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Durable results seen with ACI for full-thickness cartilage defects of the knee
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A minimum 7-year follow-up of patients who underwent autologous chondrocyte implantation for symptomatic full-thickness cartilage lesions of the knee showed sustained reductions in pain and improved function.
Keith T. Corpus, BS, shared his team’s findings at the 2011 Annual Meeting of the Arthroscopy Association of North America.
Improved outcomes
In a study lead by Brian J. Cole, MD, MBA, Corpus and colleagues prospectively evaluated 29 patients with grade 4 lesions who underwent autologous chondrocyte implantation (ACI) performed by a single surgeon. Pre- and postoperative IKDC, Tegner-Lysholm, KOOS and SF-12 measures were collected for each patient. The investigators compared the preoperative data with postoperative outcomes to assess the durability of the procedure. The patients had a mean follow-up of 8.36 years.
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Image: Cole BJ |
According to Corpus, the mean IKDC, Lysholm, SF-12 physical and mental scores, as well as all measured KOOS scores improved “significantly” and exhibited sustained improvements through the 2-, 4-, and 7-year postoperative marks when compared with preoperative measures.
Corpus noted a large increase from preoperative to 2-year postoperative Tegner-Lysholm scores. “These numbers do not really drop off,” he said. “In fact, they actually increase from the 4-year mark to the 7-year mark.”
Mean postoperative patient satisfaction rate, measured on a scale from 1 to 10 with 10 being “completely satisfied,” was reported as 8.14. Furthermore, Corpus noted, 88.9% of patients said they would undergo the surgery again.
Subanalysis
There were two significant differences reported in subgroup analyses, Corpus added: Obese or morbidly obese patients demonstrated “significantly lower” 7-year postoperative scores than non-obese patients on the Tegner-Lysholm and KOOS activity of daily living measures, and patients who had concomitant meniscal transplants demonstrated “significant improvements” in IKDC scores.
Corpus noted that the obese subgroup had four patients and the meniscal subgroup had five patients. “Due to this small number of people, we cannot draw any solid conclusions from this data, but we just wanted to express that our data was trending in this manner,” Corpus said.
Ultimately, Corpus reported, subjective scoring found “significant and sustained improvement” in patients at the 2-, 4-, and 7-year marks. Objective data also showed decreased levels of tenderness, along with increased functional ability. Thus, Corpus and his group concluded that the longer-term results of ACI are promising.
“Combined with the objective data that we received, we can say that [autologous chondrocyte implantation] is a durable long-term treatment option,” Corpus said. – by Robert Press
Reference:
- Cole BJ, Corpus KT, Bajaj S, et al. Prospective evaluation of autologous chondrocyte implantation procedure: minimum seven-year follow-up. Paper SS-26. Presented at the 2011 Annual Meeting of the Arthroscopy Association of North America. April 14-16. San Francisco.
- Brian J. Cole, MD, MBA, lead study author, can be reached at 1725 West Harrison, Suite 1063, Chicago, IL 60612; (312) 243-4244; email: bcole@rushortho.com
- Disclosure: Corpus has no relevant financial disclosures.
