Abstract
Objectives:
To evaluate the long-term clinical and magnetic resonance imaging outcomes of patients treated with an all-arthroscopic matrix-assisted autologous chondrocyte transplantation (MACT) technique for articular cartilage lesions of the knee.
Methods:
A total of 63 patients (21 women, 42 men) with a mean age of 35 ± 9.2 years, were treated with an all-arthroscopic MACT technique for articular cartilage lesions of the knee. Patients were prospectively evaluated preoperatively and after 2, 5, and 10 years of the surgery using multiple clinical scores: Lysholm, Tegner, International Knee Documentation Committee (IKDC), and the Knee injury and Osteoarthritis Outcome Score (KOOS); as well as with magnetic resonance imaging (MRI) T2-mapping at the same time points. Failure was defined as a reoperation because of symptoms caused by the primary repaired defect or a patient improvement of <10 points in the IKDC subjective score between the preoperative value and the final follow-up value.
Results:
Patients showed statistically significant clinical improvement in all PROM scores at 2, 5, and 10 years postoperative (PO) compared to their preoperative status. MRI T2-Mapping values of the repaired tissue decreased from 59.0 ± 14.6 ms preoperatively to 44.4 ± 15.6 ms at 10 years PO (P= 0.008), showing no statistical differences compared to the native cartilage values (39.1 ± 4.0 ms, P= 0.398). A surgical failure rate of 1.5% was documented, which was increased to 33% when clinical failures were also considered. Among all the analyzed factors linked to the likelihood of failure, lesions >4cm2 were the only ones to show statistical significance (P= 0.024).
Conclusions:
Patients treated with this arthroscopic MACT technique showed good and long-lasting clinical outcomes, as well as close to native cartilage characteristics on MRI T2-mapping. A limited number of failures were observed at 10 years PO, with most failures being in the first two years after treatment. Big chondral lesions (>4cm2) were found to have a greater likelihood of failing.