Profilaksa DVT kod velikih ortopedskih operacija - Depol ...

20 - 22 September 2012, Opatija, Croatia
RESULTS OF 2 ND GENERATION AUTOLOGOUS CHONDROCYTE
IMPLANTATION IN THE MANAGEMENT OF FOCAL ARTICULAR
CARTILAGE DEFECTS
Rutul Gandhi, B J Medical College, Ahmedabad, India
BACKGROUND: Autologous Chondrocyte Implantation is the most widely used cell based surgical procedure for
the repair of articular cartilage defects. Both short term and long term results are reported to be good or excellent
in 80 to 95 percent of cases. MRI has emerged as the procedure of choice for assessment of graft survival and cartilage
maturation after ACI and for predicting outcome and directing rehabilitation. In this study we intend to assess
the results of ACI in patients with focal articular defects and correlating the MRI findings with clinical outcome.
MATERIALS AND METHODS: Since July 2010, 12 patients with focal articular cartilage defects grade 3 or 4 according
to ICRS grading were treated with ACI. IKDC knee scores were calculated pre operatively and then at 6 months
and then at 12 months. All patients completed subjective knee evaluation forms before and at 6 months and 1
year after surgery. MRI was performed post procedure at 12 weeks and then at 12 months and MOCART scoring
done based on the studies. All adverse events recorded and all data analysed using appropriate tests.
OBSERVATIONS AND RESULTS:
1. Subjective evaluation and functional status: There was a significant improvement in the patients subjective
knee score from a mean of 40.5 points to 88.5 points at the end of 12 months. Before operation only 25%
graded their knee function as level I or II which significantly improved to 75% having grade I or II at 12 months
2. IKDC clinical score: Before operation 75% were classified as A or B using the IKDC objective scoring criteria,
which deteriorated to only 33.3% rated as A or B at 6 months. However again at 12 months there was a significant
clinical recovery with 83.3% rated as A or B.
3. MRI results and MOCART scores: The mean MOCART scores at 6 months were 80 which improved to 90 at 12
months. At 6 months 50% lesions showed normal or nearly normal scores which improved to 83.3% lesions
been graded as normal or nearly normal at 12 months.
CONCLUSIONS: ACI has emerged as one of the leading treatment strategies in management of focal articular
defects. These superior results are attributed to the capacity of ACI to produce hyaline articular cartilage. We recommend
12 months MRI to be a reasonable non invasive means of assessing the maturation of the graft after ACI.
Poster
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