High self-reported outcomes in ACI-treated patients 45 years old and older

Of the eight failures found in the study, six were in patients with work-related injuries.

ORLANDO, Fla. — Autologous chondrocyte implantation in patients 45 years of age and older may lead to outcomes similar to those seen for younger patients, according to a researcher from Boston.

Tom Minas, MD, prospectively studied 56 patients aged at least 45 years who underwent autologous chondrocyte implantation (ACI) for joint preservation and who were followed for an average of 5 years postop. The cohort had a total of 117 defects with an average 10 cm² surface area per knee.

Minas presented the results at the 24th Annual Current Concepts in Joint Replacement Winter 2007 Meeting, here.

At the latest follow-up, nearly 75% of patients rated their results as either good or excellent, 80% reported that they had improved and 83% reported that they would undergo the procedure again.

Postoperative modified Cincinnati scores showed a 2.5-point increase over preoperative scores and a significant improvement in Knee Society Scores. Patients also had improvements in both WOMAC and Short Form-36 (SF-36) scores.

Overall, 42% of patients required repeat arthroscopy to treat either overgrowth of the periosteal cover, adhesions or a combination of both conditions. Investigators also found an overall failure rate of 14%. However, they noted that six of the eight failures occurred in patients who had work-related injuries.

"This was our bias toward work-related injuries and ACIs," Minas said during his presentation. "I would submit to you that ACI is a surgery that can be reserved for our higher-level athletic patients over 45 [year of age], and please consider this for your patients."

For more information:
Minas T. Autologous chondrocyte implantation: Joint perseveration. #65. Presented at the 24th Annual Current Concepts in Joint Replacement Winter 2007 Meeting. Dec. 12-17, 2007. Orlando, Fla.
Minas is a consultant for Genzyme Biosurgery.