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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 1, 61-64.
doi: 10.1302/0301-620X.88B1.16796  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Who is the ideal candidate for autologous chondrocyte implantation?

S. P. Krishnan, MRCS(Ed), Research Fellow1; J. A. Skinner, FRCS(Orth), Consultant Orthopaedic Surgeon1; W. Bartlett, MRCS(Ed), Research Fellow1; R. W. J. Carrington, FRCS(Orth), Consultant Orthopaedic Surgeon1; A. M. Flanagan, MB, FRC Path, PhD, Professor of Histopathology1; T. W. R. Briggs, MCh Orth, FRCS(Orth), Consultant Orthopaedic Surgeon1; and G. Bentley, DSc, ChM, FRCS, F. Med Sci, Professor of Orthopaedics1

1 Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK.

Correspondence should sent to Mr S. P. Krishnan; e-mail: shibupkrishnan{at}yahoo.co.in

We investigated the prognostic indicators for collagen-covered autologous chondrocyte implantation (ACI-C) performed for symptomatic osteochondral defects of the knee.

We analysed prospectively 199 patients for up to four years after surgery using the modified Cincinnati score. Arthroscopic assessment and biopsy of the neocartilage was also performed whenever possible. The favourable factors for ACI-C include younger patients with higher pre-operative modified Cincinnati scores, a less than two-year history of symptoms, a single defect, a defect on the trochlea or lateral femoral condyle and patients with fewer than two previous procedures on the index knee. Revision ACI-C in patients with previous ACI and mosaicplasties which had failed produced significantly inferior clinical results. Gender (p = 0.20) and the size of the defect (p = 0.97) did not significantly influence the outcome.




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Selecting patients for Autologous chondrocyte implantation
Harish V Kurup
J Bone Joint Surg Br Online, 23 Jan 2006 [Full text]

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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General