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Clinical and Magnetic Resonance Imaging–Based outcomes to 5 years after Matrix-Induced Autologous Chondrocyte iImplantation to address articular cartilage defects in the knee
Journal article   Peer reviewed

Clinical and Magnetic Resonance Imaging–Based outcomes to 5 years after Matrix-Induced Autologous Chondrocyte iImplantation to address articular cartilage defects in the knee

J.R. Ebert, W.B. Robertson, J. Woodhouse, M. Fallon, M.H. Zheng, T. Ackland and D.J. Wood
The American Journal of Sports Medicine, Vol.39(4), pp.753-763
2011
DOI: https://doi.org/10.1177/0363546510390476
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Abstract

Background: The availability remains limited of midterm clinical and radiologic results into matrix-induced autologous chondrocyte implantation (MACI). Outcomes are required to validate the efficacy of MACI as a suitable surgical treatment option for articular cartilage defects in the knee. Hypothesis: A significant improvement in clinical and magnetic resonance imaging–based (MRI-based) outcomes after MACI will exist throughout the postoperative timeline to 5 years after surgery. Furthermore, patient demographics, cartilage defect parameters, and injury/surgery history will be associated with patient and graft outcome, whereas a significant correlation will exist between clinical and MRI-based outcomes at 5 years after surgery. Study Design: Case series; Level of evidence, 4. Methods: A prospective evaluation was undertaken to assess clinical and MRI-based outcomes to 5 years in 41 patients (53 grafts) after MACI to the knee. After MACI surgery and a 12-week structured rehabilitation program, patients underwent clinical assessments (Knee injury and Osteoarthritis Outcome Score, SF-36, 6-minute walk test, knee range of motion) and MRI assessments at 3, 12, and 24 months, as well as 5 years after surgery. The MRI evaluation assessed 8 previously defined pertinent parameters of graft repair, as well as a combined MRI composite score. Results: A significant improvement (P < .05) was demonstrated for all Knee injury and Osteoarthritis Outcome Score and SF-36 subscales over the postoperative timeline, as well as the 6-minute walk test and active knee extension. A significant improvement (P < .0001) was observed for the MRI composite score, as well as several individual graft scoring parameters. At 5 years after surgery, 67% of MACI grafts demonstrated complete infill, whereas 89% demonstrated good to excellent filling of the chondral defect. Patient demographics, cartilage defect parameters, and injury/surgery history demonstrated no significant pertinent correlations with clinical or MRI-based outcomes at 5 years, and no significant correlations existed between clinical and MRI-based outcome measures. At 5 years after surgery, 98% of patients were satisfied with the ability of MACI surgery to relieve knee pain; 86%, with improvement in their ability to perform normal daily tasks; and 73%, with their ability to participate in sport 5 years after MACI. Conclusion: These results suggest that MACI provides a suitable midterm treatment option for articular cartilage defects in the knee. Long-term follow-up is essential to confirm whether the repair tissue has the durability required to maintain long-term patient quality of life.

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Citation topics
1 Clinical & Life Sciences
1.102 Stem Cell Research
1.102.110 Mesenchymal Stem Cells
Web Of Science research areas
Orthopedics
Sport Sciences
ESI research areas
Clinical Medicine
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