Sustained Results in Long-Term Follow-Up of Autologous Chondrocyte Implantation (ACI) for Distal Femur Juvenile Osteochondritis Dissecans (JOCD)
Introduction. Concern regarding ability of autologous chondrocyte implantation (ACI) to correct for the bone and cartilage pathology of knee juvenile osteochondritis dissecans (JOCD) exists. The purpose of this study was to determine long-term, patient-based outcomes of ACI treatment of JOCD in youn...
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Wiley
2018-01-01
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| Series: | Advances in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2018/7912975 |
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| author | Jennifer J. Beck Dai Sugimoto Lyle Micheli |
| author_facet | Jennifer J. Beck Dai Sugimoto Lyle Micheli |
| author_sort | Jennifer J. Beck |
| collection | DOAJ |
| description | Introduction. Concern regarding ability of autologous chondrocyte implantation (ACI) to correct for the bone and cartilage pathology of knee juvenile osteochondritis dissecans (JOCD) exists. The purpose of this study was to determine long-term, patient-based outcomes of ACI treatment of JOCD in young patients. Authors hypothesized long-term outcomes are comparable to reported mid-term outcomes. Methods. A single institution, longitudinal cohort study design combining medical record review and outcome surveys was used. Inclusion criteria included isolated JOCD diagnosis, failed primary healing of operatively treated JOCD, ACI surgery > 5 years ago, and ≤20 years of age at time of ACI. Results. 10/26 eligible patients (38.5%) participated (M: F = 5:5, age at ACI: 18.3 ± 2.5 y, current age: 30.8 ± 5.1 y, and current BMI: 24.6 ± 2.1). Follow-up was 12.0 ± 4.5 y. Lesion size at ACI was 9.1 ± 1.9 cm2. Femoral condyle location was medial = 6 and lateral = 4. All required treatment at some point for knee symptoms after ACI. During the past one year, four patients required treatment. Patient reported outcome scores at 12 years following ACI were IKDC score: 73.0 ± 3.6, KOOS scores including pain [88.7 ± 2.3], symptoms [78.2 ± 4.6], activity of daily living [94.7 ± 1.9], function, sports, and recreational activities [73.0 ± 5.3], and quality of life [57.5 ± 5.8], and Modified Cincinnati Knee Rating score was 77.9 ± 4.1. A moderate to good relationship was found between KOOS symptoms and BMI and lesion size. Function, sports, and recreational activities of the KOOS were greater in participants who had ≤1 lesion prior to ACI procedures (p = 0.044). Conclusion. This study of ACI treatment of knee JOCD patients confirms sustained, long-term results. Number of lesions prior to ACI procedure influenced status of function, sports, and recreational activities. |
| format | Article |
| id | doaj-art-bcfb2ab0f0b34335a7fc93c75c743766 |
| institution | DOAJ |
| issn | 2090-3464 2090-3472 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advances in Orthopedics |
| spelling | doaj-art-bcfb2ab0f0b34335a7fc93c75c7437662025-08-20T03:23:18ZengWileyAdvances in Orthopedics2090-34642090-34722018-01-01201810.1155/2018/79129757912975Sustained Results in Long-Term Follow-Up of Autologous Chondrocyte Implantation (ACI) for Distal Femur Juvenile Osteochondritis Dissecans (JOCD)Jennifer J. Beck0Dai Sugimoto1Lyle Micheli2Orthopedic Institute for Children/UCLA, Los Angeles, CA, USAThe Micheli Center for Sports Injury Prevention, Waltham, MA, USAThe Micheli Center for Sports Injury Prevention, Waltham, MA, USAIntroduction. Concern regarding ability of autologous chondrocyte implantation (ACI) to correct for the bone and cartilage pathology of knee juvenile osteochondritis dissecans (JOCD) exists. The purpose of this study was to determine long-term, patient-based outcomes of ACI treatment of JOCD in young patients. Authors hypothesized long-term outcomes are comparable to reported mid-term outcomes. Methods. A single institution, longitudinal cohort study design combining medical record review and outcome surveys was used. Inclusion criteria included isolated JOCD diagnosis, failed primary healing of operatively treated JOCD, ACI surgery > 5 years ago, and ≤20 years of age at time of ACI. Results. 10/26 eligible patients (38.5%) participated (M: F = 5:5, age at ACI: 18.3 ± 2.5 y, current age: 30.8 ± 5.1 y, and current BMI: 24.6 ± 2.1). Follow-up was 12.0 ± 4.5 y. Lesion size at ACI was 9.1 ± 1.9 cm2. Femoral condyle location was medial = 6 and lateral = 4. All required treatment at some point for knee symptoms after ACI. During the past one year, four patients required treatment. Patient reported outcome scores at 12 years following ACI were IKDC score: 73.0 ± 3.6, KOOS scores including pain [88.7 ± 2.3], symptoms [78.2 ± 4.6], activity of daily living [94.7 ± 1.9], function, sports, and recreational activities [73.0 ± 5.3], and quality of life [57.5 ± 5.8], and Modified Cincinnati Knee Rating score was 77.9 ± 4.1. A moderate to good relationship was found between KOOS symptoms and BMI and lesion size. Function, sports, and recreational activities of the KOOS were greater in participants who had ≤1 lesion prior to ACI procedures (p = 0.044). Conclusion. This study of ACI treatment of knee JOCD patients confirms sustained, long-term results. Number of lesions prior to ACI procedure influenced status of function, sports, and recreational activities.http://dx.doi.org/10.1155/2018/7912975 |
| spellingShingle | Jennifer J. Beck Dai Sugimoto Lyle Micheli Sustained Results in Long-Term Follow-Up of Autologous Chondrocyte Implantation (ACI) for Distal Femur Juvenile Osteochondritis Dissecans (JOCD) Advances in Orthopedics |
| title | Sustained Results in Long-Term Follow-Up of Autologous Chondrocyte Implantation (ACI) for Distal Femur Juvenile Osteochondritis Dissecans (JOCD) |
| title_full | Sustained Results in Long-Term Follow-Up of Autologous Chondrocyte Implantation (ACI) for Distal Femur Juvenile Osteochondritis Dissecans (JOCD) |
| title_fullStr | Sustained Results in Long-Term Follow-Up of Autologous Chondrocyte Implantation (ACI) for Distal Femur Juvenile Osteochondritis Dissecans (JOCD) |
| title_full_unstemmed | Sustained Results in Long-Term Follow-Up of Autologous Chondrocyte Implantation (ACI) for Distal Femur Juvenile Osteochondritis Dissecans (JOCD) |
| title_short | Sustained Results in Long-Term Follow-Up of Autologous Chondrocyte Implantation (ACI) for Distal Femur Juvenile Osteochondritis Dissecans (JOCD) |
| title_sort | sustained results in long term follow up of autologous chondrocyte implantation aci for distal femur juvenile osteochondritis dissecans jocd |
| url | http://dx.doi.org/10.1155/2018/7912975 |
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