This Article Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal My Folders Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Henderson, I. Articles by Oakes, B. Search for Related Content PubMed Articles by Henderson, I. Articles by Oakes, B.

Reoperation after autologous chondrocyte implantation

INDICATIONS AND FINDINGS

Orthopaedic Research Department

B. Tuy, MD, Clinical Fellow

AOA Fellowship in Knee, Shoulder, Foot and Ankle Surgery, St Vincent’s and Mercy Private Hospital, 166 Gipps Street, East Melbourne, Victoria 3002, Australia.

B. Oakes, MD, Associate Professor

Department of Anatomy and Cell Biology, Monash University, Melbourne, Australia.

Correspondence should be sent to Mr I. Henderson.

We have reviewed 22 patients from a total of 135 treated by autologous chondrocyte implantation (ACI) who had undergone further surgery for pain in the knee and mechanical symptoms after a mean of 10.5 months. There were 31 grafted lesions. At operation the findings included lifting (24/31) and detachment (3/31) of periosteal patches for which arthroscopic shaving was performed. Chondroplasty was undertaken on two new lesions, another required an ACI and a further patient required trimming of a meniscus.

The mechanical symptoms resolved within two weeks. At the last review, two to 14 months from reoperation; 68% had improved, and 86% had normal or nearly normal IKDC scores. Of the 31 lesions, 30 (97%) had normal or nearly normal visual repair scores.

Biopsy showed good integration with subchondral bone and the marginal interface in all specimens, most of which showed hyaline or hyaline-like cartilage (70%). Troublesome mechanical symptoms required surgery in 13% of ACI-treated patients and were attributed to periosteal extrusion. Simple arthroscopic debridement was curative.

This article has been cited by other articles:

				W. Bartlett, J. A. Skinner, C. R. Gooding, R. W. J. Carrington, A. M. Flanagan, T. W. R. Briggs, and G. Bentley Autologous chondrocyte implantation versus matrix-induced autologous chondrocyte implantation for osteochondral defects of the knee: A PROSPECTIVE, RANDOMISED STUDY J Bone Joint Surg Br, May 1, 2005; 87-B(5): 640 - 645. [Abstract] [Full Text] [PDF]