PDF herunterladen
CC BY-NC-ND 4.0 · Joints 2017; 05(02): 093-106
DOI: 10.1055/s-0037-1603900
Review Article
Georg Thieme Verlag KG Stuttgart · New York

How to Manage a Failed Cartilage Repair: A Systematic Literature Review

Donato Rosa
1   Orthopaedic Unit, Department of Public Health, School of Medicine “Federico II” University, Naples, Italy
,
Sigismondo Luca Di Donato
1   Orthopaedic Unit, Department of Public Health, School of Medicine “Federico II” University, Naples, Italy
,
Giovanni Balato
1   Orthopaedic Unit, Department of Public Health, School of Medicine “Federico II” University, Naples, Italy
,
Alessio D'Addona
1   Orthopaedic Unit, Department of Public Health, School of Medicine “Federico II” University, Naples, Italy
,
Francesco Smeraglia
1   Orthopaedic Unit, Department of Public Health, School of Medicine “Federico II” University, Naples, Italy
,
Gaetano Correra
1   Orthopaedic Unit, Department of Public Health, School of Medicine “Federico II” University, Naples, Italy
,
Gianni Di Vico
2   Department of Orthopaedic Surgery, “S. Michele” Clinic, Maddaloni, Italy
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
28. Juli 2017 (online)

   Lizenzen und Reprints

Abstract

Purpose The aims of this paper are to report the rate and risk factors for the failure of the most common cartilage repair technique, and analyze the most important factors that could influence the choice of a specific surgical treatment to revise a failed cartilage repair.

Methods A review of the literature was performed focusing on failed cartilage repair and related treatments. Two of the authors independently screened articles. Conflicts about the inclusion of a paper was resolved by further evaluation by the senior author. Review articles, articles written in languages different from/other than English, case reports, and papers that did not evaluate the outcomes of interest were excluded. Full-text version of each included paper was obtained and relevant data were extracted and collected in a database.

Results At the end of the screening process, 31 articles were included. Microfractures and mosaicplasty showed a nonnegligible failure rate at short- and midterm. Better results, especially in terms of time to failure or revision, were reported with the use of autologous chondrocyte implantation (ACI) and osteochondral allograft (OCA) transplantation. Regarding the treatment of failed cartilage repair, the use of OCA transplantation in patients with previous failed cartilage repair may be a safe option. The revision of failed OCA transplantation with further OCA seems to have a greater failure rate. Patients with previous failed ACI or matrix-induced autologous chondrocyte implantation (MACI) who underwent further MACI or ACI reported acceptable results. Otherwise, ACI in patients with history of previous subchondral marrow stimulation (SMS) demonstrated a greater failure rate.

Conclusion From the analysis of the literature, OCA transplantation seems to be the most reliable treatment of a failed SMS. ACI or MACI showed acceptable results in patients with previously failed MACI or ACI.

Level of Evidence Level IV, systematic review of level I-IV studies.

Keywords

cartilage - repair - failure - revision - surgery
 

  • References

  • 1 Curl WW, Krome J, Gordon ES, Rushing J, Smith BP, Poehling GG. Cartilage injuries: a review of 31,516 knee arthroscopies. Arthroscopy 1997; 13 (04) 456-460
    CrossrefPubMedSuche in Google Scholar
  • 2 Biant LC, McNicholas MJ, Sprowson AP, Spalding T. The surgical management of symptomatic articular cartilage defects of the knee: consensus statements from United Kingdom knee surgeons. Knee 2015; 22 (05) 446-449
    CrossrefPubMedSuche in Google Scholar
  • 3 Bedi A, Feeley BT, Williams III RJ. Management of articular cartilage defects of the knee. J Bone Joint Surg Am 2010; 92 (04) 994-1009
    CrossrefPubMedSuche in Google Scholar
  • 4 Salzmann GM, Sah B, Südkamp NP, Niemeyer P. Reoperative characteristics after microfracture of knee cartilage lesions in 454 patients. Knee Surg Sports Traumatol Arthrosc 2013; 21 (02) 365-371
    CrossrefPubMedSuche in Google Scholar
  • 5 Solheim E, Øyen J, Hegna J, Austgulen OK, Harlem T, Strand T. Microfracture treatment of single or multiple articular cartilage defects of the knee: a 5-year median follow-up of 110 patients. Knee Surg Sports Traumatol Arthrosc 2010; 18 (04) 504-508
    CrossrefPubMedSuche in Google Scholar
  • 6 Steadman JR, Briggs KK, Matheny LM, Guillet A, Hanson CM, Willimon SC. Outcomes following microfracture of full-thickness articular cartilage lesions of the knee in adolescent patients. J Knee Surg 2015; 28 (02) 145-150
    Thieme ConnectPubMedSuche in Google Scholar
  • 7 Bentley G, Biant LC, Vijayan S, Macmull S, Skinner JA, Carrington RW. Minimum ten-year results of a prospective randomised study of autologous chondrocyte implantation versus mosaicplasty for symptomatic articular cartilage lesions of the knee. J Bone Joint Surg Br 2012; 94 (04) 504-509
    PubMedSuche in Google Scholar
  • 8 Robb CA, El-Sayed C, Matharu GS, Baloch K, Pynsent P. Survival of autologous osteochondral grafts in the knee and factors influencing outcome. Acta Orthop Belg 2012; 78 (05) 643-651
    PubMedSuche in Google Scholar
  • 9 Degen RM, Coleman NW, Chang B, Tetreault D, Mahony GT, Williams RJ. Outcomes following structural grafting of distal femoral osteochondral injuries in patients aged 40 years and older. J Knee Surg 2017; 30 (03) 244-251
    Thieme ConnectPubMedSuche in Google Scholar
  • 10 Minas T, Von Keudell A, Bryant T, Gomoll AH. The John Insall Award: a minimum 10-year outcome study of autologous chondrocyte implantation. Clin Orthop Relat Res 2014; 472 (01) 41-51
    CrossrefPubMedSuche in Google Scholar
  • 11 Beris AE, Lykissas MG, Kostas-Agnantis I, Manoudis GN. Treatment of full-thickness chondral defects of the knee with autologous chondrocyte implantation: a functional evaluation with long-term follow-up. Am J Sports Med 2012; 40 (03) 562-567
    CrossrefPubMedSuche in Google Scholar
  • 12 Gomoll AH, Gillogly SD, Cole BJ. , et al. Autologous chondrocyte implantation in the patella: a multicenter experience. Am J Sports Med 2014; 42 (05) 1074-1081
    CrossrefPubMedSuche in Google Scholar
  • 13 Farr J. Autologous chondrocyte implantation improves patellofemoral cartilage treatment outcomes. Clin Orthop Relat Res 2007; 463: 187-194
    CrossrefPubMedSuche in Google Scholar
  • 14 Minas T, Gomoll AH, Solhpour S, Rosenberger R, Probst C, Bryant T. Autologous chondrocyte implantation for joint preservation in patients with early osteoarthritis. Clin Orthop Relat Res 2010; 468 (01) 147-157
    CrossrefPubMedSuche in Google Scholar
  • 15 Jungmann PM, Salzmann GM, Schmal H, Pestka JM, Südkamp NP, Niemeyer P. Autologous chondrocyte implantation for treatment of cartilage defects of the knee: what predicts the need for reintervention?. Am J Sports Med 2012; 40 (01) 58-67
    CrossrefPubMedSuche in Google Scholar
  • 16 Erggelet C, Kreuz PC, Mrosek EH. , et al. Autologous chondrocyte implantation versus ACI using 3D-bioresorbable graft for the treatment of large full-thickness cartilage lesions of the knee. Arch Orthop Trauma Surg 2010; 130 (08) 957-964
    CrossrefPubMedSuche in Google Scholar
  • 17 Niemeyer P, Pestka JM, Kreuz PC. , et al. Characteristic complications after autologous chondrocyte implantation for cartilage defects of the knee joint. Am J Sports Med 2008; 36 (11) 2091-2099
    CrossrefPubMedSuche in Google Scholar
  • 18 Niethammer TR, Valentin S, Ficklscherer A, Gülecyüz MF, Pietschmann MF, Müller PE. Revision surgery after third generation autologous chondrocyte implantation in the knee. Int Orthop 2015; 39 (08) 1615-1622
    CrossrefPubMedSuche in Google Scholar
  • 19 Briggs DT, Sadr KN, Pulido PA, Bugbee WD. The use of osteochondral allograft transplantation for primary treatment of cartilage lesions in the knee. Cartilage 2015; 6 (04) 203-207
    CrossrefPubMedSuche in Google Scholar
  • 20 Frank RM, Lee S, Levy D. , et al. Osteochondral allograft transplantation of the knee: analysis of failures at 5 years. Am J Sports Med 2017; 45 (04) 864-874
    CrossrefPubMedSuche in Google Scholar
  • 21 Levy YD, Görtz S, Pulido PA, McCauley JC, Bugbee WD. Do fresh osteochondral allografts successfully treat femoral condyle lesions?. Clin Orthop Relat Res 2013; 471 (01) 231-237
    CrossrefPubMedSuche in Google Scholar
  • 22 Sadr KN, Pulido PA, McCauley JC, Bugbee WD. Osteochondral allograft transplantation in patients with osteochondritis dissecans of the knee. Am J Sports Med 2016; 44 (11) 2870-2875
    CrossrefPubMedSuche in Google Scholar
  • 23 Gracitelli GC, Meric G, Pulido PA, Görtz S, De Young AJ, Bugbee WD. Fresh osteochondral allograft transplantation for isolated patellar cartilage injury. Am J Sports Med 2015; 43 (04) 879-884
    CrossrefPubMedSuche in Google Scholar
  • 24 Meric G, Gracitelli GC, Görtz S, De Young AJ, Bugbee WD. Fresh osteochondral allograft transplantation for bipolar reciprocal osteochondral lesions of the knee. Am J Sports Med 2015; 43 (03) 709-714
    CrossrefPubMedSuche in Google Scholar
  • 25 Murphy RT, Pennock AT, Bugbee WD. Osteochondral allograft transplantation of the knee in the pediatric and adolescent population. Am J Sports Med 2014; 42 (03) 635-640
    CrossrefPubMedSuche in Google Scholar
  • 26 Farr J, Gracitelli GC, Shah N, Chang EY, Gomoll AH. High failure rate of a decellularized osteochondral allograft for the treatment of cartilage lesions. Am J Sports Med 2016; 44 (08) 2015-2022
    CrossrefPubMedSuche in Google Scholar
  • 27 Dhollander AA, Liekens K, Almqvist KF. , et al. A pilot study of the use of an osteochondral scaffold plug for cartilage repair in the knee and how to deal with early clinical failures. Arthroscopy 2012; 28 (02) 225-233
    CrossrefPubMedSuche in Google Scholar
  • 28 Joshi N, Reverte-Vinaixa M, Díaz-Ferreiro EW, Domínguez-Oronoz R. Synthetic resorbable scaffolds for the treatment of isolated patellofemoral cartilage defects in young patients: magnetic resonance imaging and clinical evaluation. Am J Sports Med 2012; 40 (06) 1289-1295
    CrossrefPubMedSuche in Google Scholar
  • 29 Berruto M, Delcogliano M, de Caro F. , et al. Treatment of large knee osteochondral lesions with a biomimetic scaffold: results of a multicenter study of 49 patients at 2-year follow-up. Am J Sports Med 2014; 42 (07) 1607-1617
    CrossrefPubMedSuche in Google Scholar
  • 30 Gracitelli GC, Meric G, Pulido PA, McCauley JC, Bugbee WD. Osteochondral allograft transplantation for knee lesions after failure of cartilage repair surgery. Cartilage 2015; 6 (02) 98-105
    CrossrefPubMedSuche in Google Scholar
  • 31 Gracitelli GC, Meric G, Briggs DT. , et al. Fresh osteochondral allografts in the knee: comparison of primary transplantation versus transplantation after failure of previous subchondral marrow stimulation. Am J Sports Med 2015; 43 (04) 885-891
    CrossrefPubMedSuche in Google Scholar
  • 32 Horton MT, Pulido PA, McCauley JC, Bugbee WD. Revision osteochondral allograft transplantations: do they work?. Am J Sports Med 2013; 41 (11) 2507-2511
    CrossrefPubMedSuche in Google Scholar
  • 33 Stone KR, Pelsis JR, Crues III JV, Walgenbach AW, Turek TJ. Osteochondral grafting for failed knee osteochondritis dissecans repairs. Knee 2014; 21 (06) 1145-1150
    CrossrefPubMedSuche in Google Scholar
  • 34 Vijayan S, Bentley G, Rahman J, Briggs TW, Skinner JA, Carrington RW. Revision cartilage cell transplantation for failed autologous chondrocyte transplantation in chronic osteochondral defects of the knee. Bone Joint J 2014; 96-B (01) 54-58
    CrossrefPubMedSuche in Google Scholar
  • 35 Rosa D, Balato G, Ciaramella G, Soscia E, Improta G, Triassi M. Long-term clinical results and MRI changes after autologous chondrocyte implantation in the knee of young and active middle aged patients. J Orthop Traumatol 2016; 17 (01) 55-62
    CrossrefPubMedSuche in Google Scholar
  • 36 Bert JM. Abandoning microfracture of the knee: has the time come?. Arthroscopy 2015; 31 (03) 501-505
    CrossrefPubMedSuche in Google Scholar
  • 37 Zedde P, Cudoni S, Giachetti G. , et al. Subchondral bone remodeling: comparing nanofracture with microfracture. an ovine in vivo study. Joints 2016; 4 (02) 87-93
    Thieme ConnectPubMedSuche in Google Scholar