Clinical outcomes and survival rate of autologous chondrocyte implantation with and without concomitant meniscus allograft transplantation: 10- to 15-year follow-up study.

Abstract

The purpose of this study was to compare the clinical outcomes and survival rate of autologous chondrocyte implantation (ACI) with or without concomitant meniscus allograft transplantation (MAT). Patients who underwent ACI of the medial or lateral femoral condyle with or without concomitant MAT were retrospectively reviewed. There were 14 patients (mean age, 31.2 ± 9.9years) who underwent isolated ACI and 19 patients who underwent ACI with concomitant MAT (mean age, 34.8 ± 8.4years). The International Knee Documentation Committee (IKDC) subjective score, Lysholm score, Tegner activity score, and 10- to 15-year survival rate were compared between groups. All clinical scores showed significant improvement postoperatively in both groups. At final follow-up, the IKDC subjective score was superior in isolated ACI (75.8 ± 18.4) compared to ACI with MAT (61.0 ± 16.6, p = 0.024). The Lysholm score was also higher in isolated ACI (77.5 ± 19.1) than ACI with MAT (62.5 ± 18.1, p = 0.029). The Tegner activity score did not differ between treatments (isolated ACI, 5.3 ± 1.1; ACI with MAT, 4.5 ± 1.3; p = 0.072). The 15-year survival rate for isolated ACI was higher than that of ACI with concomitant MAT (69.6% vs 50.2%), but this difference was not statistically significant (p = 0.19). ACI with concomitant MAT did not restore clinical outcomes as much as isolated ACI. There was a trend for the long-term survival rate to be greater in isolated ACI than ACI with MAT. These results should be considered in planning for the treatment of focal chondral defect with meniscus deficiency. Retrospective comparative trial; level of evidence, 3.