defects previously treated with ACI.

Keywords: autologous chondrocyte implantation; cartilage repair; clinical outcomes; knee joint preservation; osteochondral allograft transplantation.

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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.
Kaplan-Meier survival curves. Survival rate after either primary osteochondral allograft transplantation (Primary OCA [osteochondral allograft]) or revision to osteochondral allograft transplantation after prior failed autologous chondrocyte implantation (Revision to OCA). The endpoint was defined as the failure of the graft.
Figure 2.
Figure 2.
Pre- and postoperative patient-reported outcome measures between patients undergoing revision to OCA (osteochondral allograft) after failed ACI (autologous chondrocyte implantation) and primary OCA. Asterisk demonstrates significance (P < 0.05).
Figure 3.
Figure 3.
Improvement of patient-reported outcome measures from pre- to postoperative in patients undergoing revision to OCA (osteochondral allograft) after failed ACI (autologous chondrocyte implantation) and primary OCA. Asterisk demonstrates significance (P < 0.05).
See this image and copyright information in PMC

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References

    1. Batty L, Dance S, Bajaj S, Cole BJ. Autologous chondrocyte implantation: an overview of technique and outcomes. ANZ J Surg. 2011;81(1-2):18-25. - PubMed
    1. Rosenberger RE, Gomoll AH, Bryant T, Minas T. Repair of large chondral defects of the knee with autologous chondrocyte implantation in patients 45 years or older. Am J Sports Med. 2008;36(12):2336-44. - PubMed
    1. Farr J, Cole B, Dhawan A, Kercher J, Sherman S. Clinical cartilage restoration: evolution and overview. Clin Orthop Relat Res. 2011;469(10):2696-705. - PMC - PubMed
    1. Asik M, Ciftci F, Sen C, Erdil M, Atalar A. The microfracture technique for the treatment of full-thickness articular cartilage lesions of the knee: midterm results. Arthroscopy. 2008;24(11):1214-20. - PubMed
    1. Hangody L, Dobos J, Balo E, Panics G, Hangody LR, Berkes I. Clinical experiences with autologous osteochondral mosaicplasty in an athletic population: a 17-year prospective multicenter study. Am J Sports Med. 2010;38(6):1125-33. - PubMed

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