| Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | The American Journal of Sports Medicine | ||||
| Publisher: | SAGE Publications | ||||
| Place of Publication: | THOUSAND OAKS | ||||
| Volume: | 50 | ||||
| Number of Issue or Book Chapter: | 4 | ||||
| Page Range: | pp. 994-1005 | ||||
| Date: | 2022 | ||||
| Institutions: | Medicine > Lehrstuhl für Unfallchirurgie | ||||
| Identification Number: |
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| Keywords: | AUTOLOGOUS CHONDROCYTE IMPLANTATION; MARROW STIMULATION; REPAIR; knee joint; cartilage; ACI; autologous chondrocyte implantation; registry; joint preservation | ||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 57272 |
Web of ScienceAbstract
Background: Autologous chondrocyte implantation (ACI) is an established procedure for the treatment of cartilage damage in the knee joint. At present, it is still unclear how previous surgery influences outcome after ACI. Purpose: To evaluate the effect of previous knee surgery related or nonrelated to the treated cartilage defect on clinical outcome after ACI for knee cartilage defects. Study ...
Abstract
Background: Autologous chondrocyte implantation (ACI) is an established procedure for the treatment of cartilage damage in the knee joint. At present, it is still unclear how previous surgery influences outcome after ACI. Purpose: To evaluate the effect of previous knee surgery related or nonrelated to the treated cartilage defect on clinical outcome after ACI for knee cartilage defects. Study Design: Cohort study; Level of evidence, 3. Methods: An overall 730 patients with ACI who underwent previous unspecific knee surgery, whether related to the defect being currently treated or not, were identified from a cohort of 5961 patients registered in the German Cartilage Registry. Propensity score matching was used to match these patients to 690 patients with analogous characteristics but without previous surgery. Subsequently, 317 patients with previously failed cartilage treatment at the defect site were identified and compared with a matched collective of 254 patients without previous cartilage treatment. In a subgroup analysis, the type of previous cartilage surgery was additionally investigated. Outcome was evaluated by Knee injury and Osteoarthritis Outcome Score (KOOS), visual analog scale for pain, rate of reintervention, and patient satisfaction up to 36 months. A chi-square test was used to compare categorial variables and an unpaired t test to compare continuous variables. Results: Patients with previous knee surgery not related to the cartilage defect showed a lower KOOS at 6 months (68.3 vs 70.8; P = .026), while patients with previous cartilage surgery showed significantly lower KOOS values at all follow-up time points when compared with patients without any previous knee or cartilage surgery (all P < .05). A comparison of KOOS values in patients with previous therapy at the cartilage defect with ACI versus bone marrow stimulation did not show any significant differences at any follow-up. Conclusion: Previously failed cartilage treatment at the defect site represents a negative prognostic factor up to 3 years after ACI. However, this influence appears to be independent of the type of previous treatment at the defect site and applies equally to failed bone marrow stimulation as well as previous ACI. In contrast, a negative effect of previous surgery to the knee unrelated to the cartilage defect could not be shown in the 3-year follow-up.
Metadata last modified: 29 Feb 2024 12:53
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