J 2023

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, Tomáš OTAŠEVIČ et. al.

Basic information

Original name

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

Name (in English)

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

Authors

ŠIMURDA, J. (203 Czech Republic), Petr VALIŠ (203 Czech Republic, belonging to the institution), Marek ROUCHAL (203 Czech Republic, belonging to the institution), J. NOVAK (203 Czech Republic) and Tomáš OTAŠEVIČ (203 Czech Republic, belonging to the institution)

Edition

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

Other information

Language

Czech

Type of outcome

Článek v odborném periodiku

Field of Study

30211 Orthopaedics

Country of publisher

Czech Republic

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 0.400 in 2022

RIV identification code

RIV/00216224:14110/23:00133894

Organization unit

Faculty of Medicine

UT WoS

001178698100001

Keywords in English

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

Tags

Tags

Reviewed
Změněno: 27/3/2024 10:12, Mgr. Tereza Miškechová

Abstract

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.

In English

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.