Bilateral knee chondral defects are uncommon and they can be treated in one or two surgical acts, each of one having pros and cons. In this work we have studied the clinical outcome of patients with bilateral knee chondral defects treated with High-Density Autologous Chondrocyte Implantation (HD-ACI) during the same surgery
Eight patients (4 women and 4 men) with chondral defects in both knees treated with HD-ACI during the same surgical act were included. Patients were evaluated 2, 6, 12 and 24 months post-op for treatment safety and efficacy. Safety was tested with the visual analogic scale (VAS) for pain, International Knee Documentation Committee (IKDC) for subjective patient’s perception of both knees and EuroQol five-dimensional five-level questionnaire (EQ-5D-5L) for quality of life. Integrity of neo-formed tissue at 12- and 24-month follow-up was assessed by the magnetic resonance observation of cartilage repair tissue (MOCART) score
VAS decreased from baseline to 24 months from a median of 8 (6 – 9) to a median of 0 (0 – 5) (p<0.001). IKDC increased from a median value of 39.0 (17.2 – 48.3) in the basal visit to a median of 83.7 (24.0 – 98.0) in the 24-month visit (p<0.001). EQ-5D-5L decreased at 2 months post-op and increased throughout the follow-up visits thereafter, needing 24 months after surgery to reach a value higher than the basal one. Median MOCART at 12 months was 80.3 (58.0 – 89.7) and 81.3 (54.0 – 89.9) at 24 months
Treatment of both knees with HD-ACI during the same surgical act in patients with bilateral chondral lesions is a safe procedure, providing good clinical results