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Follow-up of 10 to 20 years highlights the durability and efficacy of ACI in the knee

At final follow-up, almost 95% of patients reported that they would undergo the procedure again.

Issue: Issue 5 2009

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MIAMI — Autologous chondrocyte implantation can provide high rates of patient satisfaction and maintain good outcomes at long-term follow-up, according to a Swedish study.

“We can say that ACI is an effective and desirable option for large full-thickness chondral lesions mid-term,” Haris S. Vasiliadis, MD, PhD, of Göteborg, Sweden, said during his presentation at the 8th World Congress of the International Cartilage Repair Society, here. “It has good results even 10 to 20 years after the implantation, even for difficult cases where ACI is performed as a salvage procedure.”

Significant improvement

Vasiliadis and his colleagues studied 224 patients who underwent autologous chondrocyte implantation (ACI). The patients were 33.5 years old at the time of surgery and the average lesion size was 5.2 cm².

The investigators assessed the patients using the Lysholm, Tegner-Wallgren and Brittberg-Peterson scores preoperatively, and at 3 and 10 to 20 years postoperatively. The study group averaged 13.8 years follow-up.

They found a statistically significant improvement in all of the outcome measures at 3 years. A comparison of mid- to long-term results showed improvements in Lysholm, Tegner-Wallgren and the Brittberg-Peterson scores.

No difference in OCD cases

Overall, they found no significant difference between the patients with traumatic lesions and those with osteochondritis dissecans (OCD).

“We saw a significantly greater improvement in the Lysholm score from 3 years for the OCD patients,” Vasiliadis said. “But, we also had deterioration over time of the Lysholm score until the 14 years follow-up. However, the absolute scorings were similar in all time points for both OCD and traumatic lesion groups.”

At long-term follow-up, 73% of all the patients reported that they felt better or the same compared to the 3-year follow-up. In addition, 92% of the patients reported that they would have the procedure again, he said.

Tim Spalding, FRCS, a moderator for the session, commented, “When you look at those 10- to 20-year results, the durability of the ACI is indeed impressive.”

For more information:

• Tim Spalding, FRCS, can be reached at The Warwickshire Nuffield Hospital, Old Milverton Lane, Leamington Spa, Warwickshire CV32 6RW, England; +44-19-26-772-731; e-mail: info@timspalding.com. He has any direct financial interest in any companies or products mentioned in this article.
• Haris S. Vasiliadis, MD, PhD, can be reached at Sahlgrenska University Hospital, 413 45 Göteborg, Sweden; +46-730-320-374; e-mail: vasiliadismd@gmail.com. He has any direct financial interest in any companies or products mentioned in this article.

Reference:

• Vasiliadis HS, Concaro S, Brittberg M, et al. Autologous chondrocyte implantation: 10-20 years follow-up. Paper #15.3.1. Presented at the 8th World Congress of the International Cartilage Repair Society. May 23-26, 2009. Miami