POSTER ABSTRACTS - ISAKOS

found in IKDC grading form. In T2*-weighted MRI
after three months, resurfacing of OCD lesion and
union of the osteochondral fragments was
achieved in all patients. Donor site problems were
not observed in any cases.
[Discussion]
Although mosaicplasty is widely accepted to be
one of the successful treatments for the repair of
articular cartilage defects of the knee, the donor
site morbidity and articular congruence fit are still
potential problems. In the treatment of unstable
OCD lesions, if possible, we recommend the
Berlet technique to minimize these problems. This
technique also provides for biological internal
fixation and obviates the need for later removal of
internal fixation. An added benefit is the potential
stimulation of vascularization of the subchondral
bone surrounding the recipient sites, which may
help heal the OCD fragment.
E-poster #704
Autologous Chondrocyte Implantation for
Treatment of Focal Chondal Defects of the
Knee: A Clinical, Arthroscopic, MRI &
Histologic Evaluation at Two Years
Ian J Henderson, East Melbourne, VIC
AUSTRALIA, Presenter
Ramces Francisco, Manila, PHILIPPINES
Barry Oakes, Clayton, AUSTRALIA
Julie Cameron, Melbourne, AUSTRALIA
St Vincents & Mercy Private Hospital, Melbourne,
Victoria, AUSTRALIA
To determine the efficacy of autologous
chondrocyte implantation (ACI) in treating focal
chondral defects of the knee, we reviewed the two
year treatment outcome of ACI in 53 patients
through clinical evaluation, MRI, second-look
arthroscopy and core biopsies obtained.
From November 2000 to December 2003, 54
consecutive knees with 72 focal chondral defects
(grade III or IV by modified Outerbridge) were
treated with ACI using the Peterson periosteal
patch technique. In this method, an initial
arthroscopy was carried out to confirm the
suitability for repair and when appropriate, cells
were harvested either from the margins of the
lesion, the intercondylar notch or both. The
harvested cells were proliferated in vitro. Three to
four weeks later, the cells were implanted in the
defect with a medial or lateral parapatellar
arthrotomy approach. A standardized postoperative
rehabilitation protocol was carried out
depending on the site of the lesion or lesions.
Improvement in mean subjective score from preoperative
(37.6) to 12 months (56.4) and 24 (60.1)
months post-ACI were observed. Knee function
levels also improved (86% ICRS III/IV to 66.6% I/II)
from pre-operative period to 24 months postimplantation.
Objective IKDC score of A or B were
observed in 88% pre-operatively. This decreased
to 67.9% at three months before improving to
92.5% at 12 months and 94.4% at 24 months post
implantation. Transient deterioration in all these
clinical scores was observed at three months
before progressive improvement became evident.
MRI studies demonstrated 75.3% with at least 50%
defect fill, 46.3% with near normal signal, 68.1%
with mild/no effusion and also 66.7% with mild/no
underlying bone marrow edema at three months.
These values improved to 94.2%, 86.9%, 91.3% and
88.4% respectively at 12 months. At 24 months,
further improvement to 97%, 97%, 95.6% and
92.6% respectively were observed. Second-look
arthroscopy carried out in 22 knees (32 lesions)
demonstrated all grafts to be normal / nearly
normal based on the International Cartilage
Repair Society (ICRS) visual repair assessment
while core biopsies from 20 lesions demonstrated
13 (65%) grafts to have hyaline / hyaline-like
tissue.
Improvement in clinical and MRI findings
obtained from second-look arthroscopy and core
biopsies evaluated indicate that, at 24 months
post-ACI, the resurfaced focal chondral defects of
the knee remained intact and continued to
function well.
E-poster #705
Membranous/Matrix Autologous Chondrocyte
Implantation for the Treatment of Large
Chondral Defects in the Knee and Ankle
Pedro Guillen, M.D., Madrid, SPAIN,
Stephen P. Abelow, S. Lake Tahoe, CA USA
Presenter
Tomas Fernandez Jaen, M.D., Madrid, SPAIN
Clinica CEMTRO, Madrid, SPAIN
Purpose:
To examine the effectiveness of
Membrane/Matrix Autologous Chondrocyte
Implantation on large, full-thickness articular
cartilage lesions in athletes. This technique
theoretically reduces implant morbidity, avoids
the use of a periosteal patch, avoids the use of