Two-Year Results of Injectable Matrix-Associated Autologous Chondrocyte Transplantation in the Hip Joint: Significant Improvement in Clinical and Radiological Assessment
Purpose: Articular cartilage defects are a prevalent consequence of femoroacetabular impingement (FAI) in young active patients. In accordance with current guidelines, large chondral lesions of the hip joint over 2 cm<sup>2</sup> are recommended to be treated with matrix-associated, auto...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/17/5468 |
| _version_ | 1797582327059054592 |
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| author | Moritz Riedl Henriette Bretschneider Michael Dienst Klaus-Peter Günther Stefan Landgraeber Jörg Schröder Siegfried Trattnig Stefan Fickert |
| author_facet | Moritz Riedl Henriette Bretschneider Michael Dienst Klaus-Peter Günther Stefan Landgraeber Jörg Schröder Siegfried Trattnig Stefan Fickert |
| author_sort | Moritz Riedl |
| collection | DOAJ |
| description | Purpose: Articular cartilage defects are a prevalent consequence of femoroacetabular impingement (FAI) in young active patients. In accordance with current guidelines, large chondral lesions of the hip joint over 2 cm<sup>2</sup> are recommended to be treated with matrix-associated, autologous chondrocyte transplantation (MACT); however, the conditions in the hip joint are challenging for membrane-based MACT options. Injectable MACT products can solve this problem. The purpose of the trial was to assess clinical and radiological outcomes 24 months after injectable MACT of focal chondral lesions caused by FAI. Methods: We present data of 21 patients with focal cartilage defects of the hip [3.0 ± 1.4 cm<sup>2</sup> (mean ± SD)], ICRS Grade III and IV caused by CAM-type impingement, who underwent arthroscopic MACT (NOVOCART<sup>®</sup> Inject) and FAI correction. The outcome was evaluated with the patient-reported outcome instruments iHOT33 and EQ-5D-5L (index value and VAS), whilst graft morphology was assessed based on the MOCART score over a follow-up period of 24 months. Results: The iHOT33 score increased significantly from 52.9 ± 21.1 (mean ± SD) preoperatively to 85.8 ± 14.8 (mean ± SD; <i>p</i> < 0.0001) 24 months postoperatively. The EQ-5D-5L index value (<i>p</i> = 0.0004) and EQ-5D VAS (<i>p</i> = 0.0006) showed a statistically significant improvement as well. MRI evaluation after 24 months showed successful integration of the implant in all patients with a complete defect filling in 11 of 14 patients. Conclusions: Injectable MACT for the treatment of full-thickness chondral lesions of the hip joint due to FAI in combination with FAI correction improved symptoms, function, and quality of life in the treated cohort. Alongside the treatment of the underlying pathology by the FAI correction, the developed cartilage defect can be successfully repaired by MACT, which is of considerable clinical relevance. |
| first_indexed | 2024-03-10T23:20:29Z |
| format | Article |
| id | doaj.art-6e9dc8bca9e84e98aa1c153a2c95ba96 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T23:20:29Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-6e9dc8bca9e84e98aa1c153a2c95ba962023-11-19T08:21:05ZengMDPI AGJournal of Clinical Medicine2077-03832023-08-011217546810.3390/jcm12175468Two-Year Results of Injectable Matrix-Associated Autologous Chondrocyte Transplantation in the Hip Joint: Significant Improvement in Clinical and Radiological AssessmentMoritz Riedl0Henriette Bretschneider1Michael Dienst2Klaus-Peter Günther3Stefan Landgraeber4Jörg Schröder5Siegfried Trattnig6Stefan Fickert7Department of Trauma Surgery, Regensburg University Medical Center, 93053 Regensburg, GermanyUniversity Centre for Orthopaedics and Trauma Surgery, University Hospital Carl Gustav Carus at Technische Universität Dresden, 01307 Dresden, GermanyOrthopädische Chirurgie München, OCM Klinik GmbH, 81369 Munich, GermanyUniversity Centre for Orthopaedics and Trauma Surgery, University Hospital Carl Gustav Carus at Technische Universität Dresden, 01307 Dresden, GermanyDepartment of Orthopedic Surgery, Saarland University Medical Center, 66421 Homburg, GermanyDepartment of Orthopedic Surgery, Klinikum Ernst von Bergmann Potsdam, 14467 Potsdam, GermanyChristian Doppler Laboratory for Clinical Molecular MR Imaging (MOLIMA), Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Orthopedic Surgery, Saarland University Medical Center, 66421 Homburg, GermanyPurpose: Articular cartilage defects are a prevalent consequence of femoroacetabular impingement (FAI) in young active patients. In accordance with current guidelines, large chondral lesions of the hip joint over 2 cm<sup>2</sup> are recommended to be treated with matrix-associated, autologous chondrocyte transplantation (MACT); however, the conditions in the hip joint are challenging for membrane-based MACT options. Injectable MACT products can solve this problem. The purpose of the trial was to assess clinical and radiological outcomes 24 months after injectable MACT of focal chondral lesions caused by FAI. Methods: We present data of 21 patients with focal cartilage defects of the hip [3.0 ± 1.4 cm<sup>2</sup> (mean ± SD)], ICRS Grade III and IV caused by CAM-type impingement, who underwent arthroscopic MACT (NOVOCART<sup>®</sup> Inject) and FAI correction. The outcome was evaluated with the patient-reported outcome instruments iHOT33 and EQ-5D-5L (index value and VAS), whilst graft morphology was assessed based on the MOCART score over a follow-up period of 24 months. Results: The iHOT33 score increased significantly from 52.9 ± 21.1 (mean ± SD) preoperatively to 85.8 ± 14.8 (mean ± SD; <i>p</i> < 0.0001) 24 months postoperatively. The EQ-5D-5L index value (<i>p</i> = 0.0004) and EQ-5D VAS (<i>p</i> = 0.0006) showed a statistically significant improvement as well. MRI evaluation after 24 months showed successful integration of the implant in all patients with a complete defect filling in 11 of 14 patients. Conclusions: Injectable MACT for the treatment of full-thickness chondral lesions of the hip joint due to FAI in combination with FAI correction improved symptoms, function, and quality of life in the treated cohort. Alongside the treatment of the underlying pathology by the FAI correction, the developed cartilage defect can be successfully repaired by MACT, which is of considerable clinical relevance.https://www.mdpi.com/2077-0383/12/17/5468hip-preserving surgeryhip arthroscopymatrix-associated autologous chondrocyte transplantationMACTcartilage defectfemoroacetabular impingement |
| spellingShingle | Moritz Riedl Henriette Bretschneider Michael Dienst Klaus-Peter Günther Stefan Landgraeber Jörg Schröder Siegfried Trattnig Stefan Fickert Two-Year Results of Injectable Matrix-Associated Autologous Chondrocyte Transplantation in the Hip Joint: Significant Improvement in Clinical and Radiological Assessment Journal of Clinical Medicine hip-preserving surgery hip arthroscopy matrix-associated autologous chondrocyte transplantation MACT cartilage defect femoroacetabular impingement |
| title | Two-Year Results of Injectable Matrix-Associated Autologous Chondrocyte Transplantation in the Hip Joint: Significant Improvement in Clinical and Radiological Assessment |
| title_full | Two-Year Results of Injectable Matrix-Associated Autologous Chondrocyte Transplantation in the Hip Joint: Significant Improvement in Clinical and Radiological Assessment |
| title_fullStr | Two-Year Results of Injectable Matrix-Associated Autologous Chondrocyte Transplantation in the Hip Joint: Significant Improvement in Clinical and Radiological Assessment |
| title_full_unstemmed | Two-Year Results of Injectable Matrix-Associated Autologous Chondrocyte Transplantation in the Hip Joint: Significant Improvement in Clinical and Radiological Assessment |
| title_short | Two-Year Results of Injectable Matrix-Associated Autologous Chondrocyte Transplantation in the Hip Joint: Significant Improvement in Clinical and Radiological Assessment |
| title_sort | two year results of injectable matrix associated autologous chondrocyte transplantation in the hip joint significant improvement in clinical and radiological assessment |
| topic | hip-preserving surgery hip arthroscopy matrix-associated autologous chondrocyte transplantation MACT cartilage defect femoroacetabular impingement |
| url | https://www.mdpi.com/2077-0383/12/17/5468 |
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