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AUTOLOGOUS CHONDROCYTE IMPLANTATION IN THE KNEE – 2 YEARS FOLLOW UP RESULT OF A NON REFERRAL CENTRE



Abstract

Background: We aim to compare our final results of Autologous Chondrocyte Implantation in full thickness articular cartilage defects of the knee with the outcome as reported in the literature.

Material: 9 patients median age of 29 (range 24 to 42) were operated and assessed clinically with use of International Cartilage Repair Scoring (ICRS), VAS and oxford knee score pre operation and 3, 6, 12 months post operation. 66.6% of the patients had traumatic defect due to sport injury and was located on the medial femoral condyle.

Method: Arthroscopically slivers of cartilage (300 to 500 mg) were obtained from the upper minor load-bearing area of the medial femoral condyle of the injured knee for cell culture. Implantation was performed by open procedure following periosteal cover technique and use of fibrin glue as a bioscaffold 4 weeks after the biopsy.

All the patients started knee exercise with CPM from next day and allowed to bear partial weight on the operated knee for 8 weeks.

Result: 3 patients still had pain after one year follow-up. One case had mosaicoplasty after 8 months, which we consider as a failure and two of them had second Arthroscopy, trimming of part of repaired cartilage. 67.2% of the patients had a good or excellent result.

Conclusion: All patients showed improvement of clinical symptoms except one patient who failed at 8 months. We found our results are comparable as reported in the literature in this small cohort. This kind of surgery may be performed in a non referral hospital.

Correspondence should be addressed to Mr Bimal Singh, BOSA at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE