A. Barandiaran (Westminster, US)

University of Colorado Orthopedics/Sports Medicine

Presenter Of 1 Presentation

Poster Clinical Outcome

P265 - The Fate of Patients Undergoing ACI/MACI Biopsy

Presentation Topic
Clinical Outcome
Date
13.04.2022
Lecture Time
09:30 - 09:30
Room
Exhibition Foyer
Session Name
7.3 - Poster Viewing / Coffee Break / Exhibition
Session Type
Poster Session
Disclosure
No Significant Commercial Relationship

Abstract

Purpose

Knee focal chondral defects (FCDs) can be successfully treated with Matrix-Induced Autologous Chondrocyte Implantation (MACI), it requires one biopsy surgery and a subsequent cartilage transplantation surgery. On occasion, patients don’t progress to the second surgery. The number of patients not undergoing MACI transplant following biopsy remains unclear. The purpose of this study was to determine the conversion rate to MACI transplantation and clinical outcomes following both initial biopsy and definitive treatment.

Methods and Materials

A retrospective review was performed between January 2013 and January 2018 on patients who underwent MACI biopsy by two orthopaedic surgeons. Patients were invited for a clinical follow-up at a minimum of 2-years post-operatively. Preoperative/intraoperative data and postoperative outcomes were assessed. Conversion rate from biopsy to transplantation was calculated. Reasons for not undergoing transplantation were analyzed, and descriptive statistical analysis were performed.

Results

46 (63% female) patients with a mean age of 30.0 ± 10.5 years and BMI of 25.3 ± 5.1 kg/m2 underwent MACI biopsy during the study period. 16/46 patients underwent cartilage restoration surgery, for an overall transplantation rate of 36.9%. Of these 17 patients undergoing transplantation, 11 underwent one or more concomitant procedures including realignment osteotomy (N=6), PRP augmentation (N=1), meniscus repair/meniscectomy (N=3), ligament reconstruction (N=1), and hardware removal (N=3). Furthermore, 64.7% underwent MACI transplant and 35.2% underwent osteochondral allograft (OCA) transplantation at an average 7.2 ± 7.5 months following biopsy. The reoperation rate following transplantation was 35% (N= 3 following MACI/ACI and N=3 following OCA) at an average 15.3 ± 9.0 months after transplantation surgery. No complications reported for all patients.

Conclusion

Patients undergoing biopsy for future MACI transplantation progress to cartilage restoration surgery 32.7% of the time, suggesting arthroscopy with debridement/chondroplasty of pathology at the time of biopsy may be sufficient to improve function and reduce pain in patients with knee FCDs.

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Presenter Of 1 Presentation

Clinical Outcome

P265 - The Fate of Patients Undergoing ACI/MACI Biopsy

Abstract

Purpose

Knee focal chondral defects (FCDs) can be successfully treated with Matrix-Induced Autologous Chondrocyte Implantation (MACI), it requires one biopsy surgery and a subsequent cartilage transplantation surgery. On occasion, patients don’t progress to the second surgery. The number of patients not undergoing MACI transplant following biopsy remains unclear. The purpose of this study was to determine the conversion rate to MACI transplantation and clinical outcomes following both initial biopsy and definitive treatment.

Methods and Materials

A retrospective review was performed between January 2013 and January 2018 on patients who underwent MACI biopsy by two orthopaedic surgeons. Patients were invited for a clinical follow-up at a minimum of 2-years post-operatively. Preoperative/intraoperative data and postoperative outcomes were assessed. Conversion rate from biopsy to transplantation was calculated. Reasons for not undergoing transplantation were analyzed, and descriptive statistical analysis were performed.

Results

46 (63% female) patients with a mean age of 30.0 ± 10.5 years and BMI of 25.3 ± 5.1 kg/m2 underwent MACI biopsy during the study period. 16/46 patients underwent cartilage restoration surgery, for an overall transplantation rate of 36.9%. Of these 17 patients undergoing transplantation, 11 underwent one or more concomitant procedures including realignment osteotomy (N=6), PRP augmentation (N=1), meniscus repair/meniscectomy (N=3), ligament reconstruction (N=1), and hardware removal (N=3). Furthermore, 64.7% underwent MACI transplant and 35.2% underwent osteochondral allograft (OCA) transplantation at an average 7.2 ± 7.5 months following biopsy. The reoperation rate following transplantation was 35% (N= 3 following MACI/ACI and N=3 following OCA) at an average 15.3 ± 9.0 months after transplantation surgery. No complications reported for all patients.

Conclusion

Patients undergoing biopsy for future MACI transplantation progress to cartilage restoration surgery 32.7% of the time, suggesting arthroscopy with debridement/chondroplasty of pathology at the time of biopsy may be sufficient to improve function and reduce pain in patients with knee FCDs.

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