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Arthroscopic matrix-associated, injectable autologous chondrocyte transplantation of the hip: significant improvement in patient-related outcome and good transplant quality in MRI assessment

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Acetabular chondral lesions are common in patients with FAI. For large full-thickness cartilage defects, arthroscopic matrix-associated autologous chondrocyte transplantation (MACT) using an injectable in situ crosslinking product is an option. Aim of the study was to evaluate clinical and MRI results 12 months after MACT of acetabular cartilage defects in FAI patients.

Methods

We report data on 21 patients with a focal cartilage defect of the hip [2.97 ± 1.44 cm2 (mean ± SD)] caused by FAI treated with an arthroscopically conducted MACT combined with FAI surgery. The results were assessed with patient-reported outcome measures (iHOT33, EQ-5D) pre- as well as post-operatively and by MRI using MOCART scoring system 6 and 12 months post-operatively.

Results

The iHOT33 score improved from 52.9 ± 21.14 (mean ± SD) pre-operative to 81.08 ± 22.04 (mean ± SD; p = 0.0012) 12 months post-operatively. The lower the pre-operative iHOT33 score and the larger the defect size, the greater the observed improvement compared to pre-operative scores at 12 months. Patients showed a significant improvement in EQ-5D-5L index value (p = 0.0015) and EQ-5D VAS (p = 0.0006). MRI analysis after 12 months revealed a complete integration of the transplant in 16 of 20 patients.

Conclusions

Injectable MACT is a promising minimally invasive treatment option for full-thickness cartilage defects of the hip caused by FAI. A significant improvement in symptoms and function associated with an increase in quality of life was detected in patients treated with injectable MACT combined with FAI surgery. This is of considerable clinical relevance, since, in addition to the elimination of the mechanical cause, MACT allows the successful therapy of consequential cartilage damage.

Level of evidence

Level 4, case series.

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Funding

This study was funded by TETEC Tissue Engineering Technologies AG, Reutlingen, Germany.

Author information

Authors and Affiliations

  1. University Centre for Orthopaedics and Trauma Surgery, University Hospital Carl Gustav Carus at Technische Universität Dresden, Fetscherstr. 74, Building 29, 01307, Dresden, Germany

    Henriette Bretschneider, Albrecht Hartmann & Klaus-Peter Günther

  2. Department of Biomedical Imaging and Image Guided Therapy, High Field MR Center, Medical University of Vienna, Vienna, Austria

    Siegfried Trattnig

  3. Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria

    Siegfried Trattnig

  4. Department of Orthopaedics and Trauma Surgery, University of Duisburg-Essen, Essen, Germany

    Stefan Landgraeber

  5. Orthopedic Surgery München, OCM Clinic GmbH, Munich, Germany

    Michael Dienst

  6. Center for Musculoskeletal Surgery, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany

    Jörg Schröder

  7. Medical Faculty Mannheim, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany

    Stefan Fickert

  8. Sporthopaedicum Straubing Berlin Regensburg, Straubing, Germany

    Stefan Fickert

Authors
  1. Henriette Bretschneider
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  2. Siegfried Trattnig
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  3. Stefan Landgraeber
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  4. Albrecht Hartmann
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  5. Klaus-Peter Günther
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  7. Jörg Schröder
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  8. Stefan Fickert
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Correspondence to Klaus-Peter Günther.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was approved according to the local institutional review board (#EK 48022014) and has been registered by ClinicalTrials.gov (NCT02179346).

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Bretschneider, H., Trattnig, S., Landgraeber, S. et al. Arthroscopic matrix-associated, injectable autologous chondrocyte transplantation of the hip: significant improvement in patient-related outcome and good transplant quality in MRI assessment. Knee Surg Sports Traumatol Arthrosc 28, 1317–1324 (2020). https://doi.org/10.1007/s00167-019-05466-7

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  • DOI: https://doi.org/10.1007/s00167-019-05466-7

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