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Saturday, October 9, 2010, 11:15-11:50Session A20: Knee Arthritis: Early InterventionAutologous Chondrocyte Implantation Does Not Prevent the Need forArthroplasty in Patients With Pre-Existing OsteoarthritisBaljinder Dhinsa - Royal National Orthopaedic Hospital - Stanmore, United Kingdom*Zuhair Nawaz - Royal National Orthopaedic Hospital - Stanmore, United KingdomKieran Gallagher - Royal National Orthopaedic Hospital - Stanmore, United KingdomRichard Carrington - Royal National Orthopaedic Hospital - London, UKJohn Skinner - Royal National Orthopaedic Hospital Trust - Stanmore, UKTim Briggs - . - London, UKGeorge Bentley - Royal National Orthopaedic Hospital - Stanmore, United KingdomPurpose:*Email: zuhair.nawaz@rnoh.nhs.ukThe rate of arthroplasty or osteotomy in patients who had undergone autologous chondrocyteimplantation (ACI) for osteochondral defects in the knee was determined. Furthermore, weinvestigated whether any radiographic evidence of osteoarthritis (OA) prior to ACI wasassociated with poorer outcome following surgery.Methods:We retrospectively reviewed the medical notes and radiographs of 236 patients (mean age 34.9)who underwent ACI from 1998 to 2005 at our institution. Knee function was assessed accordingto the Modified Cincinnati Score (MCS) pre-operatively and at a mean of 64.3 monthspostoperatively (range 12 – 130). Radiographic changes were graded according to the Stanmoregrading system.Results:Patients were divided into 2 groups; Group A were patients with no evidence of OA (n=72) andGroup B were patients with OA (n=164). In group A, two patients required total kneereplacement (TKR) or unicondylar knee replacement (UKR) and 3 required high tibialosteotomy (overall revision rate 6.9%). In group B, 34 patients required patello-femoralreplacement, or UKR or TKR and 17 patients required osteotomy (overall revision rate 31.1%).This difference was significant (p < 0.01). At latest follow up, the mean MCS was significantlyhigher in Group A (72.5 versus 51.8, p < 0.01).Conclusions:Patients with early radiographic of evidence of OA are unlikely to gain maximum benefit fromACI. The results suggest that ACI does not prevent patients from progressing in their arthriticprocess and hence requiring joint replacement.file:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]