Journal article
Clinical and Magnetic Resonance Imaging–Based outcomes to 5 years after Matrix-Induced Autologous Chondrocyte iImplantation to address articular cartilage defects in the knee
The American Journal of Sports Medicine, Vol.39(4), pp.753-763
2011
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.
Details
- Title
- Clinical and Magnetic Resonance Imaging–Based outcomes to 5 years after Matrix-Induced Autologous Chondrocyte iImplantation to address articular cartilage defects in the knee
- Authors/Creators
- J.R. Ebert (Author/Creator)W.B. Robertson (Author/Creator)J. Woodhouse (Author/Creator)M. Fallon (Author/Creator)M.H. Zheng (Author/Creator)T. Ackland (Author/Creator)D.J. Wood (Author/Creator)
- Publication Details
- The American Journal of Sports Medicine, Vol.39(4), pp.753-763
- Publisher
- SAGE Publications Inc.
- Identifiers
- 991005543806007891
- Copyright
- © 2022 by American Orthopaedic Society for Sports Medicine
- Murdoch Affiliation
- Murdoch University
- Language
- English
- Resource Type
- Journal article
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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