Two- to 9-year outcome after autologous chondrocyte transplantation of theknee

Autologous cultured chondrocyte transplantation was introduced in Sweden in 1987 for the treatment of large (1.5-12.0 cm(2)) full thickness chondral d efects of the knee, The clinical, arthroscopic, and histologic results from the first 101 patients treated using this technique are reported in this s tudy. Patients were assessed retrospectively using three types of endpoints : patient and physician derived clinical rating scales (five validated and two new); arthroscopic assessment of cartilage fill, integration, and surfa ce hardness; and standard histochemical techniques. Ninety-four patients wi th 2- to 9-years followup were evaluable. Good to excellent clinical result s were seen in individual groups as follows: isolated femoral condyle (92%) , multiple lesions (67%), osteochondritis dissecans (89%), patella (65%), a nd femoral condyle with anterior cruciate ligament repair (75%), Arthroscop ic findings in 53 evaluated patients showed good repair tissue fill, good a dherence to underlying bone, seamless integration with adjacent cartilage, and hardness close to that of the adjacent tissue. Hypertrophic response of the periosteum or graft or both was identified in 26 arthroscopies; seven were symptomatic and resolved after arthroscopic trimming, Graft failure oc curred in seven (four of the first 23 and three of the next 78) patients. H istologic analysis of 37 biopsy specimens showed a correlation between hyal inelike tissue (hyaline matrix staining positive for Type II collagen and l acking a fibrous component) and good to excellent clinical results, The goo d clinical outcomes of autologous chondrocyte transplantation in this study are encouraging, and clinical trials are being done to assess the outcomes versus traditional fibrocartilage repair techniques.