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Paper 240: Autologous Chondrocyte Implantation versus Matrix-induced Autologous Chondrocyte Implantation for Osteochondral Defects of the Knee Minimum 2 year follow-up results
ABSTRACTS Patients who had undergone MS had a significant minor KOSS (96.3 ⫹/⫺15.0) than patients after TC (136.2⫹/⫺11.6). Preoperatively the activity level of both groups was 5.3 ⫹/⫺1.1. Patients in MS had a significant lower Tegner score in follow-up (2.8⫹/⫺1.0) than patients in the TC group (4.1⫹/⫺1.2). Patients after TC profited in shorter rehabilitations time, got faster to their professional activities and had a minor level on pain, postoperatively. Conclusion: TC is a potential method in treatment of deep cartilage defects. The short term results are better than after MS. Long-term results are required.
Paper 239: The Reproducibility of Radiological Anterior and Posterior Horn Positioning in Preoperative Planning of Lateral Meniscus Transplantations ROMAIN SEIL, MD, LUXEMBOURG, PRESENTING AUTHOR PHILIPPE WILMES, MD, GERMANY DIETER KOHN, MD, GERMANY ABSTRACT Purpose: The objective of our investigation was to determine whether it is possible to locate and reproduce the tibial insertion areas of the anterior and posterior horns of the lateral meniscus on preoperative radiographs. Type of Study: Anatomical and radiological human cadaver study. Methods: In 20 tibia heads, we prepared anterior and posterior horn insertions and marked their circumference with radio opaque steal balls of 1.6 mm diameter. Standardized anteroposterior and lateral radiographs were made. On these radiographs, different landmarks of the tibial head were defined, their distances measured (tibial width, tibial depth, distance from lateral tibia border to meniscus insertion midpoint, distance from anterior tibial border to meniscus insertion midpoint, distance from anterior and lateral tibial border to the lateral intercondylar spine) and ratios determined. Results: The midpoint of the anterior horn is located at 45.1⫹/⫺1.3 % of tibial width and 41.9⫹/⫺3.2 % of tibial depth, the midpoint of the posterior horn at 49.8 %⫹/⫺1.9 % of tibial width and 72.1⫹/⫺2.3 % of tibial depth. The statistical analysis of these measures showed a precise and constant positioning of the lateral meniscus insertions on the tibia plateau. Inter- and intraobserver variability was very low. We also found constant topographic relations to the lateral intercondylar spine. Conclusions: Anterior and posterior lateral meniscus horn insertions can be determined on radiographs with a high precision and reproducibility. Clinical Relevance:
e313
To develop a surgical technique with a highly precise placement of the meniscal insertion areas in meniscus transplantations.
Paper 240: Autologous Chondrocyte Implantation versus Matrix-induced Autologous Chondrocyte Implantation for Osteochondral Defects of the Knee Minimum 2 year follow-up results DEREK H. PARK, MBCHB, MRCS, UNITED KINGDOM, PRESENTING AUTHOR SHIBU P. KRISHNAN, UNITED KINGDOM JOHN A. SKINNER, UNITED KINGDOM RICHARD W. CARRINGTON, UNITED KINGDOM TIMOTHY WR. BRIGGS, UNITED KINGDOM GEORGE BENTLEY, CHM FRCS, UNITED KINGDOM ABSTRACT Purpose: We report on minimum 2 year follow-up results of 74 patients randomised to autologous chondrocyte implantation (ACI) using porcine-derived collagen membrane as a cover (ACI-C) and matrix-induced autologous chondrocyte implantation (MACI) for the treatment of osteochondral defects of the knee. Introduction: ACI is used widely as a treatment for symptomatic chondral and osteochondral defects of the knee. Variations of the original periosteum-cover technique include the use of porcine-derived type I/type III collagen as a cover (ACI-C) and matrix-induced autologous chondrocyte implantation (MACI) using a collagen bilayer seeded with chondrocytes. Results: 74 patients with a mean age of 33 years (15-48) were randomised to undergo either an ACI-C or a MACI. 36 had ACI-C, 38 had MACI. The mean size of the defect was 5.0cm2. Mean duration of symptoms was 104.4 months (9-456). Mean follow-up was 33.5 months (24-45). Functional assessment using the modified Cincinnati knee score, the Bentley functional rating score and the visual analogue score was carried out. Assessment using the modified Cincinnati knee score showed a good to excellent result in 64% of patients in the ACI-C group; and 60% of patients in the MACI group. Arthroscopic assessments showed a good to excellent International Cartilage Repair Society score in 84% of ACI-C graft and 70% of MACI grafts (p⫽0.35). Hyaline-like cartilage or mixed hyaline-like cartilage with fibrocartilage was found in biopsies of 53% of the ACI-C graft and 36% of the MACI grafts. Conclusion: At this stage of the trial we conclude that the clinical, arthroscopic and histological outcomes are comparable for both ACI-C and MACI.
Paper 239: The Reproducibility of Radiological Anterior and Posterior Horn Positioning in Preoperative Planning of Lateral Meniscus Transplantations ROMAIN SEIL, MD, LUXEMBOURG, PRESENTING AUTHOR PHILIPPE WILMES, MD, GERMANY DIETER KOHN, MD, GERMANY ABSTRACT Purpose: The objective of our investigation was to determine whether it is possible to locate and reproduce the tibial insertion areas of the anterior and posterior horns of the lateral meniscus on preoperative radiographs. Type of Study: Anatomical and radiological human cadaver study. Methods: In 20 tibia heads, we prepared anterior and posterior horn insertions and marked their circumference with radio opaque steal balls of 1.6 mm diameter. Standardized anteroposterior and lateral radiographs were made. On these radiographs, different landmarks of the tibial head were defined, their distances measured (tibial width, tibial depth, distance from lateral tibia border to meniscus insertion midpoint, distance from anterior tibial border to meniscus insertion midpoint, distance from anterior and lateral tibial border to the lateral intercondylar spine) and ratios determined. Results: The midpoint of the anterior horn is located at 45.1⫹/⫺1.3 % of tibial width and 41.9⫹/⫺3.2 % of tibial depth, the midpoint of the posterior horn at 49.8 %⫹/⫺1.9 % of tibial width and 72.1⫹/⫺2.3 % of tibial depth. The statistical analysis of these measures showed a precise and constant positioning of the lateral meniscus insertions on the tibia plateau. Inter- and intraobserver variability was very low. We also found constant topographic relations to the lateral intercondylar spine. Conclusions: Anterior and posterior lateral meniscus horn insertions can be determined on radiographs with a high precision and reproducibility. Clinical Relevance:
e313
To develop a surgical technique with a highly precise placement of the meniscal insertion areas in meniscus transplantations.
Paper 240: Autologous Chondrocyte Implantation versus Matrix-induced Autologous Chondrocyte Implantation for Osteochondral Defects of the Knee Minimum 2 year follow-up results DEREK H. PARK, MBCHB, MRCS, UNITED KINGDOM, PRESENTING AUTHOR SHIBU P. KRISHNAN, UNITED KINGDOM JOHN A. SKINNER, UNITED KINGDOM RICHARD W. CARRINGTON, UNITED KINGDOM TIMOTHY WR. BRIGGS, UNITED KINGDOM GEORGE BENTLEY, CHM FRCS, UNITED KINGDOM ABSTRACT Purpose: We report on minimum 2 year follow-up results of 74 patients randomised to autologous chondrocyte implantation (ACI) using porcine-derived collagen membrane as a cover (ACI-C) and matrix-induced autologous chondrocyte implantation (MACI) for the treatment of osteochondral defects of the knee. Introduction: ACI is used widely as a treatment for symptomatic chondral and osteochondral defects of the knee. Variations of the original periosteum-cover technique include the use of porcine-derived type I/type III collagen as a cover (ACI-C) and matrix-induced autologous chondrocyte implantation (MACI) using a collagen bilayer seeded with chondrocytes. Results: 74 patients with a mean age of 33 years (15-48) were randomised to undergo either an ACI-C or a MACI. 36 had ACI-C, 38 had MACI. The mean size of the defect was 5.0cm2. Mean duration of symptoms was 104.4 months (9-456). Mean follow-up was 33.5 months (24-45). Functional assessment using the modified Cincinnati knee score, the Bentley functional rating score and the visual analogue score was carried out. Assessment using the modified Cincinnati knee score showed a good to excellent result in 64% of patients in the ACI-C group; and 60% of patients in the MACI group. Arthroscopic assessments showed a good to excellent International Cartilage Repair Society score in 84% of ACI-C graft and 70% of MACI grafts (p⫽0.35). Hyaline-like cartilage or mixed hyaline-like cartilage with fibrocartilage was found in biopsies of 53% of the ACI-C graft and 36% of the MACI grafts. Conclusion: At this stage of the trial we conclude that the clinical, arthroscopic and histological outcomes are comparable for both ACI-C and MACI.