gms | German Medical Science

The limited repair of articular cartilage is still a well-known problem. Although the clinical results of autologous chondrocyte transplantation were satisfactory, several problems are still remaining. The aim of this study was to evaluate early clinical results of a three-dimensional collagen matrix (CaReS^®) seeded with autologous chondrocytes in the treatment of deep cartilage defects.

25 patients (mean age 33.71) with chondral or osteochondral lesions of the medial or lateral femoral condyle (ICRS stage 3 or 4) were evaluated clinically (ICRS-score / IKDC-score) and radiologically (x-ray, MRI) before and after surgical treatment with a collagen I matrix seeded with autologous chondrocytes. The minimum follow-up period was 1 year.

During follow-up period the IKDC score increased from 38.96 pts. (preoperative) to 65.34 pts. 12 month after surgical treatment. The change versus baseline was 22.68 pts. (p-value <0.0001). Patients with a single lesion exhibited significant better results than patients with two or more lesions. In contrast there were no differences in the clinical outcome after surgical treatment between cartilage lesions grade 3 or 4. The value of IKDC-score was dependent on the defect size post debridement (mean change versus baseline after 12 month: defect size 4-6cm² 44.83 pts.). MRI showed a continuous integration of the transplants into the surrounding cartilage.

Early-term results of collagen I matrix transplantation seeded with autologous chondrocytes showed a distinct improvement in clinical and radiological parameters. Regarding to ACT, matrix based techniques could be a continuative step in cartilage reconstruction.