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Two- to 9-year outcome after autologous chondrocyte transplantation of the knee.

Artikel i vetenskaplig tidskrift
Författare Lars Peterson
T Minas
Mats Brittberg
Anders Nilsson
Eva Sjögren-Jansson
Anders Lindahl
Publicerad i Clinical orthopaedics and related research
Nummer/häfte 374
Sidor 212-34
ISSN 0009-921X
Publiceringsår 2000
Publicerad vid Institutionen för de kirurgiska disciplinerna, Avdelningen för ortopedi
Institutionen för laboratoriemedicin, Avdelningen för klinisk kemi/transfusionsmedicin
Sidor 212-34
Språk en
Länkar www.ncbi.nlm.nih.gov/entrez/query.f...
Ämnesord Activities of Daily Living, Adolescent, Adult, Arthroscopy, Biopsy, Cartilage Diseases, diagnosis, etiology, physiopathology, psychology, surgery, Chondrocytes, transplantation, Female, Humans, Knee Joint, Male, Middle Aged, Patient Satisfaction, Questionnaires, Retrospective Studies, Transplantation, Autologous, adverse effects, methods, psychology, Treatment Outcome
Ämneskategorier Ortopedi, Medicinsk bioteknologi (med inriktning mot cellbiologi (inklusive stamcellsbiologi), molekylärbiologi, mikrobiologi, biokemi eller biofarmaci)

Sammanfattning

Autologous cultured chondrocyte transplantation was introduced in Sweden in 1987 for the treatment of large (1.5-12.0 cm2) full thickness chondral defects of the knee. The clinical, arthroscopic, and histologic results from the first 101 patients treated using this technique are reported in this study. Patients were assessed retrospectively using three types of endpoints: patient and physician derived clinical rating scales (five validated and two new); arthroscopic assessment of cartilage fill, integration, and surface hardness; and standard histochemical techniques. Ninety-four patients with 2- to 9-years followup were evaluable. Good to excellent clinical results were seen in individual groups as follows: isolated femoral condyle (92%), multiple lesions (67%), osteochondritis dissecans (89%), patella (65%), and femoral condyle with anterior cruciate ligament repair (75%). Arthroscopic findings in 53 evaluated patients showed good repair tissue fill, good adherence to underlying bone, seamless integration with adjacent cartilage, and hardness close to that of the adjacent tissue. Hypertrophic response of the periosteum or graft or both was identified in 26 arthroscopies; seven were symptomatic and resolved after arthroscopic trimming. Graft failure occurred in seven (four of the first 23 and three of the next 78) patients. Histologic analysis of 37 biopsy specimens showed a correlation between hyalinelike tissue (hyaline matrix staining positive for Type II collagen and lacking a fibrous component) and good to excellent clinical results. The good clinical outcomes of autologous chondrocyte transplantation in this study are encouraging, and clinical trials are being done to assess the outcomes versus traditional fibrocartilage repair techniques.

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