Combination of autologous chondrocyte implantation (ACI) and osteochondral autograft transfer system (OATS) for surgical repair of larger cartilage defects of the knee joint. A review illustrated by a case report

Article type: Review Article

Authors: Duif, Christian^{a; *} | Koutah, Mohamed Abou^a | Ackermann, Ole^b | Spyrou, Georgios^a | von Engelhardt, Lars Victor^c | Kaya, Daimi^a | Willburger, Roland E.^a | Lahner, Matthias^a

Affiliations: [a] Department of Orthopaedic Surgery, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstrasse, Bochum, Germany | [b] Medical Practice Duisburg, Ruhr-University Bochum, Germany | [c] Faculty of Health, University of Witten/Herdecke, Witten, Germany

Correspondence: [*] Corresponding author: Christian Duif, Department of Orthopaedic Surgery, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstrasse 56, 44791 Bochum, Germany. Tel.: +49 234 509 6526; Fax: +49 234 509 2508; E-mail:christian.duif@freenet.de

Abstract: OBJECTIVES: Modern orthopaedic surgery provides a variety of techniques for cartilage repair. Despite comprehensive scientific data about the single procedures, there is little experience with the combination of these methods. Inspired by a case from our clinic, we performed a PubMed based literature search about the combination of cartilage restoration principles. MATERIALS AND METHODS: The literature search was performed using the terms: ``mosaicplasty'' OR ``osteochondral transplantation'' OR ``OATS'' AND ``autologous chondrocyte implantation'' OR ``autologous chondrocyte transplantation'' OR ``ACI'' OR ``matrix-associated autologous chondrocyte implantation'' OR ``MACI'' AND ``combination''. Abstracts were revised for relevance to our case. Additionally, we present a case report of the combinatory use of three established techniques. RESULTS: Two relevant publications, both reporting satisfying results concerning postoperative functional outcome, were found. Our results confirm this first encouraging assessment, although statistically valid data and prospective studies are still missing. CONCLUSIONS: The simultaneous use of different techniques for cartilage repair may provide alternative operative solutions for single complex cases, although further studies are required for a general recommendation.

Keywords: Cartilage repair, OATS, mosaicplasty, ACI, osteochondral defect

DOI: 10.3233/THC-151003

Journal: Technology and Health Care, vol. 23, no. 5, pp. 531-537, 2015