Abstract
We sought to evaluate the effectiveness of autologous chondrocyte implantation (ACI)
for the treatment of adult osteochondritis dissecans (OCD) lesions according to patient-reported
outcomes, complication rates, and failure rates. A search of MEDLINE, Scopus, and
Cochrane Library was performed to identify clinical studies (levels I–IV) reporting
outcomes after ACI treatment for OCD in adult knees. Our inclusion criteria included
the following: (1) published between January 2000 and April 2017, (2) stable and unstable
OCD lesions of the knee, (3) use of ACI in at least one group, (4) subjects ≥18 years
old or skeletally mature, (5) inclusion of at least one patient-reported clinical
outcome measure, and (6) written in English. A total of nine studies (179 patients),
mean age of 27.6 years (range: 18–49 years), were included. There were 227 OCD lesions
with an average size of 4.1 cm2 (range: 1.2–9.4 cm2). The average follow-up was 61.3 months (range: 6.5–120 months). In general, there
was significant improvement in symptoms, but better results occurred among active
male patients with smaller lesions as well as younger patients. Statistically significant
improvement in patient-reported outcomes was reported in all studies. There were 23
complications reported (15.6%), including 12 failures (8.2%). Significant improvement
in clinical outcome measures demonstrates clinical efficacy of autologous cartilage
therapies for the treatment of OCD in adult patients. Better outcomes are often observed
with males, active patients, smaller lesion sizes, and younger age at the time of
surgery.
Keywords
autologous chondrocyte implantation - osteochondritis dissecans - microfracture -
matrix-induced autologous chondrocyte implantation
