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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 2, 203-205.
doi: 10.1302/0301-620X.88B2.17009  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Collagen-covered autologous chondrocyte implantation for osteochondritis dissecans of the knee

TWO- TO SEVEN-YEAR RESULTS

S. P. Krishnan, MS, MRCS(Ed), Research Fellow1; J. A. Skinner, FRCS(Orth), Consultant Orthopaedic Surgeon1; R. W. J. Carrington, FRCS(Orth), Consultant Orthopaedic Surgeon1; A. M. Flanagan, MB, FRCPath, PhD, Professor of Histopathology1; T. W. R. Briggs, MCh(Orth), FRCS(Orth), Consultant Orthopaedic Surgeon1; and G. Bentley, DSc, ChM, FRCS, FMedSci, Professor of Orthopaedics Institute of Orthopaedics1

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

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

We prospectively studied the clinical, arthroscopic and histological results of collagen-covered autologous chondrocyte implantation (ACI-C) in patients with symptomatic osteochondritis dissecans of the knee. The study included 37 patients who were evaluated at a mean follow-up of 4.08 years.

Clinical results showed a mean improvement in the modified Cincinnati score from 46.1 to 68.4. Excellent and good clinical results were seen in 82.1% of those with juvenile-onset osteochondritis dissecans but in only 44.4% of those with adult-onset disease.

Arthroscopy at one year revealed International Cartilage Repair Society grades of 1 or 2 in 21 of 24 patients (87.5%). Of 23 biopsies, 11 (47.8%) showed either a hyaline-like or a mixture of hyaline-like and fibrocartilage, 12 (52.2%) showed fibrocartilage.

The age at the time of ACI-C determined the clinical outcome for juvenile-onset disease (p = 0.05), whereas the size of the defect was the major determinant of outcome in adult-onset disease (p = 0.01).




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