Abstract
Background: Autologous Chondrocyte Implantation (ACI) is widely used as a treatment for symptomatic chondral and osteochondral defects of the knee. Variations of the original periosteum cover technique include the use of porcine-derived type I/III collagen as a cover (ACI-C), and the use of a collagen bilayer seeded with chondrocytes (MACI).
Aim: To determine whether differences in clinical, arthroscopic and histological outcomes at 1 year exist between ACI-C and MACI techniques.
Methods: We have performed a prospective randomised comparison of ACI-C versus MACI for the treatment of symptomatic chondral defects of the knee on 91 patients of whom 44 received ACI-C and 47 received MACI grafts.
Results: Both treatments resulted in improvements of clinical scores after 1 year. Mean modified Cincinnati knee scores increased by 17.5 in the ACI-C group and 19.6 in the MACI group (p> 0.05). Arthroscopic assessments performed after 1 year demonstrated good to excellent ICRS graft repair scores in 79% of ACI-C grafts and 67% of MACI grafts. Hyaline-like or hyaline-like cartilage with fibrocartilage was found in the biopsies of 43% of ACI-C grafts and 36% of MACI grafts after 1 year. The rate of graft hypertrophy was 9% in the ACI-C group and 6% in the MACI group. The frequency of re-operation was 9% in each group.
Conclusions: We conclude that clinical, arthroscopic and histological outcomes are comparable for both ACI-C and MACI techniques. While the MACI technique is technically attractive, further long-term studies are required before widespread adoption of this new technique.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
