Advertisement for orthosearch.org.uk
Results 1 - 2 of 2
Results per page:
Applied filters
Content I can access

Include Proceedings
Dates
Year From

Year To
Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_III | Pages 415 - 415
1 Sep 2009
Saris DB Vanlauwe J Victor J Bellemans J LuytenYFortems FP
Full Access

Purpose: As a one-step surgical procedure, microfracture is frequently considered to be technically easier and associated with less postoperative morbidity than autologous chondrocyte implantation (ACI), which involves both arthrotomy and arthroscopy and therefore safety was assessed in patients with symptomatic cartilage lesions of the knee treated with characterized chondrocyte implantation (CCI) or microfracture.

Methods: CCI (n=57) was compared to microfracture (n=61) in patients with grade III–IV symptomatic cartilage defects of the femoral condyles in a Phase III, prospective, multi-center, randomized, controlled trial. Safety assessments included adverse events (AEs), physical examination, vital signs, hematology and clinical chemistry.

Results: At 18 months post-surgery, similar proportions of patients experienced AEs in the CCI (88%) and microfracture (82%) groups; 67% and 59%, respectively, experienced AEs considered treatment related. The AE profile was generally similar between groups, with no significant difference for hypertrophy, although significantly more CCI-treated patients had joint swelling (19% versus 4.9%; p=0.022) and treatment-related joint crepitation (12% versus 1.6%; p=0.028). Although the proportion of patients with severe AEs was similar for CCI (12%) and microfracture (13%), slightly more microfracture-treated patients experienced serious (life-threatening or requiring hospitalization) AEs (13% versus 8.8%). No patients discontinued due to AEs or died during the study.

Conclusion: Contrary to general opinion, the two-step CCI procedure, involving arthroscopy followed by arthrotomy, has a similar safety profile to that of microfracture, a one-step arthroscopic procedure, for treating cartilage lesions of the knee.


Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_III | Pages 415 - 415
1 Sep 2009
Saris DB Vanlauwe J Victor J Bellemans J Luyten FP Fortems Y
Full Access

Purpose: This study compared the efficacy and safety of Characterized Chondrocyte Implantation (CCI) to microfracture in the repair of symptomatic cartilage defects of the femoral condyle.

Methods: CCI (n=51) was compared to microfracture (n=61) in patients with grade III–IV symptomatic cartilage defects of the femoral condyles in a prospective, multicenter, randomized, controlled trial. Structural repair was assessed at 1 year by histopathologists blinded to the treatment using

computerized histomorphometry and

an overall histology assessment. Clinical outcome was measured using the Knee Injury and Osteoarthritis Outcome Score (KOOS). Safety was recorded throughout the study.

Results: CCI resulted in better structural repair than microfracture at 1 year post-treatment, as assessed by histomorphometry (p=0.003) and overall histology (p=0.012). Structural repair parameters relating to chondrocyte phenotype and tissue structure were also superior with CCI. Noninferiority of CCI was demonstrated for clinical outcome at 12–18 months, and both treatments were generally well tolerated.

Conclusion: At 1 year post-treatment, CCI resulted in superior tissue repair compared to microfracture. Short-term clinical outcome after 12–18 months was similar for both treatments, as was the safety profile. The superior structural repair achieved with CCI may lead to improved long-term clinical benefits.