POSTER ABSTRACTS - ISAKOS

isk to the neurovascular structures and low risk of
capsular tethering. The potential disadvantages
are that it requires the use of a posterior portal
and the ability to tie knots arthroscopically.
E-poster #748
Arthroscopic Autologous Chondrocyte
Implantation for the Treatment of Chondral
Defects in the Tibial Plateau
Mario Ronga, Varese, ITALY, Presenter
Paolo Bulgheroni, Varese, ITALY
Federico A. Grassi, Varese, ITALY
Paolo Cherubino, Varese, ITALY
Eugenio Genovese, Varese, ITALY
Dipartimento di Ortopedia e Traumatologia,
Varese, ITALY
Aims: To evaluate the clinical-functional and MRI
results achieved in two patients, who underwent
arthroscopic autologous chondrocyte
implantation for the treatment of chondral defects
in the lateral tibial plate.
Methods and materials: The matrix-induced
autologous chondrocyte implantation (MACIÃ’)
technique, which requires the use of a
chondrocyte-seeded collagen membrane, was
performed arthroscopically on two male patients
affected by traumatic chondral lesions, sized
respectively 2.5 and 2 cm2. The procedures were
performed through traditional artrhoscopic
portals and the seeded membrane was fixed on
the defects with fibrin glue. Clinical-functional
evaluation was performed according to ICRS
score, modified Cincinnati knee score, IKDC,
Lysholm II and Tegner scales. MRIs (FSE Fat-Sat
T2, SE T1, GRE T2) were taken 6, 12 and 24
months postoperatively.
Results: No complications were observed in the
postoperative period. At two-year follow up, all
the clinical scores were improved in both patients.
MRI showed filling of the defects with hyaline-like
tissue with reduction of subchondral bone edema
and restoration of a regular articular surface.
Conclusions: Even though the MACIÃ’ technique
is mostly performed with an open procedure, the
site of these lesions could not be reached without
sacrifying tendinous and ligamentous structures
of the knee. The arthroscopic approach allowed to
achieve an optimal view of the lesion and
appeared the best solution for these patients. The
use of fibrin glue for fixating the seeded
membrane has made possible to perform the
procedure arthroscopically in a simple and safe
way. No specifically designed instruments were
used in these cases. The size of these defects was
too large for bone marrow stimulation techniques
and/or osteochondral grafts to be successful.
E-poster #749
Matrix-Induced Autologous Chondrocyte
Implantation (MACI): Clinical Results, MRI
Findings and Morphological Analysis of
Implants
Mario Ronga, Varese, ITALY, Presenter
Federico A. Grassi, Varese, ITALY
Eugenio Genovese, Varese, ITALY
Marina Protasoni, Varese, ITALY
Paolo Bulgheroni, Varese, ITALY
Paolo Cherubino, Varese, ITALY
Dipartimento di Ortopedia e Traumatologia,
Varese, ITALY
Aim: To prospectively evaluate clinical results and
MRI findings on a series of 47 patients treated by
Matrix-induced Autologous Chondrocyte
Implantation (MACI) for knee and ankle chondral
defects. Histological and ultrastructural analysis
of the implants were performed on 2 biopsies,
harvested from 2 patients who underwent a
second arthroscopic look in the knee.
Methods and materials: This series of patients
included 30 males and 17 females, with an
average age of 31.7 years (range, 17 to 55 years).
The sites of the defects were the following: 30
femoral condyle, 1 femoral trochlea, 4 patella, 2
lateral tibial plate, 5 talar dome, 3 femoral
condyle + patella, 1 lateral tibial plate + patella, 1
kissing lesion in the ankle. The average size of the
defects was 3.5 cm2 (range, 2 to 4.7 cm2). Clinicalfunctional
evaluation was carried out according to
ICRS score, modified Cincinnati knee score,
Lysholm II and Tegner scales. The AOFAS score
was used for the evaluation of the ankle. MRIs
(FSE FAT SAT T2, GE T2, SE T1) were taken before
the operation as well as at 6 and 12 months
postoperatively; at 2 years, arthro-MRI was
performed. Among 10 second arthroscopic looks
(4 knees, 6 ankles), two biopsies were carried out
after 2 years, respectively from the medial femoral
condyle and the patella. Light microscopy,
immunohistochemistry (type I and II collagen),
SEM and TEM were used for morphological
analysis.
Results: Follow-up averaged 25.6 months (range, 6
to 49 months). Two cases of knee hemarthron
were observed in the immediate postoperative
period; no other complications occurred. At the
latest follow up, knee scores improved after