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General Orthopaedics

THE SEQUENTIAL IMPROVEMENT IN CLINICAL OUTCOME FOLLOWING AUTOLOGOUS CHONDROCYTE IMPLANTATION: A 6 YEAR FOLLOW-UP

British Orthopaedic Association (BOA) 2006



Abstract

Introduction

The treatment of distal femoral cartilage defects using autologous chondrocyte implantation (ACI) and matrix-guided autologous chondrocyte implantation (MACI) is become increasingly common. This prospective 7-year study reviews and compares the clinical outcome of ACI and MACI.

Methods

We present the clinical outcomes of 159 knees (156 patients) that have undergone autologous chondrocyte implantation from July 1998. One surgeon performed all operations with patients subsequently assessed on a yearly basis using 7 independent validated clinical, functional and satisfaction rating scores.

Results

Modified Cincinnati, Patient Functional Outcome and Lysholm & Gilchrist clinical rating scores all showed significant improvements compared to pre-operative levels (p<0.0001). Although ACI scores are superior at one year (p<0.05) there is no significant difference between ACI and MACI at 2 years.

Visual Analogue Score and Bentley Functional rating score showed significant improvements compared to pre-operative levels (p<0.0001) with ongoing yearly sequential improvement. Patient Rating and Brittberg scores, both subjective patient scores, similarly showed continuing improvements in the years following surgery.

Discussion

ACI and MACI produce significant improvements in knee function when compared to pre-operative levels with continued sequential improvement in outcomes for up to seven years. The initial data suggests a superior rate of clinical improvement using the MACI technique.