Treatment of Full-Thickness Chondral Defects with Hyalograft C in the Knee: A Prospective Clinical Case Series with 2 to 7 Years’ Follow-up

Background Tissue engineering has become available for cartilage repair in clinical practice. Hypothesis The treatment of full-thickness chondral defects in the knee with a hyaluronan-based scaffold seeded with autolo-gous chondrocytes provides stable improvement of clinical outcome up to 7 years. S...

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Bibliographic Details
Published in:The American journal of sports medicine 2009-11, Vol.37 (1_suppl), p.81-87
Main Authors: Nehrer, Stefan, Dorotka, Ronald, Domayer, Stephan, Stelzeneder, David, Kotz, Rainer
Format: Article
Language:English
Subjects:
Adult
Arthritis
Austria
Cartilage, Articular - injuries
Cartilage, Articular - surgery
Chondrocytes - transplantation
Clinical outcomes
Female
Follow-Up Studies
Humans
Hyaluronic Acid - therapeutic use
Joint surgery
Knee
Knee Injuries - rehabilitation
Knee Injuries - surgery
Knee Joint - surgery
Male
Orthopedic Procedures - methods
Outcome Assessment (Health Care)
Prospective Studies
Tissue engineering
Tissue Scaffolds
Transplantation, Autologous - methods
Transplants & implants
Young Adult
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Summary:Background Tissue engineering has become available for cartilage repair in clinical practice. Hypothesis The treatment of full-thickness chondral defects in the knee with a hyaluronan-based scaffold seeded with autolo-gous chondrocytes provides stable improvement of clinical outcome up to 7 years. Study Design Case series; Level of evidence, 4. Methods Fifty-three patients with deep osteochondral defects in the knee were treated with Hyalograft C. The mean age at implantation was 32 6 12 years, the mean defect size was 4.4 6 1.9 cm2, and the mean body mass index was 24.5 6 3.8 kg/m2. Implantations were performed with miniarthrotomy or arthroscopy. The primary indications for implantation with Hyalograft C included young patients with a stable joint, normal knee alignment, and isolated chondral defects with otherwise healthy adjacent cartilage. The secondary indications were patients who did not meet the primary indication criteria or were salvage procedures. Forty-two patients with primary indications and 11 patients with secondary indications were evaluated. Outcome was evaluated with the International Cartilage Repair Society and International Knee Documentation Committee scales, the Lysholm score, the modified Cincinnati score, and with Kaplan-Meier survival analysis. Statistical analysis consisted of bivariate correlation analysis and unpaired, 2-tailed t tests. Results A highly significant increase (P
ISSN:0363-5465
1552-3365
DOI:10.1177/0363546509350704