Managing Chondral Lesions: A Literature Review and Evidence-Based Clinical Guidelines.

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Abstract

Conflict of interest statement: Conflict of interestOn behalf of all authors, the corresponding author states that there is no conflict of interest. No financial aid of any nature was obtained from any source for this article. 19. J Orthop Sci. 2024 Jan;29(1):207-216. doi: 10.1016/j.jos.2022.12.001. Epub 2023 Jan 9. Atelocollagen-associated autologous chondrocyte implantation for the repair of large cartilage defects of the knee: Results at three to seven years. Kaibara T(1), Kondo E(2), Matsuoka M(3), Iwasaki K(4), Onodera T(5), Sakamoto K(6), Oda Y(7), Tanei ZI(8), Momma D(9), Tanaka S(10), Iwasaki N(11). Author information: (1)Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15, Nish-7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan. Electronic address: t-kaibara@eis.hokudai.ac.jp. (2)Centre for Sports Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo 060-8648, Japan. Electronic address: eijik@med.hokudai.ac.jp. (3)Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15, Nish-7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan. Electronic address: masatakem@pop.med.hokudai.ac.jp. (4)Department of Functional Reconstruction for the Knee Joint, Hokkaido University, Kita-15, Nish-7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan. Electronic address: rockcape324@gmail.com. (5)Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15, Nish-7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan. Electronic address: tomozou@med.hokudai.ac.jp. (6)Department of Diagnostic and Interventional Radiology, Hokkaido Univeresity Hospital, Kita-14, Nish-5, Kita-ku, Sapporo, Hokkaido 060-8648, Japan. Electronic address: ht_ks@hotmail.com. (7)Department of Cancer Pathology, Faculty of Medicine, Hokkaido University, Kita-15, Nish-7, Kita-ku, Sapporo, Japan. Electronic address: yoshitaka_oda_0622@yahoo.co.jp. (8)Department of Cancer Pathology, Faculty of Medicine, Hokkaido University, Kita-15, Nish-7, Kita-ku, Sapporo, Japan. Electronic address: tanei@med.hokudai.ac.jp. (9)Centre for Sports Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo 060-8648, Japan. Electronic address: d-momma@med.hokudai.ac.jp. (10)Department of Cancer Pathology, Faculty of Medicine, Hokkaido University, Kita-15, Nish-7, Kita-ku, Sapporo, Japan. Electronic address: tanaka@med.hokudai.ac.jp. (11)Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15, Nish-7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan. Electronic address: niwasaki@med.hokudai.ac.jp. BACKGROUND: Recently, various types of engineered autologous chondrocyte implantation (ACI) have been developed. Atelocollagen-associated ACI (A-ACI) is the only ACI procedure covered by Japanese Health Insurance since 2013. The indications of the A-ACI are traumatic cartilage defects and osteochondral dissecans (OCD) for knee joints. PURPOSE: To evaluate midterm clinical results after A-ACI for the treatment for full-thickness cartilage defects of the knee. METHODS: Thirteen consecutive patients who underwent A-ACI between 2014 and 2018 had been prospectively enrolled in this study. There were 11 men and 2 women with a mean age of 34 years at the time of surgery. The causes of the cartilage defect were trauma in 10 knees and OCD in 3 knees. The total number of lesions was 15, which were comprised of the medial femoral condyle in 5 knees, the lateral femoral condyle in 5 knees, and the femoral trochlea in 5 knees. The mean size of the lesion was 5.3 cm2. Each knee was clinically and radiologically evaluated preoperatively and postoperatively. RESULTS: The mean Lysholm score improved significantly from 74.0 points to 94.0 points (p = 0.008) and each subscale in Knee injury and Osteoarthritis Outcome Score improved significantly (p