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Autologous chondrocyte implantation to repair knee cartilage injury : ultrastructural evaluation at 2 years and long term follow up including muscle strength measurements

Løken, Sverre; Ludvigsen, Tom C.; Høysveen, Turid; Holm, Inger; Engebretsen, Lars; Reinholt, Finn P.
Journal article, Peer reviewed
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Loken KneeSurgSportTraumaArthro 2009.pdf (4.403Mb)
URI
http://hdl.handle.net/11250/170623
Date
2009-07-02
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  • Artikler / Articles [2385]
Original version
Knee Surgery, Sports Traumatology, Arthroscopy. 2009, 17(11), 1278-1288  
Abstract
Autologous chondrocyte implantation (ACI)

usually results in improvement in clinical scores. However,

long-term isokinetic muscle strength measurements have

not been reported. Biopsies from the repair tissue have

shown variable proportions of hyaline-like cartilage. In this

study, 21 consecutive patients were treated with autologous

cartilage implantations in the knee. Mean size of the lesions

was 5.5 cm2. Follow-up arthroscopy with biopsy was performed

at 2 years in 19 patients. The biopsies were examined

with both light microscopy and transmission electron

microscopy (TEM) techniques including immunogold

analysis of collagen type 1. Patient function was evaluated

with modified 10-point scales of the Cincinnati knee rating

system obtained preoperatively and at 1 and 8.1 years.

Isokinetic quadriceps and hamstrings muscle strength testing

was performed at 1, 2 and 7.4 years. Light microscopy

and TEM both showed predominately fibrous cartilage. The

immunogold analysis showed a high percentage of collagen

type I. At 7.4 years, the total work deficits when compared

with the contra-lateral leg for isokinetic extension were 19.1

and 11.4%, and for isokinetic flexion 11.8 and 8.5% for 60

and 2408/s, respectively. Mean pain score improved from

4.3 preoperatively to 6.3 at 1 year (p = 0.031) and 6.6 at

8.1 years (p = 0.013). Overall health condition score

improved from 4.1 preoperatively to 6.1 at 1 year

(p = 0.004) and 6.5 at 8.1 years (p = 0.008). Three

patients later went through revision surgery with other

resurfacing techniques and are considered failures. In

summary, the formation of fibrous cartilage following ACI

was confirmed by TEM with immunogold histochemistry.

Although the functional scores were generally good,

strength measurements demonstrated that the surgically

treated leg remained significantly weaker.
Description
I Brage finner du siste tekst-versjon av artikkelen, og den kan inneholde ubetydelige forskjeller fra forlagets pdf-versjon. Forlagets pdf-versjon finner du på www.springerlink.com: http://dx.doi.org/10.1007/s00167-009-0854-5 / In Brage you'll find the final text version of the article, and it may contain insignificant differences from the journal's pdf version. The original publication is available at www.springerlink.com: http://dx.doi.org/10.1007/s00167-009-0854-5
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Springer

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