Therapy of Severe Chondral Defects of the Patella by Autologous Chondrocyte Implatation

The aim of this study was to present the results of treatment of deep chondral defects of the patella by transplantation of a solid chondral graft formed by autologous cultured chondrocytes. MATERIAL AND METHODSIndications for autologous chondrocyte implantation most frequently included acute trauma to the knee, particularly the patella, which resulted in a severe focal cartilage defect.The lesions were assessed on the basis of the Bessette and Hunter classification preoperatively, and on the Outerbridge classification during arthroscopy.A sample of healthy cartilage was harvested from a non-weight-bearing area of the trochlea femoris.After cultivation of chondrocytes for 28 to 42 days in the tissue bank, a solid chondral graft, prepared with the use of fibrin glue (Tissucol), was ready for implantation. RESULTSSix patients, two males and four females (average age, 21.1 years; range, 13 to 39 years) were treated by this method in the period from July 2003 to October 2005.Follow-up ranged from 1 to 25 months, with an average of 18.5 months.The patients were examined postoperatively by magnetic resonance imaging (MRI) at 2 weeks, 2 and 6 months, and at 1 year.The clinical results were evaluated by the Meyers, the Tegner and the Lysholm knee scoring systems.Two of the six patients, in whom the follow-up period was shorter than 6 months, were not included in the evaluation. CONCLUSIONSA significant improvement in knee function was recorded when the preoperative and final follow-up stages were compared, as well as on comparison with the healthy contralateral knee joint.MRI examination showed good graft incorporation in all patients.