I. Guillen-Vicente (MADRID, ES)
Clinica CEMTRO Research Unit and TraumatologyPresenter Of 2 Presentations
10.1.7 - Long-term clinical outcome of Matrix-assisted Autologous Chondrocyte Implantation (MACI) in the knee
Abstract
Purpose
The aim of this work was to analyze the long-term clinical outcome of MACI treatment for cartilage repair in the knee
Methods and Materials
Eighty-six patients (71 male and 15 female) with cartilage lesions in the knee treated with MACI.Patient’s mean age ± SD was 31.1 ± 10.0 years. Most patients usually practiced sports (65.9%), being 8.9% of them professional athletes. Patients had 1 lesion as a median (Minimum – Maximum: 1 – 4 lesions) and were more frequently located at the medium femoral condyle (53%), patella (22%) and lateral femoral condyle (20%). Treatment outcome at 1, 2 and 7 years was evaluated with the Visual Analogic Scale for pain, theInternational Knee Documentation Committee (IKDC) questionnaire and mobility. Presence of inflammation was also recorded
Results
One year after implantation, mean pain significantly decreased from respect to baseline and continued like this 2 and 7 years post-op (Basal:7.3±1.6; 1 year: 2.8 ± 2.1; 2 years: 1.8 ± 2.0; 7 years: 2.2 ± 2.7; p<0.001, ANOVA). Difference of IKDC mean with respect to basal determination was 28.6 (95% CI: 24.3 – 32.9) at 1-year follow-up; 37.2 (95% CI: 32.0 – 42.4) at 2-year follow-up and 34.3 (95% CI: 28.2 – 40.5) 7 years post-op. Minimum Clinically Important Difference (MCID) of IKDC at 12 months is 16.7. The contrast for the mean IKDC differences at the different time points showed that they were statistically higher than 16.7 (p<0.001; Student’s T test) in all cases. The percentage of patients with complete mobility and without inflammation significantly increased 1 year post-op and continued like this 7 years after (p<0.001; Chi-square Test, in the 3 cases).
Conclusion
MACI is an effective technique in the long-term follow-up. Results on Pain and IKDC score suggest that patients perceive a real improvement in the knee 7 years after implantation
12.1.10 - Treatment of Chondral Lesions in the ankle by High-Density Autologous Chondrocyte Implantation: Two-Year follow-up
Abstract
Purpose
Two-year follow-up to assess efficacy and safety of High-Density Autologous Chondrocyte Implantation (HD-ACI) in patients with cartilage lesions in the ankle treated in our hospital from 2010 to 2016
Methods and Materials
Twenty-four consecutive patients (14 men and 10 female) with ICRS grade III-IV cartilage lesions of the ankle were included. The patients’ median age was 31 (minimum – maximum: 18 – 59). Five million chondrocytes per cm2 of lesion were implanted using a type I/III collagen membrane as a carrier and treatment effectiveness was assessed by evaluating pain with the Visual Analogical Scale (VAS) and American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score at baseline, 12 and 24 months follow-up, together with dorsal and plantar flexion. Magnetic resonance observation for cartilage repair tissue (MOCART) score was used to evaluate cartilage healing. Histological study was possible in 5 cases
Results
Median VAS score was 8 (5 – 10) at baseline, 1.5 (0 – 8) at 12-month follow-up and 2 (0 – 5) at 24-month follow-up (p<0.001). Median AOFAS score was 39.5 (29 – 48) at baseline, 90 (38 – 100) at 12-month follow-up and 90 (40 – 100) at 24-month follow-up (p<0.001). Complete dorsal flexion significantly increased at 12 (16/24: 66.7%) and 24 months (17/24: 70.8%) with respect to baseline (13/24: 54.2%) (p=0.002). MOCART at 12- and 24-month follow-ups were 73.71 ± 15.99 and 72.33 ± 16.21. Histological study confirmed that neo-synthetized tissue was cartilage with hyaline extracellular matrix and numerous viable chondrocytes
Conclusion
HD-ACI is a safe and effective technique to treat osteochondral lesions in the talus, providing good clinical and histological results at short- and mid-term follow-ups.