Comparative evaluation of autologous chondrocyte implantation and mosaicplasty: A multicentered randomized clinical trial

Beatrice Dozin, Mara Malpeli, Ranieri Cancedda, Paolo Bruzzi, Silvano Calcagno, Luigi Molfetta, Ferdinando Priano, Elisaveta Kon, Maurilio Marcacci

Research output: Contribution to journalArticle

140 Citations (Scopus)

Abstract

Objective: To compare the respective performance and effectiveness of autologous chondrocyte implantation (ACI) and mosaicplasty at resurfacing local full-thickness chondral defects of the knee. Design: Randomized clinical trial. Setting: Multicenter trial at orthopedic clinics and university hospitals conducted from 1997 to 2000. Patients: A population of patients selected according to eligibility criteria of age, traumatic origin of the defect, its localization, size, and gravity, and above all, no previous surgical treatment of the lesion. Forty-seven patients were randomly assigned to ACI or mosaicplasty and subjected to arthroscopic debridement of the lesion at the time of enrollment. They were called for surgery 6 months after the initial debridement. Main Outcome: Improved knee functionality as assessed by repeated clinical evaluation based on the International Knee Documentation Committee Scale and the Lysholm Knee Scoring Scale. Results: Fourteen patients (31.8%) experienced substantial improvement following the initial debridement and, being clinically cured, received no further treatment. Seven patients (15.9%) were lost to follow-up. Among the 23 patients (52.3%) who could effectively be evaluated, a complete recovery (ie, Lysholm Knee Scoring Scale score, 90-100) was observed upon clinical examination in 88% of the mosaicplasty-treated patients and in 68% of the ACI-treated ones (P = 0.093). Conclusions: Although the low power of our study prevents definitive conclusions, ACI and mosaicplasty are cartilage repair techniques that are clinically equivalent and similar in performance. The high percentage of spontaneous improvement (1/3 of the patients) observed after simple debridement calls into question the need for prompt surgical treatment of patients with lesions similar to those included in this clinical trial. Moreover, this finding warrants further investigation, ideally through randomized clinical trials in which patients subjected to debridement alone are compared with patients undergoing reconstructive surgery.

Original languageEnglish
Pages (from-to)218-224
Number of pages7
JournalClinical Journal of Sport Medicine
Volume15
Issue number4
Publication statusPublished - Jul 2005

Fingerprint

Chondrocytes
Randomized Controlled Trials
Debridement
Knee
Cartilage
Reconstructive Surgical Procedures
Lost to Follow-Up
Gravitation
Documentation
Multicenter Studies
Orthopedics
Therapeutics
Clinical Trials

Keywords

  • Articular cartilage
  • Autologous chondrocyte implantation
  • Mosaicplasty
  • Randomized study
  • Traumatic lesion

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Comparative evaluation of autologous chondrocyte implantation and mosaicplasty : A multicentered randomized clinical trial. / Dozin, Beatrice; Malpeli, Mara; Cancedda, Ranieri; Bruzzi, Paolo; Calcagno, Silvano; Molfetta, Luigi; Priano, Ferdinando; Kon, Elisaveta; Marcacci, Maurilio.

In: Clinical Journal of Sport Medicine, Vol. 15, No. 4, 07.2005, p. 218-224.

Research output: Contribution to journalArticle

Dozin, Beatrice ; Malpeli, Mara ; Cancedda, Ranieri ; Bruzzi, Paolo ; Calcagno, Silvano ; Molfetta, Luigi ; Priano, Ferdinando ; Kon, Elisaveta ; Marcacci, Maurilio. / Comparative evaluation of autologous chondrocyte implantation and mosaicplasty : A multicentered randomized clinical trial. In: Clinical Journal of Sport Medicine. 2005 ; Vol. 15, No. 4. pp. 218-224.
@article{04453470a8f743cb82a0fa8c4b88b1e8,
title = "Comparative evaluation of autologous chondrocyte implantation and mosaicplasty: A multicentered randomized clinical trial",
abstract = "Objective: To compare the respective performance and effectiveness of autologous chondrocyte implantation (ACI) and mosaicplasty at resurfacing local full-thickness chondral defects of the knee. Design: Randomized clinical trial. Setting: Multicenter trial at orthopedic clinics and university hospitals conducted from 1997 to 2000. Patients: A population of patients selected according to eligibility criteria of age, traumatic origin of the defect, its localization, size, and gravity, and above all, no previous surgical treatment of the lesion. Forty-seven patients were randomly assigned to ACI or mosaicplasty and subjected to arthroscopic debridement of the lesion at the time of enrollment. They were called for surgery 6 months after the initial debridement. Main Outcome: Improved knee functionality as assessed by repeated clinical evaluation based on the International Knee Documentation Committee Scale and the Lysholm Knee Scoring Scale. Results: Fourteen patients (31.8{\%}) experienced substantial improvement following the initial debridement and, being clinically cured, received no further treatment. Seven patients (15.9{\%}) were lost to follow-up. Among the 23 patients (52.3{\%}) who could effectively be evaluated, a complete recovery (ie, Lysholm Knee Scoring Scale score, 90-100) was observed upon clinical examination in 88{\%} of the mosaicplasty-treated patients and in 68{\%} of the ACI-treated ones (P = 0.093). Conclusions: Although the low power of our study prevents definitive conclusions, ACI and mosaicplasty are cartilage repair techniques that are clinically equivalent and similar in performance. The high percentage of spontaneous improvement (1/3 of the patients) observed after simple debridement calls into question the need for prompt surgical treatment of patients with lesions similar to those included in this clinical trial. Moreover, this finding warrants further investigation, ideally through randomized clinical trials in which patients subjected to debridement alone are compared with patients undergoing reconstructive surgery.",
keywords = "Articular cartilage, Autologous chondrocyte implantation, Mosaicplasty, Randomized study, Traumatic lesion",
author = "Beatrice Dozin and Mara Malpeli and Ranieri Cancedda and Paolo Bruzzi and Silvano Calcagno and Luigi Molfetta and Ferdinando Priano and Elisaveta Kon and Maurilio Marcacci",
year = "2005",
month = "7",
language = "English",
volume = "15",
pages = "218--224",
journal = "Clinical Journal of Sport Medicine",
issn = "1050-642X",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Comparative evaluation of autologous chondrocyte implantation and mosaicplasty

T2 - A multicentered randomized clinical trial

AU - Dozin, Beatrice

AU - Malpeli, Mara

AU - Cancedda, Ranieri

AU - Bruzzi, Paolo

AU - Calcagno, Silvano

AU - Molfetta, Luigi

AU - Priano, Ferdinando

AU - Kon, Elisaveta

AU - Marcacci, Maurilio

PY - 2005/7

Y1 - 2005/7

N2 - Objective: To compare the respective performance and effectiveness of autologous chondrocyte implantation (ACI) and mosaicplasty at resurfacing local full-thickness chondral defects of the knee. Design: Randomized clinical trial. Setting: Multicenter trial at orthopedic clinics and university hospitals conducted from 1997 to 2000. Patients: A population of patients selected according to eligibility criteria of age, traumatic origin of the defect, its localization, size, and gravity, and above all, no previous surgical treatment of the lesion. Forty-seven patients were randomly assigned to ACI or mosaicplasty and subjected to arthroscopic debridement of the lesion at the time of enrollment. They were called for surgery 6 months after the initial debridement. Main Outcome: Improved knee functionality as assessed by repeated clinical evaluation based on the International Knee Documentation Committee Scale and the Lysholm Knee Scoring Scale. Results: Fourteen patients (31.8%) experienced substantial improvement following the initial debridement and, being clinically cured, received no further treatment. Seven patients (15.9%) were lost to follow-up. Among the 23 patients (52.3%) who could effectively be evaluated, a complete recovery (ie, Lysholm Knee Scoring Scale score, 90-100) was observed upon clinical examination in 88% of the mosaicplasty-treated patients and in 68% of the ACI-treated ones (P = 0.093). Conclusions: Although the low power of our study prevents definitive conclusions, ACI and mosaicplasty are cartilage repair techniques that are clinically equivalent and similar in performance. The high percentage of spontaneous improvement (1/3 of the patients) observed after simple debridement calls into question the need for prompt surgical treatment of patients with lesions similar to those included in this clinical trial. Moreover, this finding warrants further investigation, ideally through randomized clinical trials in which patients subjected to debridement alone are compared with patients undergoing reconstructive surgery.

AB - Objective: To compare the respective performance and effectiveness of autologous chondrocyte implantation (ACI) and mosaicplasty at resurfacing local full-thickness chondral defects of the knee. Design: Randomized clinical trial. Setting: Multicenter trial at orthopedic clinics and university hospitals conducted from 1997 to 2000. Patients: A population of patients selected according to eligibility criteria of age, traumatic origin of the defect, its localization, size, and gravity, and above all, no previous surgical treatment of the lesion. Forty-seven patients were randomly assigned to ACI or mosaicplasty and subjected to arthroscopic debridement of the lesion at the time of enrollment. They were called for surgery 6 months after the initial debridement. Main Outcome: Improved knee functionality as assessed by repeated clinical evaluation based on the International Knee Documentation Committee Scale and the Lysholm Knee Scoring Scale. Results: Fourteen patients (31.8%) experienced substantial improvement following the initial debridement and, being clinically cured, received no further treatment. Seven patients (15.9%) were lost to follow-up. Among the 23 patients (52.3%) who could effectively be evaluated, a complete recovery (ie, Lysholm Knee Scoring Scale score, 90-100) was observed upon clinical examination in 88% of the mosaicplasty-treated patients and in 68% of the ACI-treated ones (P = 0.093). Conclusions: Although the low power of our study prevents definitive conclusions, ACI and mosaicplasty are cartilage repair techniques that are clinically equivalent and similar in performance. The high percentage of spontaneous improvement (1/3 of the patients) observed after simple debridement calls into question the need for prompt surgical treatment of patients with lesions similar to those included in this clinical trial. Moreover, this finding warrants further investigation, ideally through randomized clinical trials in which patients subjected to debridement alone are compared with patients undergoing reconstructive surgery.

KW - Articular cartilage

KW - Autologous chondrocyte implantation

KW - Mosaicplasty

KW - Randomized study

KW - Traumatic lesion

UR - http://www.scopus.com/inward/record.url?scp=22944439374&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=22944439374&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:22944439374

VL - 15

SP - 218

EP - 224

JO - Clinical Journal of Sport Medicine

JF - Clinical Journal of Sport Medicine

SN - 1050-642X

IS - 4

ER -