Arthroscopic autologous minced cartilage implantation for one stage reconstruction of chondral lesion of the femoral condyle of the knee joint: Surgical decision making and short term outcome with review of literature- case report

Abstract

Background: Chondral defects of the knee joint are commonly seen but it still remains a management challenge. (1) Recently joint preserving treatment options have become popular like the autologous chondrocyte implantation (ACI) and minced cartilage implantation (MCI). (2) ACI is the gold standard for larger lesions but it is a two-stage procedure and less cost effective when compared to MCI. Arthroplasty is mostly reserved for elderly patients and low demand patients. Case report: 35 year female suffered from persistent stress related knee pain. MRI revealed full thickness grade 3 ICRS cartilage lesion in the medial femoral condyle. She underwent Autocart procedure (Arthrex, Munich, Germany) followed by regular observed physiotherapy. Conclusion: She was followed up after 6 weeks, 3 months, 6 months and 1 year and 2 year. Lysholm score improved to 96.03 and her KOOS sub scores improved for pain (from 50 to 92), symptoms (from 55 to 95), sports and recreation (from 36 to 92), and quality of life (from 38 to 94). 1 year post-operative MRI revealed a healed cartilage lesion. The preoperative MRI AMADEUS score was 40 which improved to 1 year post-operative MOCART score of 80. Minced autologous cartilage implantation methods for full thickness cartilage defects is an attractive alternative when compared to other cartilage repair techniques even though long term data are still awaited.

Keywords

• Full thickness cartilage defect
• ACI
• MCI
• Arthroscopic autocart
• Case report