caa a22 4500 605457611 CHVBK 20210128100224.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s00167-014-3295-8 doi (NATIONALLICENCE)springer-10.1007/s00167-014-3295-8 Matrix-induced autologous chondrocyte implantation (MACI) in the knee: clinical outcomes and challenges [Elektronische Daten] [Erhan Basad, Fabian Wissing, Patrick Fehrenbach, Markus Rickert, Jürgen Steinmeyer, Bernd Ishaque] Purpose: Matrix-induced autologous chondrocyte implantation (MACI) has demonstrated effectiveness in treating isolated cartilage defects of the knee but medium- and long-term evidence and information on the management of postoperative complications or partially successful cases are sparse. This study hypothesised that MACI is effective for up to 5years and that patients with posttreatment problems may go on to obtain clinical benefit from other interventions. Methods: A follow-on, prospective case series of patients recruited into a previous controlled, randomised, prospective study or newly enroled. Patients were followed up 6, 12, 24 and 60months after surgery. Outcome measures were Tegner (activity levels) and Lysholm (pain, stability, gait, clinical symptoms) scores. Zone-specific subgroups were analysed 6, 12 and 24months postoperatively. Results: Sixty-five patients were treated with MACI. Median Tegner score improved from II to IV at 12months; an improvement maintained to 60months. Mean Lysholm score improved from 28.5 to 76.6 points (±19.8) at 24months, settling back to 75.5 points after 5years (p>0.0001). No significant differences were identified in the zone-specific analysis. Posttreatment issues (N=12/18.5%) were resolved with microfracture, debridement, OATS or bone grafting. Conclusions: MACI is safe and effective in the majority of patients. Patients in whom treatment is only partially successful can go on to obtain clinical benefit from other cartilage repair options. This study adds to the clinical evidence on the MACI procedure, offers insight into likely treatment outcomes, and highlights MACI's usefulness as part of an armamentarium of surgical approaches to the treatment of isolated knee defects. Level of evidence: Prospective case control study with no control group, Level III. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA), 2014 Cartilage nationallicence Knee nationallicence Chondrocytes nationallicence Autologous transplantation nationallicence Matrix-induced autologous chondrocyte implantation nationallicence Basad Erhan ATOS Clinic, Center for Knee and Hip Replacement and Regenerative Joint Surgery, Bismarckstrasse 9-15, 69115, Heidelberg, Germany aut Wissing Fabian Department for Trauma and Orthopedic Surgery, Asklepios Klinik Langen, Röntgenstrasse 20, 63225, Langen, Germany aut Fehrenbach Patrick Sportklinik Stuttgart GmbH, Taubenheimstr. 8, 70372, Stuttgart, Germany aut Rickert Markus Department for Orthopaedic Surgery, Giessen University Hospital, Klinikstrasse 33, 35392, Giessen, Germany aut Steinmeyer Jürgen Laboratory for Experimental Orthopaedics, University of Giessen, Paul-Meimberg-Str.3, 35392, Giessen, Germany aut Ishaque Bernd Department for Orthopaedic Surgery, Giessen University Hospital, Klinikstrasse 33, 35392, Giessen, Germany aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/12(2015-12-01), 3729-3735 0942-2056 23:12<3729 2015 23 167 https://doi.org/10.1007/s00167-014-3295-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-3295-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Basad Erhan ATOS Clinic, Center for Knee and Hip Replacement and Regenerative Joint Surgery, Bismarckstrasse 9-15, 69115, Heidelberg, Germany aut NATIONALLICENCE 700 1- Wissing Fabian Department for Trauma and Orthopedic Surgery, Asklepios Klinik Langen, Röntgenstrasse 20, 63225, Langen, Germany aut NATIONALLICENCE 700 1- Fehrenbach Patrick Sportklinik Stuttgart GmbH, Taubenheimstr. 8, 70372, Stuttgart, Germany aut NATIONALLICENCE 700 1- Rickert Markus Department for Orthopaedic Surgery, Giessen University Hospital, Klinikstrasse 33, 35392, Giessen, Germany aut NATIONALLICENCE 700 1- Steinmeyer Jürgen Laboratory for Experimental Orthopaedics, University of Giessen, Paul-Meimberg-Str.3, 35392, Giessen, Germany aut NATIONALLICENCE 700 1- Ishaque Bernd Department for Orthopaedic Surgery, Giessen University Hospital, Klinikstrasse 33, 35392, Giessen, Germany aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/12(2015-12-01), 3729-3735 0942-2056 23:12<3729 2015 23 167