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Majority of active patients returned to pretreatment function level after second-generation patellofemoral joint ACI
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TORONTO — Investigators reported good success at about 2-years follow-up when they treated cartilage lesions sized 502 mm2 in the patellofemoral joint with a second-generation cartilage repair technique. Most of the lesions were on the patella in the 75 knees in a treated military population of 74 active, young high-demand patients.
At the American Orthopaedic Society for Sports Medicine Annual Meeting, here, Nicholas J. Zarkadis, DO, CPT, MC, said, “We have identified the potential predictors of failure for [autologous chondrocyte implantation] ACI in the patellofemoral joint. We demonstrated that ACI can be performed in the patellofemoral joint and can return approximately 75% of our active population to their preoperative level of function and that, regardless of outcome, the patients can expect improvement in their knee pain,” Zarkadis said.
The retrospective study included U.S. military and Tricare beneficiaries who underwent ACI for Outerbridge grade 3 or 4 patellofemoral chondral defects. The procedures were performed at two military medical centers between 2007 and 2014. The surgeries involved autologous, cultured chondrocytes (Vericel Corp.) with a type I/III collagen bilayer membrane.
Investigators performed a univariate analysis to determine whether there were significant independent predictors of surgical failure, which was defined as a revision chondral procedure or later conversion to arthroplasty.
The patients had a median age of about 34 years and some of them used tobacco.
Among the 16 failures in the series, 2% of patients required a revision. At an average of 1.9 years postoperatively, 14 patients underwent medical discharge, which Zarkadis said was reportedly due to persistent knee pain.
However, according to results, investigators found no surgical or demographic factors that were significantly associated with an adverse clinical outcome.
The retrospective study design and short-term outcomes were limitations of the study, “as well as insufficient patient-reported outcome measures, as well as a lack of a control group,” Zarkadis said. – by Susan M. Rapp
Reference:
Zarkadis NJ, et al. Paper #122. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 20-23, 2017; Toronto.
Disclosure: Zarkadis reports no relevant financial disclosures.