Autologous chondrocyte implantation to repair knee cartilage injury: ultrastructural evaluation at 2 years and long-term follow-up including muscle strength measurements.
Knee Surg Sports Traumatol Arthrosc
; 17(11): 1278-88, 2009 Nov.
Article
em En
| MEDLINE
| ID: mdl-19572120
ABSTRACT
Autologous chondrocyte implantation (ACI) usually results in improvement in clinical scores. However, long-term isokinetic muscle strength measurements have not been reported. Biopsies from the repair tissue have shown variable proportions of hyaline-like cartilage. In this study, 21 consecutive patients were treated with autologous cartilage implantations in the knee. Mean size of the lesions was 5.5 cm(2). Follow-up arthroscopy with biopsy was performed at 2 years in 19 patients. The biopsies were examined with both light microscopy and transmission electron microscopy (TEM) techniques including immunogold analysis of collagen type 1. Patient function was evaluated with modified 10-point scales of the Cincinnati knee rating system obtained preoperatively and at 1 and 8.1 years. Isokinetic quadriceps and hamstrings muscle strength testing was performed at 1, 2 and 7.4 years. Light microscopy and TEM both showed predominately fibrous cartilage. The immunogold analysis showed a high percentage of collagen type I. At 7.4 years, the total work deficits when compared with the contra-lateral leg for isokinetic extension were 19.1 and 11.4%, and for isokinetic flexion 11.8 and 8.5% for 60 and 240 masculine/s, respectively. Mean pain score improved from 4.3 preoperatively to 6.3 at 1 year (p = 0.031) and 6.6 at 8.1 years (p = 0.013). Overall health condition score improved from 4.1 preoperatively to 6.1 at 1 year (p = 0.004) and 6.5 at 8.1 years (p = 0.008). Three patients later went through revision surgery with other resurfacing techniques and are considered failures. In summary, the formation of fibrous cartilage following ACI was confirmed by TEM with immunogold histochemistry. Although the functional scores were generally good, strength measurements demonstrated that the surgically treated leg remained significantly weaker.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Cartilagem Articular
/
Condrócitos
/
Traumatismos do Joelho
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Adolescent
/
Adult
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Knee Surg Sports Traumatol Arthrosc
Assunto da revista:
MEDICINA ESPORTIVA
/
TRAUMATOLOGIA
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Noruega