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Background <p>Autologous chondrocyte implantation (ACI) procedures have improved the treatment of chondral lesions.</p> Aim <p>To evaluate the clinical efficacy of an ACI technique utilizing a&#xa0;collagen 1‑based hydrogel as a&#xa0;3D scaffold in mid-term to long-term follow-up.</p> Method <p>In this study 44&#xa0;patients were treated at a&#xa0;single, specialized center between 2006 and 2011. Of these 26&#xa0;patients were included in the follow-up at a&#xa0;median of 12&#xa0;years (SD ± 1.5&#xa0;years). Of these, 12&#xa0;cases of knee cartilage defects were assessed with the IKDC (International Knee Documentation Committee), ICRS (International Cartilage Regeneration &amp; Joint Preservation Society), modified Cincinnati and TAS (Tegner Activity Scale) Scores. Another&#xa0;6 of these agreed to a&#xa0;post-surgical magnetic resonance imaging (MRI) evaluation where the regenerated cartilage tissue was assessed via magnetic resonance observation of cartilage repair tissue (MOCART&#xa0;2.0) score (median follow up 159.17 ± 20.9 months). Additionally, 14&#xa0;patients were assessed via a&#xa0;telephone questionnaire assessing subjective patient satisfaction and pain on numeric rating scales (NRS) and the necessity for further surgery.</p> Results <p>The postoperative Lysholm score was 81.69 ± 11.39 (<i>p</i> &lt; 0.05), and the modified Cincinnati score was 7.38 ± 1.89 (<i>p</i> &lt; 0.001). Both scores improved significantly. The post-surgical subjective IKDC score was 64.80 ± 8.46 and the post-surgical TAS score was 4.23 ± 1.30. The MOCART 2.0&#xa0;was 53.33 (± 17.51).</p> <p>The questionnaire resulted in 12&#xa0;participants with no complications and&#xa0;2 requiring a&#xa0;second surgery. Subjective satisfaction resulted in a&#xa0;mean NRS of&#xa0;6.3 (± 3.4) and pain with&#xa0;3.6 (± 2.2).</p> Conclusion <p>The use of ACI utilizing a&#xa0;collagen 1‑based hydrogel as a&#xa0;3D scaffold was shown to result in a&#xa0;significant improvement after a&#xa0;long-term follow-up of 12&#xa0;(± 1.5) years with a&#xa0;good to moderate subjective satisfaction and low to moderate levels of pain.</p>

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Clinical follow-up 7–12 years after autologous chondrocyte implantation with a hydrogel scaffold (CaReS©) in knee cartilage defects

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  • 发表日期：

    2026年7月29日

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  • Markus Neubauer,
  • Ines Theiler,
  • Johannes Neugebauer,
  • Thomas Luksch,
  • Dietmar Dammerer,
  • Lukas B. Moser,
  • Thomas Klestil,
  • Stefan Nehrer

摘要

Background

Autologous chondrocyte implantation (ACI) procedures have improved the treatment of chondral lesions.

Aim

To evaluate the clinical efficacy of an ACI technique utilizing a collagen 1‑based hydrogel as a 3D scaffold in mid-term to long-term follow-up.

Method

In this study 44 patients were treated at a single, specialized center between 2006 and 2011. Of these 26 patients were included in the follow-up at a median of 12 years (SD ± 1.5 years). Of these, 12 cases of knee cartilage defects were assessed with the IKDC (International Knee Documentation Committee), ICRS (International Cartilage Regeneration & Joint Preservation Society), modified Cincinnati and TAS (Tegner Activity Scale) Scores. Another 6 of these agreed to a post-surgical magnetic resonance imaging (MRI) evaluation where the regenerated cartilage tissue was assessed via magnetic resonance observation of cartilage repair tissue (MOCART 2.0) score (median follow up 159.17 ± 20.9 months). Additionally, 14 patients were assessed via a telephone questionnaire assessing subjective patient satisfaction and pain on numeric rating scales (NRS) and the necessity for further surgery.

Results

The postoperative Lysholm score was 81.69 ± 11.39 (p < 0.05), and the modified Cincinnati score was 7.38 ± 1.89 (p < 0.001). Both scores improved significantly. The post-surgical subjective IKDC score was 64.80 ± 8.46 and the post-surgical TAS score was 4.23 ± 1.30. The MOCART 2.0 was 53.33 (± 17.51).

The questionnaire resulted in 12 participants with no complications and 2 requiring a second surgery. Subjective satisfaction resulted in a mean NRS of 6.3 (± 3.4) and pain with 3.6 (± 2.2).

Conclusion

The use of ACI utilizing a collagen 1‑based hydrogel as a 3D scaffold was shown to result in a significant improvement after a long-term follow-up of 12 (± 1.5) years with a good to moderate subjective satisfaction and low to moderate levels of pain.