HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text Full Text (PDF) All Versions of this Article: 33/11/1658    most recent 0363546505275148v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (9) Citing Articles via Google Scholar Google Scholar Articles by Fu, F. H. Articles by Micheli, L. J. Search for Related Content PubMed PubMed Citation Articles by Fu, F. H. Articles by Micheli, L. J. Related Collections Chondral/cartilage Knee Operative

Autologous Chondrocyte Implantation Versus Debridement for Treatment of Full-Thickness Chondral Defects of the Knee

An Observational Cohort Study With 3-Year Follow-up

Freddie H. Fu, MD^*, David Zurakowski, PhD^,, Jon E. Browne, MD, Bert Mandelbaum, MD^||, Christoph Erggelet, MD, PhD^¶, J. Bruce Moseley, Jr, MD^#, Allen F. Anderson, MD^** and Lyle J. Micheli, MD

From the ^* University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, Children’s Hospital, Harvard Medical School, Boston, Massachusetts, the Orthopaedic Sports Medicine Fellowship Program, University of Missouri–Kansas City, Kansas City, Missouri, ^|| Santa Monica Orthopaedic and Sports Medicine Research Foundation, Santa Monica, California, the ^¶ Department of Orthopaedic Surgery, Albert-Ludwigs University, Freiburg, Germany, ^# Baylor Sports Medicine Institute, Baylor College of Medicine, Houston, Texas, the ^** Sports Medicine Fellowship, Tennessee Sports Alliance/The Lipscomb Clinic, Nashville, Tennessee, and the Division of Sports Medicine, Department of Orthopaedic Surgery, Children’s Hospital, Harvard Medical School, Boston, Massachusetts

Address correspondence to David Zurakowski, PhD, Director of Biostatistics, Department of Orthopaedic Surgery, Children’s Hospital, 300 Longwood Avenue, Boston, MA 02115 (e-mail: david.zurakowski{at}childrens.harvard.edu).

Background: Studies that compare the effectiveness of different cartilage repair treatments are needed to update treatment algorithms.

Hypothesis: Autologous chondrocyte implantation provides greater improvement in overall condition score than does debridement at a minimum of 3 years’ follow-up.

Study Design: Cohort study; Level of evidence, 3.

Methods: Cohorts for debridement and autologous chondrocyte implantation each included 58 Cartilage Repair Registry patients who met study criteria. A retrospective analysis was performed on prospectively collected baseline and follow-up data.

Results: Patients in the autologous chondrocyte implantation and debridement groups had similar demographics and chondral lesions at baseline. However, more autologous chondrocyte implantation patients failed a previous debridement or marrow stimulation procedure than did debridement patients. Follow-up outcome assessments were completed by 54 autologous chondrocyte implantation patients and 42 debridement patients. Eighty-one percent of the autologous chondrocyte implantation patients and 60% of the debridement patients reported median improvements of 5 points and 2 points, respectively, in the overall condition score. Autologous chondrocyte implantation patients also reported greater improvements in the median pain and swelling scores than did debridement patients. The treatment failure rate was the same for both autologous chondrocyte implantation and debridement patients. Eighteen autologous chondrocyte implantation patients and 1 debridement patient had at least 1 subsequent operation.

Conclusion: Although patients treated with debridement for symptomatic, large, focal, chondral defects of the distal femur had some functional improvement at follow-up, patients who received autologous chondrocyte implantations obtained higher levels of knee function and had greater relief from pain and swelling at 3 years.

Key Words: autologous chondrocyte implantation (ACI) • debridement • chondral defects • outcomes • knee

This article has been cited by other articles:

				D. B. F. Saris, J. Vanlauwe, J. Victor, M. Haspl, M. Bohnsack, Y. Fortems, B. Vandekerckhove, K. F. Almqvist, T. Claes, F. Handelberg, et al. Characterized Chondrocyte Implantation Results in Better Structural Repair When Treating Symptomatic Cartilage Defects of the Knee in a Randomized Controlled Trial Versus Microfracture Am. J. Sports Med., February 1, 2008; 36(2): 235 - 246. [Abstract] [Full Text] [PDF]

				B. Mandelbaum, J. E. Browne, F. Fu, L. J. Micheli, J. B. Moseley Jr, C. Erggelet, and A. F. Anderson Treatment Outcomes of Autologous Chondrocyte Implantation for Full-Thickness Articular Cartilage Defects of the Trochlea Am. J. Sports Med., June 1, 2007; 35(6): 915 - 921. [Abstract] [Full Text] [PDF]

				G. Treme, J. A. Hart, and M. D. Miller What's New in Sports Medicine J. Bone Joint Surg. Am., March 1, 2007; 89(3): 686 - 696. [Full Text] [PDF]

				M. M. Braun, C. E. Zinderman, J. J. Wood, M. A. Malek, F. J. Frassica, J. A. Polder, and T. R. Cote J. Bone Joint Surg. Am., November 1, 2006; 88(11): 2539 - 2539. [Full Text] [PDF]