Short- to Midterm Clinical and Radiological Outcomes After Matrix-Associated Autologous Chondrocyte Implantation for Chondral Defects in Knees

Xuesong Dai; Jinghua Fang; Siheng Wang; Jianyang Luo; Yan Xiong; Miaofeng Zhang; Sunan Zhu; Xinning Yu

doi:10.1177/2325967120982139

Short- to Midterm Clinical and Radiological Outcomes After Matrix-Associated Autologous Chondrocyte Implantation for Chondral Defects in Knees

Orthop J Sports Med. 2021 Feb 24;9(2):2325967120982139. doi: 10.1177/2325967120982139. eCollection 2021 Feb.

Authors

Xuesong Dai^{1

2}, Jinghua Fang^{1

2}, Siheng Wang^{1

2}, Jianyang Luo³, Yan Xiong^{1

2}, Miaofeng Zhang^{1

2}, Sunan Zhu^{1

2}, Xinning Yu^{1

2}

Affiliations

¹ Department of Orthopaedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
² Orthopaedics Research Institute, Zhejiang University, Hangzhou, China.
³ Department of Orthopaedic Surgery, Shaoxing Second Hospital, Shaoxing, China.

Abstract

Background: Matrix-associated autologous chondrocyte implantation (MACI) has been proven to provide favorable short-term results for chondral defects in knees. However, it remains unclear whether the clinical benefits of MACI persist in the longer term.

Purpose: The purpose of this prospective study was to evaluate the clinical and radiological outcomes, at short- and midterm follow-up, for patients undergoing MACI for focal chondral defects of the knee.

Study design: Case series; Level of evidence, 4.

Methods: A total of 30 consecutive patients (31 knees) were treated using MACI between October 2010 and March 2018. There were 24 male patients and 6 female patients with an average age of 26 years (range, 12-48 years). The areas of the cartilage defect were consistently >2 cm². All patients underwent MACI for a focal chondral defect of the femoral condyles or trochlea in the knee. These patients had been evaluated for up to 5 years, with an average follow-up of 44 months (range, 6-60 months) postoperatively.The International Knee Documentation Committee (IKDC) score, Lysholm score, and magnetic resonance imaging (MRI) with T2 mapping were used to assess the outcomes.

Results: No patients were lost to follow-up. Mean IKDC scores improved from 58.6 (range, 40.2-80.5) to 79.1 (range, 39.1-94.3) at 12 months and up to 88.4 (range, 83.9-100) at 5 years; mean Lysholm scores improved from 67.3 (range, 46-95) to 90.6 (range, 71-100) at 12 months and up to 95.9 (range, 85-100) at 5 years. The MRI with T2 mapping value of the transplanted area was evaluated for 21 knees, which revealed no differences compared with the normal area at 12 months postoperatively.

Conclusion: From the first year onward, the clinical outcome scores and MRI with T2 mapping values showed continuous and marked improvement, suggesting that MACI is a valid option for localized cartilage defects in the knee.

Keywords: articular cartilage; biologic healing enhancement; biology of cartilage; clinical assessment/grading scales; knee; matrix-induced autologous chondrocyte implantation.