[en] An increasing number of patients with cartilage defects of the knee are being treated with autologous chondrocyte implantation (ACI). To date, no clear guidelines exist for the use and indications of this technique. The BVOT and SOBCOT have established a working group to review the clinical results and the cost-effectiveness of the various treatment modalities and particularly of ACI. This group has formulated recommendations and presents a treatment algorithm based on an in-depth review of recent European and American literature, on peer-reviewed opinions of leading investigators in the field and on a comparative analysis of the clinical results and health-economic aspects of current cartilage repair techniques.
Disciplines :
Surgery Orthopedics, rehabilitation & sports medicine
Author, co-author :
Vanlauwe, Johan
Almqvist, Frederik
Bellemans, Johan
Huskin, Jean-Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie appareil locomoteur
Verdonk, Rene
Victor, Jan
Language :
English
Title :
Repair of symptomatic cartilage lesions of the knee: the place of autologous chondrocyte implantation.
Almqvist KF, Wang L, Wang J et al. Culture of chondrocytes in alginate surrounded by fibrin gel: characteristics of the cells over a period of eight weeks. Ann Rheum Dis 2001; 60 8: 781-790.
Angermann P, Riegels-Nielsen P, Pedersen H. Osteochondritis dissecans of the femoral condyle treated with periosteal transplantation. Poor outcome in 14 patients followed for 6-9 years. Acta Orthop Scand 1998; 69 6: 595-597.
Aroen A, Loken S, Heir S et al. Articular cartilage lesions in 993 consecutive knee arthroscopies. Am J Sports Med 2004; 32: 211-215.
Aubin PP, Cheah HK, Davis AM et al. Long-term followup of fresh femoral osteochondral allografts for posttraumatic knee defects. Clin Orthop 2001; 391 Suppl, S318-S327.
Barbero A, Grogan S, Schafer D et al. Age related changes in human articular chondrocyte yield, proliferation and post-expansion chondrogenic capacity. Osteoarthritis Cartilage 2004; 12: 476-484.
Bartlett W, Gooding CR, Carrington RW et al. Autologous chondrocyte implantation at the knee using a bilayer collagen membrane with bone graft. A preliminary report. J Bone Joint Surg 2005; 87-B: 330-332.
Bartlett W, Skinner JA, Gooding CR et al. Autologous chondrocyte implantation versus matrix-induced autologous chondrocyte implantation for osteochondral defects of the knee: a prospective, randomised study. J Bone Joint Surg 2005; 87: 640-645.
Baumgaertner MR, Cannon WD, Jr., Vittori JM et al. Arthroscopic debridement of the arthritic knee. Clin Orthop 1990; 253: 197-202.
Behrens P, Bosch U, Bruns J et al. [Recommendations for indication and application of ACT of the Joined Advisory Board of the German Societies for Traumatology (DGU) and Orthopaedic Surgery (DGOOC).]. Z Orthop Ihre Grenzgeb 2004; 142: 529-539.
Bentley G, Biant LC, Carrington RW et al. A prospective, randomised comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects in the knee. J Bone Joint Surg 2003; 85-B: 223-230.
Benz K, Breit S, Lukoschek M et al. Molecular analysis of expansion, differentiation, and growth factor treatment of human chondrocytes identifies differentiation markers and growth-related genes. Biochem Biophys Res Commun 2002; 293: 284-292.
Bert JM. Role of abrasion arthroplasty and debridement in the management of osteoarthritis of the knee. Rheum Dis Clin North Am 1993; 19: 725-739.
Bert JM, Maschka K. The arthroscopic treatment of unicompartmental gonarthrosis: a five-year follow-up study of abrasion arthroplasty plus arthroscopic debridement and arthroscopic debridement alone. Arthroscopy 1989; 5: 25-32.
Billings E Jr, von Schroeder HP, Mai MT et al. Cartilage resurfacing of the rabbit knee. The use of an allogeneic demineralized bone matrix-autogeneic perichondrium composite implant. Acta Orthop Scand 1990; 61: 201-206.
Bobic V. Arthroscopic osteochondral autograft transplantation in anterior cruciate ligament reconstruction: a preliminary clinical study. Knee Surg Sports Traumatol Arthrosc 1996; 3: 262-264.
Bobic V. [Autologous osteo-chondral grafts in the management of articular cartilage lesions]. (German) Orthopäde. 1999; 28: 19-25.
Bonassar LJ, Frank EH, Murray JC et al. Changes in cartilage composition and physical properties due to stromelysin degradation. Arthritis Rheum 1995; 38 2: 173-183.
Brittberg M, Faxen E, Peterson L. Carbon fiber scaffolds in the treatment of early knee osteoarthritis. A prospective 4-year follow-up of 37 patients. Clin Orthop 1994; 307: 155-164.
Brittberg M, Lindahl A, Nilsson A et al. Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med 1994; 331 14: 889-895.
Brittberg M, Peterson L, Sjogren-Jansson E et al. Articular cartilage engineering with autologous chondrocyte transplantation. A review of recent developments. J Bone Joint Surg. 2003; 85-A Suppl 3, 109-115.
Brown WE, Potter HG, Marx RG et al. Magnetic resonance imaging appearance of cartilage repair in the knee. Clin Orthop 2004; 422: 214-223.
Buma P, Pieper JS, van Tienen T et al. Cross-linked type I and type II collagenous matrices for the repair of full-thickness articular cartilage defects-A study in rabbits. Biomaterials 2003; 24 19, 3255-3263.
Clar C, Cummins E, McIntyre L et al. Clinical and cost-effectiveness of autologous chondrocyte implantation for cartilage defects in knee joints: systematic review and economic evaluation. Health Technol Assess 2005; 9: 1-82.
Cohen SB, Meirisch CM, Wilson HA et al. The use of absorbable co-polymer pads with alginate and cells for articular cartilage repair in rabbits. Biomaterials 2003; 24: 2653-2660.
Curl WW, Krome J, Gordon ES et al. Cartilage injuries: a review of 31,516 knee arthroscopies. Arthroscopy 1997; 13: 456-460.
Dausse Y, Grossin L, Miralles G et al. Cartilage repair using new polysaccharidic biomaterials: macroscopic, histological and biochemical approaches in a rat model of cartilage defect. Osteoarthritis Cartilage 2003; 11: 16-28.
Dell'Accio F, De Bari C, Luyten FP. Molecular markers predictive of the capacity of expanded human articular chondrocytes to form stable cartilage in vivo. Arthritis Rheum 2001; 44: 1608-1619.
Dervin GF, Stiell IG, Rody K et al. Effect of arthroscopic debridement for osteoarthritis of the knee on health-related quality of life. J Bone Joint Surg 2003; 85-A: 10-19.
Domm C, Schunke M, Steinhagen J et al. Influence of various alginate brands on the redifferentiation of dedifferentiated bovine articular chondrocytes in alginate bead culture under high and low oxygen tension. Tissue Eng 2004; 10: 1796-1805.
Erggelet C, Sittinger M, Lahm A. The arthroscopic implantation of autologous chondrocytes for the treatment of full-thickness cartilage defects of the knee joint. Arthroscopy 2003; 19: 108-110.
Federico DJ, Lynch JK, Jokl P. Osteochondritis dissecans of the knee: a historical review of etiology and treatment. Arthroscopy 1990; 6: 190-197.
Fond J, Rodin D, Ahmad S et al. Arthroscopic debridement for the treatment of osteoarthritis of the knee: 2-and 5-year results. Arthroscopy 2002; 18: 829-834.
Freed LE, Marquis JC, Nohria A et al. Neocartilage formation in vitro and in vivo using cells cultured on synthetic biodegradable polymers. J Biomed Mater Res 1993; 27: 11-23.
Gaissmaier C, Fritz J, Krackhardt T et al. Effect of human platelet supernatant on proliferation and matrix synthesis of human articular chondrocytes in monolayer and three-dimensional alginate cultures. Biomaterials 2005; 26: 1953-1960.
Gaissmaier C, Fritz J, Mollenhauer J et al. Verlauf klinisch symptomatischer Knorpelschäden des Kniegelenks: Ergebnisse ohne und mit biologischer Rekonstruktion. Deutsches Ärzteblatt. 2003; 100: 2448-2453.
Gelb HJ, Glasgow SG, Sapega AA et al. Magnetic resonance imaging of knee disorders. Clinical value and cost-effectiveness in a sports medicine practice. Am J Sports Med 1996; 24: 99-103.
Gelber AC, Hochberg MC, Mead LA et al. Joint injury in young adults and risk for subsequent knee and hip osteoarthritis. Ann Intern Med 2000; 133: 321-328.
Gross AE. Repair of cartilage defects in the knee. J Knee Surg 2002; 15: 167-169.
Haddo O, Mahroof S, Higgs D et al. The use of chondrogide membrane in autologous chondrocyte implantation. Knee 2004; 11: 51-55.
Hambly K, Bobic V, Wondrasch B et al. Autologous chondrocyte implantation postoperative care and rehabilitation: Science and practice. Am J Sports Med 2006; 34: 1020-1038.
Hangody L, Feczko P, Bartha L et al. Mosaicplasty for the treatment of articular defects of the knee and ankle. Clin Orthop 2001; 391 Suppl, S328-S336.
Hangody L, Fules P. Autologous osteochondral mosaicplasty for the treatment of full-thickness defects of weight-bearing joints: ten years of experimental and clinical experience. J Bone Joint Surg 2003; 85-A Suppl 2: 25-32.
Hangody L, Karpati Z. [New possibilities in the management of severe circumscribed cartilage damage in the knee]. (Hungarian) Magy Traumatol Ortop Kezseb Plasztikai Seb 1994; 37: 237-243.
Hangody L, Rathonyi GK, Duska Z et al. Autologous osteochondral mosaicplasty. Surgical technique. J Bone Joint Surg 2004; 86-A Suppl 1: 65-72.
Hankemeier S, Muller EJ, Kaminski A et al. [10-year results of bone marrow stimulating therapy in the treatment of osteochondritis dissecans of the talus]. (German). Unfallchirurg 2003; 106: 461-466.
Harrison PE, Ashton IK, Johnson WE et al. The in vitro growth of human chondrocytes. Cell Tissue Bank 2000; 1: 255-260.
Henderson I, Tuy B, and Oakes B. Reoperation after autologous chondrocyte implantation. Indications and findings. J Bone Joint Surg 2004; 86-B: 205-211.
Hjelle K, Solheim E, Strand T et al. Articular cartilage defects in 1,000 knee arthroscopies. Arthroscopy 2002; 18: 730-734.
Homminga GN, Buma P, Koot HW et al. Chondrocyte behavior in fibrin glue in vitro. Acta Orthop Scand 1993; 64: 441-445.
Horas U, Pelinkovic D, Herr G et al. Autologous chondrocyte implantation and osteochondral cylinder transplantation in cartilage repair of the knee joint: a prospective, comparative trial. J Bone Joint Surg 2003; 85-A: 185-192.
Hubbard MJ. Articular debridement versus washout for degeneration of the medial femoral condyle. A five-year study. J Bone Joint Surg 1996; 78: 217-219.
Hunziker EB. Articular cartilage repair: basic science and clinical progress. A review of the current status and prospects. Osteoarthritis. Cartilage 2002; 10: 432-463.
Jakob RP, Franz T, Gautier E et al. Autologous osteochondral grafting in the knee: indication, results, and reflections. Clin Orthop 2002; 401: 170-184.
Johnson LL. Arthroscopic abrasion arthroplasty: a review. Clin Orthop 2001; 391 Suppl, S306-S317.
Johnson LL. A controlled trial of arthroscopic surgery for Osteoarthritis of the knee. Arthroscopy 2002; 18: 683-687.
Jones G, Ding C, Zhai G et al. Chondral defects: Genetic contribution and relevance and associations with pain, age, body mass index, joint surface area, cartilage volume and radiographic features of osteoarthritis. ACR Annual meeting. 2004.
Knutsen G, Engebretsen L, Ludvigsen TC et al. Autologous chondrocyte implantation compared with microfracture in the knee. A randomized trial. J Bone Joint Surg 2004; 86-A: 455-464.
Kreuz PC, Erggelet C, Steinwachs MR et al. Is microfracture of chondral defects in the knee associated with different results in patients aged 40 years or younger? Arthroscopy 2006; 22:1180-1186.
Krishnan SP, Skinner JA, Bartlett W et al. Who is the ideal candidate for autologous chondrocyte implantation? J Bone Joint Surg 2006; 88-B: 61-64.
Lemare F, Steimberg N, Le GC et al. Dedifferentiated chondrocytes cultured in alginate beads: restoration of the differentiated phenotype and of the metabolic responses to interleukin-1beta. J Cell Physiol 1998; 176: 303-313.
Lindahl A, Brittberg M, Peterson L. Health economics benefits following autologous chondrocyte transplantation for patients with focal chondral lesions of the knee. Knee Surg Sports Traumatol Arthrosc 2001; 9: 358-363.
Linden B. The incidence of osteochondritis dissecans in the condyles of the femur. Acta Orthop Scand 1976; 47: 664-667.
Madsen BL, Noer HH, Carstensen JP et al. Long-term results of periosteal transplantation in osteochondritis dissecans of the knee. Orthopedics 2000; 23: 223-226.
Mainil-Varlet P, Aigner T, Brittberg M et al. Histological assessment of cartilage repair: A report by the Histology Endpoint Committee of the International Cartilage Repair Society (ICRS). J Bone Joint Surg 2003; 85-A Suppl 2, 45-57.
Mandelbaum B, Gersoff WK, Bugbee WD et al. Articular cartilage injury in the athlete: treatment options in 2005. AAOS annual meeting. 2005; ICL 286.
Marcacci M, Berruto M, Brocchetta D. Articular cartilage engineering with Hyalograft(R) C: 3-Year clinical results. Clin Orthop 2005; 435: 96-105.
Marijnissen WJ, van Osch GJ, Aigner J et al. Alginate as a chondrocyte-delivery substance in combination with a non-woven scaffold for cartilage tissue engineering. Biomaterials 2002; 23: 1511-1517.
Marlovits S, Singer P, Zeller P et al. Magnetic resonance observation of cartilage repair tissue (MOCART) for the evaluation of autologous chondrocyte transplantation: Determination of interobserver variability and correlation to clinical outcome after 2 years. Eur J Radiol 2006; 57: 16-23.
Marlovits S, Striessnig G, Resinger CT et al. Definition of pertinent parameters for the evaluation of articular cartilage repair tissue with high-resolution magnetic resonance imaging. Eur J Radiol 2004; 52: 310-319.
Minas T. Chondrocyte implantation in the repair of chondral lesions of the knee: economics and quality of life. Am J Orthop 1998; 27: 739-744.
Minas T, Peterson L. Advanced techniques in autologous chondrocyte transplantation. Clin Sports Med 1999; 18: 13-44.
Mithofer K, Minas T, Peterson L et al. Functional outcome of knee articular cartilage repair in adolescent athletes. Am J Sports Med 2005; 33: 1147-1153.
Mithofer K, Williams RJ, III, Warren RF et al. The microfracture technique for the treatment of articular cartilage lesions in the knee. A prospective cohort study. J Bone Joint Surg 2005; 87: 1911-1920.
Moseley JB, O'Malley K, Petersen NJ et al. A controlled trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med 2002; 347: 81-88.
Nehrer S, Spector M, Minas T. Histologic analysis of tissue after failed cartilage repair procedures. Clin Orthop 1999; 365: 149-162.
Ogilvie-Harris DJ, Fitsialos DP. Arthroscopic management of the degenerative knee. Arthroscopy 1991; 7: 151-157.
Otte P. Physiologie der Gelenkerhaltung. In: Otte P. (ed). Der Arthrose-Prozess. Gelenkerhaltung - Gefährdung - Destruktion. Novartis Pharma Verlag, Nürnberg, 2000, pp 7-192.
Passler HH. [Microfracture for treatment of cartilage detects]. (German) Zentralbl Chir 2000; 125: 500-504.
Pavesio A, Abatangelo G, Borrione A et al. Hyaluronan-based scaffolds (Hyalograft C) in the treatment of knee cartilage defects: preliminary clinical findings. Novartis Found Symp 2003; 249: 203-217.
Peterson L, Minas T, Brittberg M et al. Treatment of osteochondritis dissecans of the knee with autologous chondrocyte transplantation: results at two to ten years. J Bone Joint Surg 2003; 85-A Suppl 2, 17-24.
Peterson L, Minas T, Brittberg M et al. Two- to 9-year outcome after autologous chondrocyte transplantation of the knee. Clin Orthop 2000; 374: 212-234.
Recht M, Bobic V, Burstein D et al. Magnetic resonance imaging of articular cartilage. Clin Orthop 2001; 391 Suppl, S379-S396.
Roberts S, Hollander AP, Caterson B et al. Matrix turnover in human cartilage repair tissue in autologous chondrocyte implantation. Arthritis Rheum 2001; 44: 2586-2598.
Roberts S, McCall IW, Darby AJ et al. Autologous chondrocyte implantation for cartilage repair: monitoring its success by magnetic resonance imaging and histology. Arthritis Res Ther 2003; 51: R60-R73.
Saris DB, Dhert WJ, Verbeut AJ. Joint homeostasis. The discrepancy between old and fresh defects in cartilage repair. J Bone Joint Surg 2003; 85-B: 1067-1076.
Schneider U,Andereya S. [First results of a prospective randomized clinical trial on traditional chondrocyte transplantation vs CaReS-Technology]. (German) Z Orthop Ihre Grenzgeb 2003; 141: 496-497.
Schuman L, Buma P, Versleyen D et al. Chondrocyte behaviour within different types of collagen gel in vitro. Biomaterials 1995; 16: 809-814.
Solchaga LA, Temenoff JS, Gao J et al. Repair of osteochondral defects with hyaluronan- and polyester-based scaffolds. Osteoarthritis Cartilage 2005; 13: 297-309.
Steadman JR, Briggs KK, Rodrigo JJ et al. Outcomes of microfracture for traumatic chondral defects of the knee: average 11-year follow-up. Arthroscopy 2003; 19: 477-484.
Steinwachs MR, Erggelet C, Lahm A et al. [Clinical and cell biology aspects of autologous chondrocytes transplantation]. (German) Unfallchirurg 1999; 102: 855-860.
van Susante JL, Buma P, Homminga GN et al. Chondrocyte-seeded hydroxyapatite for repair of large articular cartilage defects. A pilot study in the goat. Biomaterials 1998; 19: 2367-2374.
van Susante JL, Buma P, Schuman L et al. Resurfacing potential of heterologous chondrocytes suspended in fibrin glue in large full-thickness defects of femoral articular cartilage: an experimental study in the goat. Biomaterials 1999; 20: 1167-1175.
van Susante JL, Buma P, van Osch GJ et al. Culture of chondrocytes in alginate and collagen carrier gels. Acta Orthop Scand 1995; 66: 549-556.
Wakitani S, Goto T, Young RG et al. Repair of large full-thickness articular cartilage defects with allograft articular chondrocytes embedded in a collagen gel. Tissue Eng 1998; 4: 429-444.
Wildner M, Behren C, Sangha O. Economic evaluation of autologous chondrocyte transplantation (ACT). Arthroskopie 2000; 13: 123-131.
Wood JJ, Malek MA, Frassica FJ et al. Autologous cultured chondrocytes: adverse events reported to the United States Food and Drug Administration. J Bone Joint Surg 2006; 88-A: 503-507.
Zheng MH, King E, Kirilak Y et al. Molecular characterisation of chondrocytes in autologous chondrocyte implantation. Int J Mol Med 2004; 13: 623-628.
