Revision surgery after third generation autologous chondrocyte implantation in the knee
Purpose Third generation autologous chondrocyte implantation (ACI) is an established treatment for full thickness cartilage defects in the knee joint. However, little is known about cases when revision surgery is needed. The aim of the present study is to investigate the complication rates and the m...
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| Veröffentlicht in: | International orthopaedics 2015-08, Vol.39 (8), p.1615-1622 |
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| creator | Niethammer, Thomas Valentin, Siegfried Ficklscherer, Andreas Gülecyüz, Mehmet Pietschmann, Matthias Müller, Peter |
| description | Purpose
Third generation autologous chondrocyte implantation (ACI) is an established treatment for full thickness cartilage defects in the knee joint. However, little is known about cases when revision surgery is needed. The aim of the present study is to investigate the complication rates and the main reasons for revision surgery after third generation autologous chondrocyte implantation in the knee joint. It is of particular interest to examine in which cases revision surgery is needed and in which cases a “wait and see” strategy should be used.
Methods
A total of 143 consecutive patients with 171 cartilage defects were included in this study with a minimum follow-up of two years. All defects were treated with third generation ACI (NOVACART®3D). Clinical evaluation was carried out after six months, followed by an annual evaluation using the International Knee Documentation Committee (IKDC) subjective score and the visual analogue scale (VAS) for rest and during activity. Revision surgery was documented.
Results
The revision rate was 23.4 % (
n
= 36). The following major reasons for revision surgery were found in our study: symptomatic bone marrow edema (8.3 %,
n
= 3), arthrofibrosis (22.2 %,
n
= 8) and partial graft cartilage deficiency (47.2 %,
n
= 17). The following revision surgery was performed: retrograde drilling combined with Iloprost infusion therapy for bone marrow oedema (8.4 %,
n
= 3), arthroscopic arthrolysis of the suprapatellar recess (22.2 %,
n
= 8) and microfracturing/antegrade drilling (47.3 %,
n
= 17). Significant improvements of clinical scores after revision surgery were observed.
Conclusion
Revision surgery after third generation autologous chondrocyte implantation is common and is needed primarily in cases with arthrofibrosis, partial graft cartilage deficiency and symptomatic bone marrow oedema resulting in a significantly better clinical outcome. |
| doi_str_mv | 10.1007/s00264-015-2792-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1698960229</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1698960229</sourcerecordid><originalsourceid>FETCH-LOGICAL-c414t-e7f6c5164b0d33ee22474981b4c022877982e1beb3f77547c2e7d65a423449a23</originalsourceid><addsrcrecordid>eNp9kMtOwzAQRS0EoqXwAWxQlmwC9sSO4yWqeEmVkBCIpZXHpE1J4mI7SP17HKWwZDWLOfdq5hByyegNo1TeOkoh5TFlIgapIFZHZM54ArFgShyTOU04iyFVYkbOnNtSymSasVMyA6G4VBTm5OMVvxvXmD5yg12j3Ud57dFGftPYKlpjjzb34zofvGnN2gwuKjemr6wp9x6jptu1ee8npulDDqPPHvGcnNR56_DiMBfk_eH-bfkUr14en5d3q7jkjPsYZZ2WgqW8oFWSIAJwyVXGCl5SgExKlQGyAoukllJwWQLKKhU5h4RzlUOyINdT786arwGd113jSmzDURhu1SxVmUpDlwoom9DSGucs1npnmy63e82oHn3qyacOPvXoU4-Zq0P9UHRY_SV-BQYAJsCFVR8E6q0ZbB9e_qf1B8MHgNs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1698960229</pqid></control><display><type>article</type><title>Revision surgery after third generation autologous chondrocyte implantation in the knee</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>SpringerNature Journals</source><creator>Niethammer, Thomas ; Valentin, Siegfried ; Ficklscherer, Andreas ; Gülecyüz, Mehmet ; Pietschmann, Matthias ; Müller, Peter</creator><creatorcontrib>Niethammer, Thomas ; Valentin, Siegfried ; Ficklscherer, Andreas ; Gülecyüz, Mehmet ; Pietschmann, Matthias ; Müller, Peter</creatorcontrib><description>Purpose
Third generation autologous chondrocyte implantation (ACI) is an established treatment for full thickness cartilage defects in the knee joint. However, little is known about cases when revision surgery is needed. The aim of the present study is to investigate the complication rates and the main reasons for revision surgery after third generation autologous chondrocyte implantation in the knee joint. It is of particular interest to examine in which cases revision surgery is needed and in which cases a “wait and see” strategy should be used.
Methods
A total of 143 consecutive patients with 171 cartilage defects were included in this study with a minimum follow-up of two years. All defects were treated with third generation ACI (NOVACART®3D). Clinical evaluation was carried out after six months, followed by an annual evaluation using the International Knee Documentation Committee (IKDC) subjective score and the visual analogue scale (VAS) for rest and during activity. Revision surgery was documented.
Results
The revision rate was 23.4 % (
n
= 36). The following major reasons for revision surgery were found in our study: symptomatic bone marrow edema (8.3 %,
n
= 3), arthrofibrosis (22.2 %,
n
= 8) and partial graft cartilage deficiency (47.2 %,
n
= 17). The following revision surgery was performed: retrograde drilling combined with Iloprost infusion therapy for bone marrow oedema (8.4 %,
n
= 3), arthroscopic arthrolysis of the suprapatellar recess (22.2 %,
n
= 8) and microfracturing/antegrade drilling (47.3 %,
n
= 17). Significant improvements of clinical scores after revision surgery were observed.
Conclusion
Revision surgery after third generation autologous chondrocyte implantation is common and is needed primarily in cases with arthrofibrosis, partial graft cartilage deficiency and symptomatic bone marrow oedema resulting in a significantly better clinical outcome.</description><identifier>ISSN: 0341-2695</identifier><identifier>EISSN: 1432-5195</identifier><identifier>DOI: 10.1007/s00264-015-2792-9</identifier><identifier>PMID: 25947902</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Cartilage, Articular - injuries ; Cartilage, Articular - surgery ; Chondrocytes - transplantation ; Female ; Humans ; Knee Joint - surgery ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Paper ; Orthopedic Procedures - methods ; Orthopedics ; Pain Measurement ; Reoperation ; Transplantation, Autologous ; Watchful Waiting</subject><ispartof>International orthopaedics, 2015-08, Vol.39 (8), p.1615-1622</ispartof><rights>SICOT aisbl 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c414t-e7f6c5164b0d33ee22474981b4c022877982e1beb3f77547c2e7d65a423449a23</citedby><cites>FETCH-LOGICAL-c414t-e7f6c5164b0d33ee22474981b4c022877982e1beb3f77547c2e7d65a423449a23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00264-015-2792-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00264-015-2792-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25947902$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Niethammer, Thomas</creatorcontrib><creatorcontrib>Valentin, Siegfried</creatorcontrib><creatorcontrib>Ficklscherer, Andreas</creatorcontrib><creatorcontrib>Gülecyüz, Mehmet</creatorcontrib><creatorcontrib>Pietschmann, Matthias</creatorcontrib><creatorcontrib>Müller, Peter</creatorcontrib><title>Revision surgery after third generation autologous chondrocyte implantation in the knee</title><title>International orthopaedics</title><addtitle>International Orthopaedics (SICOT)</addtitle><addtitle>Int Orthop</addtitle><description>Purpose
Third generation autologous chondrocyte implantation (ACI) is an established treatment for full thickness cartilage defects in the knee joint. However, little is known about cases when revision surgery is needed. The aim of the present study is to investigate the complication rates and the main reasons for revision surgery after third generation autologous chondrocyte implantation in the knee joint. It is of particular interest to examine in which cases revision surgery is needed and in which cases a “wait and see” strategy should be used.
Methods
A total of 143 consecutive patients with 171 cartilage defects were included in this study with a minimum follow-up of two years. All defects were treated with third generation ACI (NOVACART®3D). Clinical evaluation was carried out after six months, followed by an annual evaluation using the International Knee Documentation Committee (IKDC) subjective score and the visual analogue scale (VAS) for rest and during activity. Revision surgery was documented.
Results
The revision rate was 23.4 % (
n
= 36). The following major reasons for revision surgery were found in our study: symptomatic bone marrow edema (8.3 %,
n
= 3), arthrofibrosis (22.2 %,
n
= 8) and partial graft cartilage deficiency (47.2 %,
n
= 17). The following revision surgery was performed: retrograde drilling combined with Iloprost infusion therapy for bone marrow oedema (8.4 %,
n
= 3), arthroscopic arthrolysis of the suprapatellar recess (22.2 %,
n
= 8) and microfracturing/antegrade drilling (47.3 %,
n
= 17). Significant improvements of clinical scores after revision surgery were observed.
Conclusion
Revision surgery after third generation autologous chondrocyte implantation is common and is needed primarily in cases with arthrofibrosis, partial graft cartilage deficiency and symptomatic bone marrow oedema resulting in a significantly better clinical outcome.</description><subject>Adult</subject><subject>Aged</subject><subject>Cartilage, Articular - injuries</subject><subject>Cartilage, Articular - surgery</subject><subject>Chondrocytes - transplantation</subject><subject>Female</subject><subject>Humans</subject><subject>Knee Joint - surgery</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Paper</subject><subject>Orthopedic Procedures - methods</subject><subject>Orthopedics</subject><subject>Pain Measurement</subject><subject>Reoperation</subject><subject>Transplantation, Autologous</subject><subject>Watchful Waiting</subject><issn>0341-2695</issn><issn>1432-5195</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtOwzAQRS0EoqXwAWxQlmwC9sSO4yWqeEmVkBCIpZXHpE1J4mI7SP17HKWwZDWLOfdq5hByyegNo1TeOkoh5TFlIgapIFZHZM54ArFgShyTOU04iyFVYkbOnNtSymSasVMyA6G4VBTm5OMVvxvXmD5yg12j3Ud57dFGftPYKlpjjzb34zofvGnN2gwuKjemr6wp9x6jptu1ee8npulDDqPPHvGcnNR56_DiMBfk_eH-bfkUr14en5d3q7jkjPsYZZ2WgqW8oFWSIAJwyVXGCl5SgExKlQGyAoukllJwWQLKKhU5h4RzlUOyINdT786arwGd113jSmzDURhu1SxVmUpDlwoom9DSGucs1npnmy63e82oHn3qyacOPvXoU4-Zq0P9UHRY_SV-BQYAJsCFVR8E6q0ZbB9e_qf1B8MHgNs</recordid><startdate>20150801</startdate><enddate>20150801</enddate><creator>Niethammer, Thomas</creator><creator>Valentin, Siegfried</creator><creator>Ficklscherer, Andreas</creator><creator>Gülecyüz, Mehmet</creator><creator>Pietschmann, Matthias</creator><creator>Müller, Peter</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150801</creationdate><title>Revision surgery after third generation autologous chondrocyte implantation in the knee</title><author>Niethammer, Thomas ; Valentin, Siegfried ; Ficklscherer, Andreas ; Gülecyüz, Mehmet ; Pietschmann, Matthias ; Müller, Peter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c414t-e7f6c5164b0d33ee22474981b4c022877982e1beb3f77547c2e7d65a423449a23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Cartilage, Articular - injuries</topic><topic>Cartilage, Articular - surgery</topic><topic>Chondrocytes - transplantation</topic><topic>Female</topic><topic>Humans</topic><topic>Knee Joint - surgery</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Paper</topic><topic>Orthopedic Procedures - methods</topic><topic>Orthopedics</topic><topic>Pain Measurement</topic><topic>Reoperation</topic><topic>Transplantation, Autologous</topic><topic>Watchful Waiting</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Niethammer, Thomas</creatorcontrib><creatorcontrib>Valentin, Siegfried</creatorcontrib><creatorcontrib>Ficklscherer, Andreas</creatorcontrib><creatorcontrib>Gülecyüz, Mehmet</creatorcontrib><creatorcontrib>Pietschmann, Matthias</creatorcontrib><creatorcontrib>Müller, Peter</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International orthopaedics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Niethammer, Thomas</au><au>Valentin, Siegfried</au><au>Ficklscherer, Andreas</au><au>Gülecyüz, Mehmet</au><au>Pietschmann, Matthias</au><au>Müller, Peter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Revision surgery after third generation autologous chondrocyte implantation in the knee</atitle><jtitle>International orthopaedics</jtitle><stitle>International Orthopaedics (SICOT)</stitle><addtitle>Int Orthop</addtitle><date>2015-08-01</date><risdate>2015</risdate><volume>39</volume><issue>8</issue><spage>1615</spage><epage>1622</epage><pages>1615-1622</pages><issn>0341-2695</issn><eissn>1432-5195</eissn><abstract>Purpose
Third generation autologous chondrocyte implantation (ACI) is an established treatment for full thickness cartilage defects in the knee joint. However, little is known about cases when revision surgery is needed. The aim of the present study is to investigate the complication rates and the main reasons for revision surgery after third generation autologous chondrocyte implantation in the knee joint. It is of particular interest to examine in which cases revision surgery is needed and in which cases a “wait and see” strategy should be used.
Methods
A total of 143 consecutive patients with 171 cartilage defects were included in this study with a minimum follow-up of two years. All defects were treated with third generation ACI (NOVACART®3D). Clinical evaluation was carried out after six months, followed by an annual evaluation using the International Knee Documentation Committee (IKDC) subjective score and the visual analogue scale (VAS) for rest and during activity. Revision surgery was documented.
Results
The revision rate was 23.4 % (
n
= 36). The following major reasons for revision surgery were found in our study: symptomatic bone marrow edema (8.3 %,
n
= 3), arthrofibrosis (22.2 %,
n
= 8) and partial graft cartilage deficiency (47.2 %,
n
= 17). The following revision surgery was performed: retrograde drilling combined with Iloprost infusion therapy for bone marrow oedema (8.4 %,
n
= 3), arthroscopic arthrolysis of the suprapatellar recess (22.2 %,
n
= 8) and microfracturing/antegrade drilling (47.3 %,
n
= 17). Significant improvements of clinical scores after revision surgery were observed.
Conclusion
Revision surgery after third generation autologous chondrocyte implantation is common and is needed primarily in cases with arthrofibrosis, partial graft cartilage deficiency and symptomatic bone marrow oedema resulting in a significantly better clinical outcome.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>25947902</pmid><doi>10.1007/s00264-015-2792-9</doi><tpages>8</tpages></addata></record> |
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| ispartof | International orthopaedics, 2015-08, Vol.39 (8), p.1615-1622 |
| issn | 0341-2695 1432-5195 |
| language | eng |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; SpringerNature Journals |
| subjects | Adult Aged Cartilage, Articular - injuries Cartilage, Articular - surgery Chondrocytes - transplantation Female Humans Knee Joint - surgery Male Medicine Medicine & Public Health Middle Aged Original Paper Orthopedic Procedures - methods Orthopedics Pain Measurement Reoperation Transplantation, Autologous Watchful Waiting |
| title | Revision surgery after third generation autologous chondrocyte implantation in the knee |
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