Article
Treatment of cartilage defects of the knee with a three-dimensional collagen matrix and autologous chondrocytes
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Published: | June 13, 2005 |
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Outline
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Introduction
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.
Material and methods
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.
Results
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.
Conclusion
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.