Vyhodnocení klinických výsledků metody implantace solidního chondrograftu v léčbě chondrálních lézí kolenního kloubu po více než 10 letech

ŠIMURDA, J., Petr VALIŠ, Marek ROUCHAL, J. NOVAK a Tomáš OTAŠEVIČ. Vyhodnocení klinických výsledků metody implantace solidního chondrograftu v léčbě chondrálních lézí kolenního kloubu po více než 10 letech. Acta chirurgiae orthopaedicae et traumatologiae čechoslovaca. Praha: Galén, 2023, roč. 90, č. 6, s. 369-374. ISSN 0001-5415. Dostupné z: https://dx.doi.org/10.55095/ACHOT2023/044.

Základní údaje

Originální název

Vyhodnocení klinických výsledků metody implantace solidního chondrograftu v léčbě chondrálních lézí kolenního kloubu po více než 10 letech

Název anglicky

Evaluation of the Clinical Outcomes of Autologous Chondrocyte Implantation in the Management of Chondral Lesions of the Knee after 10+Years

Autoři

ŠIMURDA, J. (203 Česká republika), Petr VALIŠ (203 Česká republika, domácí), Marek ROUCHAL (203 Česká republika, domácí), J. NOVAK (203 Česká republika) a Tomáš OTAŠEVIČ (203 Česká republika, domácí)

Vydání

Acta chirurgiae orthopaedicae et traumatologiae čechoslovaca, Praha, Galén, 2023, 0001-5415

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Další údaje

Jazyk

čeština

Typ výsledku

Článek v odborném periodiku

Obor

30211 Orthopaedics

Stát vydavatele

Česká republika

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 0.400 v roce 2022

Kód RIV

RIV/00216224:14110/23:00133894

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.55095/ACHOT2023/044

UT WoS

001178698100001

Klíčová slova anglicky

knee joint; chondrocytes; autologous cartilage implantation; long-term

Štítky

14110217, rivok

Příznaky

Recenzováno

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Anotace

V originále

PURPOSE OF THE STUDY: The authors present the outcomes of more than ten-year clinical follow-up of patients who underwent surgical treatment of deep chondral defect of the knee (medial or lateral condyle). The method of treatment was the implantation of autologous cultured chondrocytes in the form of a solid chondral graft. The aim was also to compare the mid-term and long-term outcomes and to evaluate how the knee condition affects the everyday life and sports activities more than 10 years after surgery. MATERIAL AND METHODS: Thirty patients of the total of 56 patients (26 patients dropped out of the long-term follow-up) operated in the period between 2001 and 2012 were available for retrospective evaluation of the clinical condition before surgery, at 1, 2, 5 years after surgery and at 10+ years after surgery. The mean follow-up period of patients was 14.5 years (10 - 20.5 years) after surgery. The clinical evaluation was performed using the Lysholm Knee Scoring Scale and the Tegner Activity Scale. RESULTS: The mean preoperative Lysholm score of the followed-up study population was 37.5. During the first two years, improvement was achieved to the maximum value of 83.1. At 5 years and subsequently also at more than 10 years after surgery, a slight decline was reported to the mean value of 78.6. When comparing the outcomes at 5 years and at more than 10 years after surgery, the decline in the value was statistically non-significant. The mean value of the Tegner Activity Scale at more than 10 years after surgery was 4.5 points out of 10 points. DISCUSSION: Management of a chondral defect especially in younger patients constitutes a common challenge in everyday orthopaedic practice. There are multiple methods at hand, all of which have their pros and cons. The size of the chondral lesion appears to be the limiting and decisive factor. The greatest pitfall are large chondral lesions (>4cm2), where many methods fail to yield satisfactory outcomes. One of the suitable options is the autologous chondrocyte implantation method. CONCLUSIONS: The clinical outcomes of patients followed-up for more than 10 years after surgery do not show a statistically significant decline compared to the mid-term outcomes. Based on the data obtained, we continue to consider the autologous chondrocyte implantation as an effective method to manage deep chondral defects in the knee. The patients were mostly able to get back to normal life, including their sports activities, with a significant improvement of its quality compared to that before surgery.

Anglicky

PURPOSE OF THE STUDY: The authors present the outcomes of more than ten-year clinical follow-up of patients who underwent surgical treatment of deep chondral defect of the knee (medial or lateral condyle). The method of treatment was the implantation of autologous cultured chondrocytes in the form of a solid chondral graft. The aim was also to compare the mid-term and long-term outcomes and to evaluate how the knee condition affects the everyday life and sports activities more than 10 years after surgery. MATERIAL AND METHODS: Thirty patients of the total of 56 patients (26 patients dropped out of the long-term follow-up) operated in the period between 2001 and 2012 were available for retrospective evaluation of the clinical condition before surgery, at 1, 2, 5 years after surgery and at 10+ years after surgery. The mean follow-up period of patients was 14.5 years (10 - 20.5 years) after surgery. The clinical evaluation was performed using the Lysholm Knee Scoring Scale and the Tegner Activity Scale. RESULTS: The mean preoperative Lysholm score of the followed-up study population was 37.5. During the first two years, improvement was achieved to the maximum value of 83.1. At 5 years and subsequently also at more than 10 years after surgery, a slight decline was reported to the mean value of 78.6. When comparing the outcomes at 5 years and at more than 10 years after surgery, the decline in the value was statistically non-significant. The mean value of the Tegner Activity Scale at more than 10 years after surgery was 4.5 points out of 10 points. DISCUSSION: Management of a chondral defect especially in younger patients constitutes a common challenge in everyday orthopaedic practice. There are multiple methods at hand, all of which have their pros and cons. The size of the chondral lesion appears to be the limiting and decisive factor. The greatest pitfall are large chondral lesions (>4cm2), where many methods fail to yield satisfactory outcomes. One of the suitable options is the autologous chondrocyte implantation method. CONCLUSIONS: The clinical outcomes of patients followed-up for more than 10 years after surgery do not show a statistically significant decline compared to the mid-term outcomes. Based on the data obtained, we continue to consider the autologous chondrocyte implantation as an effective method to manage deep chondral defects in the knee. The patients were mostly able to get back to normal life, including their sports activities, with a significant improvement of its quality compared to that before surgery.