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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-06-2016 | Hip

Arthroscopic three-dimensional autologous chondrocyte transplantation using spheroids for the treatment of full-thickness cartilage defects of the hip joint

Authors: Konrad Körsmeier, Tim Claßen, Michael Kamminga, Jan Rekowski, Marcus Jäger, Stefan Landgraeber

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 6/2016

Abstract

Purpose

Treatment of full-thickness cartilage defects in the hip is a major issue for orthopaedic surgeons. Autologous matrix-induced three-dimensional chondrocyte transplantation using three-dimensional spheroids (ACT 3D) may be an option for treatment. The aim of the study is to describe the feasibility and first clinical results of ACT 3D with spheroids at the hip.

Methods

In this report, the surgical technique was described for the first time, and the outcome of sixteen patients with chondral defects induced by cam-type femoroacetabular impingement (FAI) who were followed up in a prospective study was evaluated. All patients underwent physical examination before the first surgery and again before the second (about 6 weeks later). Further examinations were performed 6 weeks after the second surgery and at an average follow-up period of 16.09 months. At every visit, the non-arthritic hip score (NAHS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) were obtained. In addition, patient satisfaction was evaluated during the last follow-up examination by means of a questionnaire.

Results

The NAHS and WOMAC scores had significantly improved 6 weeks after arthroscopic treatment of the cam-type FAI, and a further significant enhancement was seen 6 weeks after the second surgery with application of the chondrocyte spheroids. In the last follow-up, the mean results were equally as good as the second follow-up examination 12 weeks after surgery.

Conclusions

The present study shows that ACT 3D using spheroids is a feasible method that can be easily performed during arthroscopy. As the first results have been encouraging, the ACT 3D with spheroids at the hip should be continued. More studies should be initiated to get an impression of the quality grade of this method in comparison with other treatment options in case of chondral defects at the hip.

Level of evidence

III.

Anderer U, Libera J (2002) In vitro engineering of human autogenous cartilage. J Bone Miner Res 17(8):1420–1429CrossRefPubMed

Dienst M, Godde S, Seil R, Hammer D, Kohn D (2001) Hip arthroscopy without traction: in vivo anatomy of the peripheral hip joint cavity. Arthroscopy 17(9):924–931CrossRefPubMed

Fickert S, Gerwien P, Helmert B, Schattenberg T, Weckbach S, Kaszkin-Bettag M, Lehmann L (2012) One-year clinical and radiological results of a prospective, investigator-initiated trial examining a novel, purely autologous 3-dimensional autologous chondrocyte transplantation product in the knee. Cartilage 3(1):27–42CrossRefPubMedPubMedCentral

Filardo G, Kon E, Di Martino A, Patella S, Altadonna G, Balboni F, Bragonzoni L, Visani A, Marcacci M (2012) Second-generation arthroscopic autologous chondrocyte implantation for the treatment of degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 20(9):1704–1713CrossRefPubMed

Fontana A (2012) A novel technique for treating cartilage defects in the hip: a fully arthroscopic approach to using autologous matrix-induced chondrogenesis. Arthrosc Tech 1(1):e63–e68CrossRefPubMedPubMedCentral

Fontana A, Bistolfi A, Crova M, Rosso F, Massazza G (2012) Arthroscopic treatment of hip chondral defects: autologous chondrocyte transplantation versus simple debridement—a pilot study. Arthroscopy 28(3):322–329CrossRefPubMed

Ganz R, Leunig M, Leunig-Ganz K, Harris WH (2008) The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res 466(2):264–272CrossRefPubMedPubMedCentral

Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA (2003) Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res 417:112–120PubMed

Ilizaliturri VM Jr, Byrd JW, Sampson TG, Guanche CA, Philippon MJ, Kelly BT, Dienst M, Mardones R, Shonnard P, Larson CM (2008) A geographic zone method to describe intra-articular pathology in hip arthroscopy: cadaveric study and preliminary report. Arthroscopy 24(5):534–539CrossRefPubMed

10.

Karthikeyan S, Roberts S, Griffin D (2012) Microfracture for acetabular chondral defects in patients with femoroacetabular impingement: results at second-look arthroscopic surgery. Am J Sports Med 40(12):2725–2730CrossRefPubMed

11.

Konan S, Rayan F, Meermans G, Witt J, Haddad FS (2011) Validation of the classification system for acetabular chondral lesions identified at arthroscopy in patients with femoroacetabular impingement. J Bone Joint Surg Br 93(3):332–336CrossRefPubMed

12.

Lund B, Soballe K, Winge S, Holmich P, Jacobsen S, Lind M (2011) Hip arthroscopy. Ugeskr Laeger 173(3):197–200PubMed

13.

Pestka JM, Bode G, Salzmann G, Sudkamp NP, Niemeyer P (2012) Clinical outcome of autologous chondrocyte implantation for failed microfracture treatment of full-thickness cartilage defects of the knee joint. Am J Sports Med 40(2):325–331CrossRefPubMed

14.

Philippon MJ, Schenker ML, Briggs KK, Maxwell RB (2008) Can microfracture produce repair tissue in acetabular chondral defects? Arthroscopy 24(1):46–50CrossRefPubMed

15.

Rossing S, Thermann H, Paessler H, Baum P, Schreyer T (2007) For discussion–new technique for arthroscopic, autologous chondrocyte transplantation using chondrospheres. Z Orthop Unfall 145(3):276–277PubMed

16.

Sampson TG (2011) Arthroscopic treatment for chondral lesions of the hip. Clin Sports Med 30(2):331–348CrossRefPubMed

17.

Schubert T, Anders S, Neumann E, Scholmerich J, Hofstadter F, Grifka J, Muller-Ladner U, Libera J, Schedel J (2009) Long-term effects of chondrospheres on cartilage lesions in an autologous chondrocyte implantation model as investigated in the SCID mouse model. Int J Mol Med 23(4):455–460PubMed

18.

Steimer O, Kusma M, Grun U (2011) Hip arthroscopy—indications and limits. Orthopade 40(12):1054–1060CrossRefPubMed

19.

Streich NA, Gotterbarm T, Barie A, Schmitt H (2009) Prognostic value of chondral defects on the outcome after arthroscopic treatment of acetabular labral tears. Knee Surg Sports Traumatol Arthrosc 17(10):1257–1263CrossRefPubMed

20.

Tannast M, Goricki D, Beck M, Murphy SB, Siebenrock KA (2008) Hip damage occurs at the zone of femoroacetabular impingement. Clin Orthop Relat Res 466(2):273–280CrossRefPubMedPubMedCentral

21.

Umlauf D, Frank S, Pap T, Bertrand J (2010) Cartilage biology, pathology, and repair. Cell Mol Life Sci 67(24):4197–4211CrossRefPubMed

22.

Vanlauwe J, Saris DB, Victor J, Almqvist KF, Bellemans J, Luyten FP (2011) Five-year outcome of characterized chondrocyte implantation versus microfracture for symptomatic cartilage defects of the knee: early treatment matters. Am J Sports Med 39(12):2566–2574CrossRefPubMed

23.

Zaltz I, Leunig M (2012) Parafoveal chondral defects associated with femoroacetabular impingement. Clin Orthop Relat Res 470(12):3383–3389CrossRefPubMedPubMedCentral

Title: Arthroscopic three-dimensional autologous chondrocyte transplantation using spheroids for the treatment of full-thickness cartilage defects of the hip joint
Authors: Konrad Körsmeier
Tim Claßen
Michael Kamminga
Jan Rekowski
Marcus Jäger
Stefan Landgraeber
Publication date: 01-06-2016
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 6/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-014-3293-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Arthroscopic three-dimensional autologous chondrocyte transplantation using spheroids for the treatment of full-thickness cartilage defects of the hip joint

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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