Abstract
Introduction: We report one surgeon’s experience with autologous chondrocyte implantation (ACI) for the treatment of large chondral knee defects
Method: Over a five-year period, 295 chondral knee defects in 169 patients were treated with ACI. Most patients were complex having failed other treatments. Only 4% of patients had simple condylar lesions. Patients were followed prospectively. Patients were independently evaluated by an history, clinical examination, WOMAC score, Cincinnati Knee Score (CKS), IKDC, SF-36 and patient satisfaction scores administered pre-operatively and at 12, 24, 36 and 48 months post-operatively.
Results: Two hundred and sixty seven grafts (89%) were functioning well. The common causes for graft failure were poor graft incorporation and delamination, non-compliant rehabilitation and progressive osteoarthritis. Periosteal hypertrophy was present in 20% requiring arthroscopic debridement. All outcome measures improved significantly with time.
Conclusion: In a complex group of patients ACI showed encouraging results in the short term.
The abstracts were prepared by Professor Alan Thurston. Correspondence should be addressed to him at the New Zealand Orthopaedic Association, PO Box 7451, Wellington, New Zealand.
