Summary: M-ACI is a highly effective treatment for chondral and osteochondral defects in adolescent patients with low revision rates and high patient satisfaction at 10 years

Purpose

To evaluate long-term survival and clinical and radiographic outcomes of third generation matrix-induced autologous chondrocyte implantation (M-ACI) in adolescents and compare them to a propensity score-matched adult cohort.

Methods

The present study examines prospectively collected data from adolescents who underwent M-ACI for focal cartilage defects. A total of 23 adolescents were matched to a homogeneous group of 23 adults. Clinical and radiographic outcomes were assessed at the time of surgery and at 12, 24, and 96 months using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score.

Results

No surgical complications, graft hypertrophy or reoperations were found in the cohorts studied. Adolescents treated with M-ACI achieved a clinically meaningful superior PRO at 96 months and were significantly more likely to achieve PASS (73.9% vs. 56.5%; p=0.02) compared to the adult cohort. Both groups exceeded the MCID. Adolescents benefit from M-ACI especially in symptom improvement, pain reduction, activities of daily living and quality of life compared to adults (p<0.05). Adolescents showed consistently high MOCART scores at 24 and 96 months (83.2±11.5 and 80.3±16.3; p=(n.s.)).

Conclusions

M-ACI is a highly effective treatment for chondral defects in adolescent patients with low revision rates, high patient satisfaction, and excellent long-term osteoarthritis prevention. Surgeons should be less concerned about the previously reported high revision rates for first-generation ACI in adolescents. Surgeons, legislators and health insurers should consider expanding the indication to include skeletally immature patients to avoid failures due to less reliable cartilage regeneration techniques.

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Matrix-Induced Autologous Chondrocyte Implantation in Adolescents - 10 Year Results From a Propensity Score Matched Cohort Study

Matrix-Induced Autologous Chondrocyte Implantation in Adolescents - 10 Year Results From a Propensity Score Matched Cohort Study

Purpose

Methods

Results

Conclusions

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Matrix-Induced Autologous Chondrocyte Implantation in Adolescents - 10 Year Results From a Propensity Score Matched Cohort Study

Matrix-Induced Autologous Chondrocyte Implantation in Adolescents - 10 Year Results From a Propensity Score Matched Cohort Study

Purpose

Methods

Results

Conclusions