So first I want to thank AOSSM for letting us present our study here. My name is Antonio and I'm going to present on behalf of my team. These are our disclosures. So as we all know, cardiac lesions are a really common finding in arthroscopic surgeries, especially of young athletic adults. And if we don't treat these lesions, the patients will have pain and will eventually develop early osteoarthritis. So classic cartilage repair techniques, such as microfractures, have shown to have a clinical decline in the long term. So we're still looking for a long-term alternative to repair these lesions. And matrix-assisted autologous chondrocyte transplantation or third-generation ACI could be an alternative. However, there's still limited information about how does this technique do in the long term. Therefore, we have decided to carry out a study to evaluate the clinical and structural outcomes after undergoing matrix-assisted autologous chondrocyte transplantation. So we designed a case series where we included 36 patients, all had symptomatic grade III or IV cartilage lesions. None of them had any previous cartilage repair technique performed. And all of them underwent all arthroscopic matrix-assisted autologous chondrocyte transplantation. This is a drawing which was recently published at AHSM last year, where we show our technique where we basically take a biopsy, osteochondral biopsy, then we isolate the chondrocyte, we expand them, then we seed them into a polyglycolic acid scaffold. And then that construct we implant it to the cartilage lesion arthroscopically. So we followed up patients up to 10 years using magnetic resonance imaging, patient-reported outcome measures, and an arthroscopic second look. And this is what we found. Out of the 36 patients, we couldn't contact 13, but we did contact 23 of the patients and all of them completed a 10-year follow-up. And these are the baseline characteristics of the 23 patients. As we can see, the average chondral lesion was around 2 centimeters squared. Most of them were grade IV. And around 74% of the patients underwent another concomitant procedure, such as ACL repair, PCL repair, or another meniscal procedure. So starting with the structural outcomes, here we can see that T2 mapping values between the healthy cartilage, which is the gray dotted line, compared to the repair tissue, T2 mapping values are pretty different before the surgery. However, these differences were decreased throughout the whole follow-up, having no significant differences after 5 to 10 years. MOCART scores were stable throughout the whole follow-up, and we obtained a final score of 60 after 10 years. In the arthroscopic second look, patients obtained a median score of 11, ICRA's microscopic score, meaning that patients had a nearly normal cartilage after a year of the procedure. This is an actual picture of a patient. And clinically, patients were feeling significantly better after the 10 years of the follow-up, compared to how they were feeling for the surgery. And we didn't observe any major clinical decline, as you can see in these Holman AKDC graphs. So clinically-wise, patients were having significantly better activity after 10 years, compared to before the surgery. However, this activity level was still lower than what they used to have before having the injury. We only had one patient that underwent a re-operation, because he was having symptoms after two years. We had no failures, because we defined it as total knee replacement, and we had 70% of the patients considered responders, using the minimum clinical importance difference for the AKDC score at 10 years. Throughout the follow-up, throughout the study, we encountered some limitations, starting with the small sample size, the patient that we couldn't contact for this presentation, and then we had no control group to compare with. So we don't really know the effectiveness of the technique, compared to other treatments. These are all the points that I previously mentioned in the previous slides, and with all of this, we can conclude that matrix-assisted autologous chondrocyte transplantation could be a long-lasting alternative for patients with focal chondral lesions in the knee. Thank you very much.

matrix-assisted autologous chondrocyte transplantation

third-generation ACI

cardiac lesions

arthroscopic surgeries

cartilage lesions