Chondral and Osteochondritis Dissecans Lesions Treated by Autologous Chondrocytes Implantation: A Mid- to Long-Term Nonrandomized Comparison.,CARTILAGE

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Chondral and Osteochondritis Dissecans Lesions Treated by Autologous Chondrocytes Implantation: A Mid- to Long-Term Nonrandomized Comparison.
CARTILAGE ( IF 2.7 ) Pub Date : 2020-06-30 , DOI: 10.1177/1947603520935953
Teemu Paatela ₁ , Anna Vasara ₁ , Markus Sormaala ₂ , Heikki Nurmi ₃ , Hannu Kautiainen _{4,

5} , Ilkka Kiviranta _{1,

6}

Affiliation

Objective

The aim of this study was to compare the clinical outcome of cartilage repair with autologous chondrocyte implantation (ACI) in patients with osteochondritis dissecans (OCD) lesions and full-thickness cartilage lesions.

Design

This study included a cohort of 115 consecutive patients with a cartilage lesion of the knee treated with ACI. Of the patients, 35 had an OCD lesion and 80 a full-thickness cartilage lesion. During a follow-up period from 2 to 13 years all treatment failures were identified. The failure rate between OCD lesions and full-thickness cartilage lesions was compared with Kaplan-Meier analysis. Patient-reported outcome was evaluated 2 years postoperatively with the Lysholm score.

Results

During the follow-up 21 out of 115 patients encountered a treatment failure. The failure rate for full-thickness cartilage lesions was 19.1% and for OCD lesions 43.3% over the 10-year follow-up. Patient-reported outcome improved from baseline to 2 years postoperatively. The improvement from baseline was statistically significant, and the Lysholm score improved more than the minimal clinically important difference. The patient-reported outcome showed no difference between lesion types at 2 years.

Conclusions

In the presented retrospective study, the failure rate of first-generation ACI was higher in OCD lesions than in large full-thickness cartilage lesions, suggesting that OCD lesions may associate with properties that affect the durability of repair tissue. Future prospective studies are needed to tell us how to best repair OCD lesions with biological tissue engineering.

中文翻译：

自体软骨细胞植入治疗的软骨和剥脱性骨软骨炎病变：中长期非随机比较。

客观的

本研究的目的是比较剥脱性骨软骨炎 (OCD) 病变和全层软骨病变患者软骨修复与自体软骨细胞植入 (ACI) 的临床结果。

设计

这项研究包括一组 115 名连续接受 ACI 治疗的膝关节软骨损伤患者。在这些患者中，35 名患有强迫症，80 名患有全层软骨损伤。在 2 至 13 年的随访期间，所有治疗失败均被确定。采用 Kaplan-Meier 分析比较 OCD 病变和全层软骨病变之间的失败率。术后 2 年使用 Lysholm 评分对患者报告的结果进行评估。

结果

在随访期间，115 名患者中有 21 名治疗失败。在 10 年的随访中，全层软骨病变的失败率为 19.1%，OCD 病变的失败率为 43.3%。患者报告的结果从基线改善到术后 2 年。与基线相比的改善具有统计学意义，并且 Lysholm 评分的改善超过了最小的临床重要差异。患者报告的结果显示 2 年时病变类型之间没有差异。