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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-03-2013 | Knee

Autologous chondrocyte implantation in children and adolescents

Authors: H. Schmal, J. M. Pestka, G. Salzmann, P. C. Strohm, N. P. Südkamp, P. Niemeyer

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 3/2013

Abstract

Purpose

Autologous chondrocyte implantation (ACI) is a well-established treatment method for cartilage defects in knees. Age-related grouping was based on expression data of cartilage-specific markers. Specificities of ACI in the different populations were analysed.

Methods

Two hundred and sixty-seven patients undergoing ACI in the knee between 2006 and 2010 were included in this analysis. Cell characteristics and expression data of cartilage-specific surface markers as CD44, aggrecan and collagen type II were statistically analysed for age association. Epidemiological data of the defined groups were compared. Course of treatment was evaluated using MRI.

Results

A correlation analysis showed statistically significant associations between age and aggrecan or collagen type II expression in all patients <30 years. A cluster analysis could predict age-dependent expression of these markers separating groups with an average age of 18.1 ± 2.3 and 23.6 ± 4.2 years, respectively (p < 0.02). Discriminance analysis suggested the age border between adults and juveniles at about 20 years. There was no influence of age on cell characteristics or CD44 expression. In the 19 of 267 patients with an age ≤18 years, gender distribution was not different compared to adults, but patella was significantly more affected. Cartilage lesions were mainly caused by osteochondritis dissecans (OCD) and trauma. The Knee Osteoarthritis Scoring System in MRI reached 4.8 ± 2.3 points before, declining to 3.3 ± 2.3 points 6 and 12 months after the operation.

Conclusions

Age-related expression of cartilage-specific markers allows definition of adolescents in cartilage regenerating surgery. Chondromalacia in these patients is mainly caused by OCD or trauma.

Level of evidence

Case series, Level IV.

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Title: Autologous chondrocyte implantation in children and adolescents
Authors: H. Schmal
J. M. Pestka
G. Salzmann
P. C. Strohm
N. P. Südkamp
P. Niemeyer
Publication date: 01-03-2013
Publisher: Springer-Verlag
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 3/2013
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-012-2036-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Autologous chondrocyte implantation in children and adolescents

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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