Rates and predictors of reimplantation of matrix-induced autologous chondrocyte implantation following first stage cartilage harvest: A cohort study.

Autor: Mason TW; Wake Forest University School of Medicine, Winston-Salem, NC, United States of America. Electronic address: twmason@wakehealth.edu., Gwilt MS; Wake Forest University School of Medicine, Winston-Salem, NC, United States of America., Glover MA; Wake Forest University School of Medicine, Winston-Salem, NC, United States of America., Villa RS; Wake Forest University School of Medicine, Winston-Salem, NC, United States of America., van der List JP; Atrium Health Wake Forest Baptist, Department of Orthopaedic Surgery and Rehabilitation, Winston-Salem, NC, United States of America., Trasolini NA; Wake Forest University School of Medicine, Winston-Salem, NC, United States of America; Atrium Health Wake Forest Baptist, Department of Orthopaedic Surgery and Rehabilitation, Winston-Salem, NC, United States of America., Waterman BR; Wake Forest University School of Medicine, Winston-Salem, NC, United States of America; Atrium Health Wake Forest Baptist, Department of Orthopaedic Surgery and Rehabilitation, Winston-Salem, NC, United States of America.
Jazyk: angličtina
Zdroj: The Knee [Knee] 2024 Jun; Vol. 48, pp. 257-264. Date of Electronic Publication: 2024 May 23.
DOI: 10.1016/j.knee.2024.04.006
Abstrakt: Purpose: To assess the reimplantation rate and predictors of patients requiring second-staged matrix-induced autologous chondrocyte implantation (MACI) reimplantation after initial first stage cartilage biopsy.
Methods: A retrospective review was performed from 2018 to 2022 among patients who underwent only phase I MACI biopsy procedure (biopsy group) or both phase I with transition to phase II implantation of chondrocytes (implantation group) at a single tertiary center. Demographic, qualitative, and quantitative measurements were recorded, and univariate and multivariate regression analysis was performed to assess predictors of ultimately requiring second stage MACI implantation.
Results: A total of 71 patients (51% female, age 27.7 ± 10.6 years (range 12-50)) were included in this study. Eventually, 25 of 71 patients (35.2%) experienced persistence of symptoms after initial MACI biopsy and other concomitant procedures, requiring second-stage implantation. Univariate analysis showed the implantation group compared to the biopsy group had a greater lesion size (5.2 cm 2  ± 3.3 vs. 3.3 cm 2  ± 1.4, p = 0.024), a higher proportion patients ≥ 26 years of age (76% vs. 43%, p = 0.009), a medial femoral condyle lesion more commonly (33% vs 11%, p = 0.005), were more often female (72% vs. 39%, p = 0.008), and had less often soft tissue repair at time of biopsy (32% vs. 61%, p = 0.020). Backward multivariate logistic regression analysis revealed that size of the lesion (OR 1.43, p = 0.031) and age ≥ 26 years old at time of biopsy (OR 3.55, p = 0.042) were independent predictors of not responding to initial surgery and requiring implantation surgery.
Conclusion: This study found that 35% of patients undergoing MACI phase I biopsy harvest eventually required autologous implantation. Independent risk factors for progressing to implantation after failed initial surgery were larger defect size and older age.
Level of Evidence: III, Cohort Study.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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