Matrix induced autologous chondrocytes implantation in the treatment of large osteochondral lesions: 1-5 year results

Focal, symptomatic cartilage lesions are a common problem in young patients. Current studies in the treatment of cartilage lesions are in the field of tissue engineering and cellular therapies. The aim of this study was to investigate the efficacy of Matrix-induced Autologous Chondrocyte Implantation (MACI) technique in the treatment of large osteochondral lesions in the knee joint and to determine the factors that affect the functional outcomes. In our study, 34 patients who were operated with third generation Matrix-induced Autologous Chondrocyte Implantation technique between 2009-2013, were retrospectively investigated. The mean age of the patients was 30.4 ± 9.3 (18-48) and the male / female ratio was 30/4. The mean defect size was calculated as 5.4 ± 1.4 (3.2-8) cm2 in the knee. Pathologies accompanying the disease were also recorded. All of the patients received MACI® (Verigen Transplantation Service, Copenhagen, Denmark) treatment which was obtained by cell transplantation to collagen type I / III membranes, underwent standard surgical approach and accelerated rehabilitation program was performed after the operation. The modified Cincinnati and Tegner Lysholm scores of the patients were found to increase significantly after the sixth month of the surgery (p=0.0001). The scores of male patients, especially at 24 and 36 months, were significantly higher than female patients. BMI<25 and BMI>25 groups were grouped and the results were analyzed but no significant difference was found between the two groups. Better clinical outcomes were observed in all patients without concomitant pathology and this improvement was found to be statistically significant especially at 6 and 12 months (p = 0.0001). Matrix-induced autologous chondrocyte implantation provides a good and stable result in focal cartilage damage in young patients. The importance of appropriate patient selection and concomitant pathologies should not be forgotten in obtaining the intended results.