The Use of Bone Marrow Aspirate Concentrated for Full-thickness Knee Cartilage Lesions in a One-step Procedure: A Prospective Study (SS-25)

ABSTRACTS biological resurfacing and were later converted to total shoulder arthroplasty (TSA). Methods: Seven patients (mean age 37.4 ⫾ 10.3 years) treated with biologic resurfacing of the glenoid using lateral meniscal allograft (5 patients) or human acellular dermal tissue matrix (2 patients) failed the procedure and were converted to TSA after an average of 2.0 ⫾ 1.4 years. All patients were available for follow up at an average of 3.3 ⫾ 1.8 years. Results: Only limited improvement was observed postconversion. Forward flexion and external rotation improved from 103.3° ⫾ 34.4° and 28.3° ⫾ 12.9° to 109.4° ⫾ 52.9° and 41.0° ⫾ 14.8°, respectively. The mean ASES, SST, and VAS scores for this group were 29.5 ⫾ 12.1, 1.0 ⫾ 1.4, and 6.25 ⫾ 1.7 preoperatively and 38.3 ⫾ 18.6, 3.7 ⫾ 3.5, and 5.3 ⫾ 1.9 postoperatively, respectively. The threshold of failure was set at an ASES score of ⬍50, therefore the average patient was considered to have failed both procedures at the time of final follow-up. Conclusion: Biological interposition arthroplasty is designed to postpone the need for prosthetic glenoid components and thus delay the risks associated with polyethylene glenoid implants such as component wear, fragmentation, and glenoid loosening or disassociation. The poor clinical outcomes seen in patients who are converted to a TSA after failure of biological resurfacing suggests that TSA may be the preferred primary procedure in young patients with severe glenohumeral arthritis. The Use of Bone Marrow Aspirate Concentrated for Full-thickness Knee Cartilage Lesions in a One-step Procedure: A Prospective Study (SS-25) Alberto W. Gobbi, M.D., Georgios Karnatzikos, M.D., Vivek Mahajan, M.D. Introduction: The purpose of our study was to determine the effectiveness of cartilage repair utilizing onestep surgery with autologous bone marrow aspirate concentrate (BMAC) and a collagen I/III matrix. Methods: We prospectively followed-up 25 patients (mean age 46 years) operated for grade IV cartilage lesions of the knee, for an average of 2 years. All patients underwent a mini-arthrotomy and concomitant transplantation with BMAC covered with the collagen matrix (Chondro-Gide; Geistlich, Wolhusen, Switzerland). Bone marrow was harvested from ipsilateral iliac crest and subjected to concentration and activation with Batroxobin solution (Plateltex; act-Plateltex SRO, Bratislava, Slovakia). Co-existing pathologies were treated before or dur-

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ing the same surgery. All patients followed the same specific rehabilitation program for a minimum of 6 months. Ten patients had multiple chondral lesions and the average lesion size was 8.3 cm2. X-rays and MRI were collected preoperatively, at 1 year, and at final follow-up. VAS, IKDC, KOOS, Lysholm, Marx, SF36, and Tegner scores were collected preoperatively, at 6-12 months, and final follow-up; nonparametric analysis was performed with the Wilcoxon rank test to compare these variations. Six patients gave their consent for secondlook arthroscopy and 5 of them for a concomitant biopsy. Results: Patients showed significant improvement in all scores at final follow-up (p ⬍ .005). Mean preoperative values were: VAS 5.2, IKDC subjective 43.6, KOOS Scores P⫽66.2/ S⫽68.2/ ADL⫽70.0/ SP⫽41.6/ QOL⫽ 37.2, Lysholm 60.4, Marx 4.2, SF36 (P/M) 40.4/ 51.5 and Tegner 2.0. At final follow-up, mean scores were: VAS 0.7, IKDC subjective 80.7, KOOS P⫽94.0/ S⫽90.1/ ADL⫽95.1/ SP⫽71.3/ QOL⫽77.5, Lysholm 92.9, Marx 10.3, SF36 (P/M) 55.5/54.0 and Tegner 4.9. MRI showed good coverage of the lesion and tissue quality in all patients in accordance with clinical results. Good histologic findings were reported for all the specimens analyzed that presented hyaline-like features. No adverse reactions or postoperative complications were noted. Conclusion: This study showed that the use of autologous bone marrow derived and collagen I/III matrix in a one-step procedure could represent an improvement on the currently available techniques for cartilage transplantation could be a viable technique in the treatment of grade IV knee chondral lesions. Prospective Evaluation of Autologous Chondrocyte Implantation Procedure: Minimum Seven-Year Follow-Up (SS-26) Brian J. Cole, M.D., M.B.A., Keith T. Corpus, B.S., Sarvottam Bajaj, B.E., Erika L. Daley, B.S., Vasili Karas, B.S., M.A., James S. Kercher, M.D., Nikhil N. Verma, M.D. Introduction: Autologous chondrocyte implantation (ACI) shows promising short and intermediate-term results for the treatment of full thickness cartilage defects in the knee. However, the long-term outcomes of the procedure are not well described. The purpose of this study is to report the clinical outcomes following ACI from a single orthopedic surgeon at a minimum of 7 years’ follow-up using validated outcome scores and physical examination. Methods: 29 patients were contacted at minimum 7 years postoperatively after a retrospective review be-