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Document Title: Mithoefer-AJSM-Aug05.shtml
Article Title: Functional Outcome of Knee Articular Cartilage Repair in Adolescent Athletes
Authors: Kai Mithöfer, MD, Tom Minas, MD, Lars Peterson, MD, PhD, Howard Yeon, MD, and Lyle J. Micheli, MD.
Location:
Publication: American Journal of Sports Medicine, Baltimore, Maryland
Date: August 2005
Volume 33, pages 1147-1153
Keywords: Genzyme, Carticel, autologous chondrocyte implantation, articular-cartilage repair, adolescent, osteoarthritis.
(Reference-denoting numbers appear in the same font and point size as the document text. As with all Knee Library documents, this article is provided in full-text form, complete with all figures and tables.)
Comments: This study looked at adolescent athletes with full-thickness articular-cartilage damage (arising from various causes: osteochondritis dissecans, sports injuries, and in a few cases accompanied by ACL tearing and meniscal damage). The people in this study were treated with autologous chondrocyte transplantation (ACI, also known by the brand names Genzyme/Carticel). The surgery entails a three-step process: firstly, harvesting a small sample of the patient's own articular cartilage cells, and secondly, using these cells growing more articular cartilage from these cell in a laboratory setting, and thirdly, implanting these grown cells (chondrocytes) into the patient. Results were excellent at the mean 47 months post-implantation. Hopefully there will be long-term follow-up, since it would be interesting to follow these patients as they progress through life. Ideally, the patients would be followed up annually for the rest of their lives.
ABSTRACT
Background: Limited information exists about the treatment of full-thickness articular cartilage lesions of the knee in adolescent athletes.
Purpose: To evaluate the functional outcome and athletic activity after articular cartilage repair in the knees of adolescent athletes.
Study Design: Case series; Level of evidence, 4.
Methods: Twenty adolescent athletes with full-thickness articular cartilage lesions of the knee were treated with autologous chondrocyte transplantation. Functional outcome was evaluated by subjective patient outcome rating, knee activity scores, and level of athletic participation.
Results: At a mean of 47 months after autologous chondrocyte transplantation, 96% of adolescents reported good or excellent results with significant increases in postoperative Tegner activity scores and Lysholm scores. Ninety-six percent returned to high-impact sports and 60% to an athletic level equal or higher than that before knee injury. Return to preinjury sports correlated with shorter preoperative symptoms and a lower number of prior operations. All adolescents with preoperative symptoms 12 months returned to preinjury-level athletics, compared to 33% with preoperative intervals longer than 12 months.
Conclusion: Treatment of full-thickness articular injuries of the knee in adolescent athletes with autologous chondrocyte transplantation yields a high rate of functional success at a mean follow-up of 47 months. The rate of return to demanding athletic activities is higher in cases in which the preoperative duration of symptoms is 12 months or less.
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