Treatment of cartilage defects in the patellofemoral joint with matrix-associated autologous chondrocyte implantation effectively improves pain, function, and radiological outcomes after 5-7 years

Introduction The aim of the present study was to evaluate midterm outcomes 5-7 years after matrix-associated autologous chondrocyte implantation (MACI) in the patellofemoral joint.Materials and methods Twenty-six patients who had undergone MACI using the Novocart (R) 3D scaffold were prospectively evaluated. Clinical outcomes were determined by measuring the 36-Item Short-Form Health Survey (SF-36) and International Knee Documentation Committee (IKDC) scores and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) values preoperatively and 3, 6, and 12 months, and a mean of 6 years postoperatively. At the final follow-up, the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was evaluated.Results Twenty-two patients with 23 focal cartilage defects (19 patella and four trochlea) were available for the final follow-up. The mean defect size was 4.0 +/- 1.9 cm(2) (range 2.4-9.4 cm(2)). All clinical outcome scores improved significantly until 5-7 years after MACI (SF-36 score, 61.2 +/- 19.6 to 83.2 +/- 11.6; P = 0.001; IKDC score, 47.5 +/- 20.6 to 74.7 +/- 15.5; P < 0.001; and WOMAC, 29.8 +/- 15.7 to 8.2 +/- 10.3; P < 0.001). The mean MOCART score was 76.0 +/- 11.0 at the final follow-up. Nineteen of the 22 patients (86.4%) were satisfied with the outcomes after 5-7 years and responded that they would undergo the procedure again.Conclusion MACI in the patellofemoral joint demonstrated good midterm clinical results with a significant reduction in pain, improvement in function, and high patient satisfaction. These clinical findings are supported by radiological evidence from MOCART scores.