Loose Body Versus Trochlear Biopsy Matrix-Induced Autologous Chondrocyte Implantation (MACI) MOCART Scores and IKDC Reported Outcomes in Pediatric Patients.

Autor:	Hill Z; Department of Orthopaedic Surgery, UC Davis Medical Center., Delman C; Department of Orthopaedic Surgery, UC Davis Medical Center., Shelton T; Southern California Orthopedic Institute, Van Nuys, CA., Vander Voort W; Department of Orthopaedic Surgery, UC Davis Medical Center., Haus B; Department of Orthopaedic Surgery, Shriners Hospitals for Children-Northern California, UC Davis Medical Center, Sacramento.
Jazyk:	angličtina
Zdroj:	Journal of pediatric orthopedics [J Pediatr Orthop] 2023 Jan 01; Vol. 43 (1), pp. e25-e29. Date of Electronic Publication: 2022 Oct 17.
DOI:	10.1097/BPO.0000000000002279
Abstrakt:	Background: Matrix-induced autologous chondrocyte implantation (MACI) has shown promising results in the treatment of osteochondral lesions of the knee. A recent study showed similar viability comparing chondrocytes harvested from the intercondylar notch compared to those harvested from osteochondral loose bodies. However, there is limited evidence assessing how these different biopsies perform clinically. The goal of this study was to compare both radiographic and patient-reported outcomes in patients with patellar and femoral osteochondral lesions treated with MACI using either a standard intercondylar notch biopsy or an osteochondral loose body biopsy. Methods: A retrospective study was performed on all pediatric autologous chondrocyte implantation procedures performed from 2014 to 2017 at a single institution. Patients were divided into 2 groups: one group had cartilage derived from a standard intercondylar notch biopsy (n=9) and the other group had cartilage derived from an osteochondral loose body found within the ipsilateral knee (n=10). At a minimum of 1-year postimplantation, magnetic resonance imagings of the operative knee were performed and the Magnetic Resonance Observation of Cartilage Repair Tissue Knee Score (MOCART 2.0) knee score was used to assess the integrity and quality of the cartilage repair tissue. Interclass correlation coefficients were calculated between the 2 groups. International Knee Documentation Committee (IKDC) outcome scores were determined at a minimum 2 years post-implantation. Results: The interclass correlation coefficient between three independent examiners for the MOCART scoring was excellent at 0.94. With regards to the MOCART score, the loose body group had an insignificant 17-point lower median score at 63 [interquartile range (IQR): 58 to 89] compared to the intercondylar group at 80 (IQR: 65 to 90) ( P =0.15). There was no difference in IKDC scores with the loose body group having a median score of 82 (IQR: 65 to 95) and the intercondylar group having a median score of 84 (IQR: 53 to 99) ( P =0.90). Conclusion: These results demonstrate that osteochondral loose bodies can be used as viable harvest site in MACI procedures with no difference in functional and radiographic outcomes at 2 years postimplantation. This may limit both short and long-term donor site morbidity. Level of Evidence: Level III-retrospective comparative study. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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