Abstract
To report arthroscopic second look as well as clinical results after arthroscopic autologous chondrocyte implantation (ACI) for articular cartilage repair at the knee joint. A second-look assessment after arthroscopic ACI using spheroides was performed in 41 patients with 57 full-size articular cartilage defects of the knee. The median time from ACI to second-look arthroscopy was 10 (6-72) months. The ACI was assessed macroscopically and by probing according to the International Cartilage Repair Score (ICRS)-Cartilage Repair Assessment (CRA) to get information on the amount and quality of regeneration. Clinical follow-up with subjective outcome scores was performed an average of 34.5±19.2months after ACI. Twenty-seven (65.8%) of ACI's were combined with additional procedures. The ICRS-CRA was rated "normal" or "nearly normal" in 52 of 57 (91.3%) and "abnormal" in 5 (8.8%) of all cartilage defects. At follow-up, evaluation of KOOS was an average of 81.0±12.9 for pain, 76.8±16.6 for symptoms, 85.1±14.9 for activities of daily living, 55.3±27.7 for sport and recreation and 50.6±23.8 for quality of live. IKDC was 63.0±18.8, Lysholm score was 79.0±18.0, and Tegner score was 4 (1-6). Subjective assessment according to the VAS scale was an average of 7.4±2.1 for overall satisfaction and 6.7±2.5 satisfaction for the operated knee. Seven patients (22.6%) showed low subjective outcome scores at last follow-up-of these, 2 patients showed a CRA 3 and 5 a CRA 1 or 2. At second-look arthroscopy, 52 (91.3%) of all cartilage defects showed a normal or nearly normal macroscopic articular cartilage regeneration after arthroscopic ACI using spheroides. Twenty-four patients (77.4%) showed good subjective clinical results. The high number of concomitant surgery reflexes the complex aetiology of cartilage lesions and complexity of treatment. Thus, a strict indication and surgical planing is necessary to avoid clinical failures. IV.
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