This article is more than 5 years old. Information may no longer be current.

Chondrocyte transplantation effective in high-demand soccer players

Despite increases in subjective ratings and activity scores, however, only 33% of patients were able to return to play.

Issue: September 2004

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

Autologous chondrocyte transplantation improved activity levels in high-demand athletes such as soccer players who sustain knee articular cartilage injuries, a recent study has found.

“Return to demanding activity like soccer is possible. Return rates are significantly higher in younger soccer players with shorter preoperative duration of symptoms and more competitive levels of play,” said Kai Mithoefer, MD, of the Brigham and Women’s Hospital in Boston.

Mithoefer undertook the study because while a great deal of follow-up data are available on autologous chondrocyte transplantation, there were no data on its use in a high-demand population. In addition, previous research had pointed out that soccer players offer a homogenous study population for investigating treatment of articular cartilage injuries.

Increased chondral injuries

“There’s a documented increase in chondral injuries in soccer players, with up to 50% of players undergoing anterior cruciate ligament reconstruction demonstrating cartilage lesions in a recent study. More importantly, however, the sport is associated with very high mechanical joint stressors from frequent pivoting, deceleration motions and high-impact torsional rolling,” Mithoefer said.

Forty-five soccer players with full-thickness articular cartilage lesions of the knee were evaluated preoperatively and followed for an average of 40 months. Their ability to return to soccer, the timing of their return, their postoperative skill level, activity scores and subjective outcome rating were recorded.

Most patients were male, had undergone previous surgery and were performing at the recreational level. Lesion location was primarily on the femoral condyle, and 35% of the patients presented with multiple lesions.

“At the time of last follow-up, 72% of the players reported good to excellent knee function and very few of the players reported poor knee function. The overall results improved to 85% in players with single lesions and to 93% in players with lesions off the medial femoral condyle,” Mithoefer said.

Tegner activity scores increased in 82% of patients, from an average of 3.6 points preoperatively to 6.1 points postoperatively. Six patients had traumatic and nontraumatic graft failures that were successfully treated with revision autologous chondrocyte transplantation.

Despite increases in subjective ratings and activity scores, only 33% of patients were able to return to play. “There was a clear discrepancy between recreational and high-level players, with only 16% of recreational players being able to return compared to 81% of players performing at higher levels. Of the players able to return to soccer, 80% were able to return to the same level. At an average follow-up of 48 months, 87% of them were still performing at the same level, attesting to the durability of the cartilage repair.”

Age had a significant impact on return to play. Patients who returned to play had an average age of 22; patients unable to return to play had an average age of 28. “We found that 71% of the players who were younger than 25 were able to return to soccer, while only 29% of the older players were able to do the same.”

Mithoefer said duration of symptoms preoperatively was also a factor. Duration of symptoms in patients who returned to play averaged 16 months; duration of symptoms averaged 31 months in patients unable to return to play.

For more information:

• Mithoefer K, Peterson L, Mandelbaum BR, Minas T. Articular cartilage repair in high-demand athletes with autologous chondrocyte transplantation: functional outcome and return to competition. Presented at the American Orthopaedic Society for Sports Medicine 2004 Annual Meeting. June 24-27, 2004. Quebec.