Transplantation of Tissue-engineered Cartilage for Repair of Osteochondral Defects in the Knee (SS-27)

Abstract

The use of chondral progenitor cells is an innovative therapeutic option for treatment of osteochondral lesions of the knee and this study was conducted to evaluate the clinical outcome at medium-term follow-up. Arthroscopic repair of osteochondral lesion of the knee by autologous highly committed chondrogenic precursors (Co.don AG, Teltow, Germany) was performed in twenty-three patients, 18 men and 5 women with a mean age of 29.2 ± 10.4 years. Fifteen lesions were located on medial femoral condyle, six on lateral and two on femoral throclea. The average size was 3.4 ± 1.0 cm(2). All patients were evaluated preoperatively and postoperatively using VAS score, Lysholm knee score and International Knee Documentation Committee(IKDC). Magnetic resonance imaging (MRI) examinations were performed at 12 and 24 months after surgery. Three patients had second-look arthroscopies and biopsies. No early or late complications related to arthroscopic procedure were reported. Median follow-up time was 39 months(36-41). Clinical evaluation showed significant improvement in the Lysholm score (from 54.8 to 82.5), IKDC (from 48.5 to 72.5) (P≤.001). The average VAS score decreased from a preoperative value of 5.6(SD:2.5) to 1.8(SD:2.0). The postoperative MRI examinations showed complete defect filling in 22 of 23 treated patients. The second-look arthroscopies and biopsies were done 18.5 ± 5.4 months after transplantation. All the second-look arthroscopies confirmed good integration of repair tissue to the adjacent cartilage and complete defect filling. Biopsies were categorized as hyaline cartilage in all cases. arthroscopic transplantation of autologous highly committed chondrogenic precursors is an effective and safe method of treating symptomatic osteochondral defects of the knee. The reported medium-term outcomes are encouraging, however, further study with longer follow-up are necessary to determine the inner endurance of reparative tissue and its structural integrity over time.