Abstract
Autologous chondrocyte implantation (ACI) is an effective method of treatment of chondral
defects of the knee. ACI outcomes are influenced by patient-, knee-, and lesion-specific
factors. We compiled subject-level data from current studies on ACI and quantitatively
analyzed this data set for associations between patient-, knee-, and lesion-specific
factors and the outcome of ACI surgery. A systematic review of studies investigating
ACI treatment outcomes in the knee was performed. Only studies that published subject-level
data were included. Data on patient and lesion characteristics, as well as clinical
outcome scores, were collected. Thirteen studies (305 defects) were included in this
review. These studies showed that ACI treatment improves clinical outcomes in different
patient populations. However, subject-specific variables such as patient age, gender,
body mass index, duration of preoperative symptoms, as well as defect size and location
were not associated with International Knee Documentation Committee score or visual
analog scale score changes (p > 0.05 for all). Covariate analysis showed that patient age was related to symptom
duration prior to surgery (p = 0.009). ACI surgery has been shown to improve outcomes in patients with chondral
lesions of the knee. Despite evidence in the literature showing that multiple patient-,
knee-, and lesion-specific factors may influence treatment outcomes, our review shows
that these factors, solely, do not affect outcomes. However, together, they may synergistically
affect outcomes.
Keywords
autologous chondrocyte implantation (ACI) - outcomes - chondral lesion
