TY - JOUR
T1 - Prior procedures, graft location, preoperative physical health, postoperative strength and graft integrity are associated with 10-year clinical outcome after matrix-induced autologous chondrocyte implantation
AU - Ebert, Jay R.
AU - Edwards, Peter K.
AU - Klinken, Sven
AU - Wood, David J.
AU - Janes, Gregory C.
N1 - Publisher Copyright:
© 2025 The Author(s). Knee Surgery, Sports Traumatology, Arthroscopy published by John Wiley & Sons Ltd on behalf of European Society of Sports Traumatology, Knee Surgery and Arthroscopy.
PY - 2026/2
Y1 - 2026/2
N2 - Purpose: To investigate factors associated with 10-year clinical scores after matrix-induced autologous chondrocyte implantation (MACI). Methods: This retrospective case series included 143 MACI patients with 10-year clinical and radiological follow-up. Clinical assessment included the Knee Injury and Osteoarthritis Outcome Score (KOOS) quality of life (KOOS-QOL) and sport and recreation (KOOS-Sport/Rec) subscales, and patient satisfaction. Regression analysis investigated the contribution of patient (age, sex, body mass index and preoperative physical health), surgical (symptom duration, prior surgeries, defect size and location) and postoperative variables, such as knee extensor strength and a magnetic resonance imaging (MRI) composite graft score, to 10-year clinical scores and being ‘very satisfied’. Results: The KOOS-QOL (p < 0.001) and KOOS-Sport/Rec (p < 0.0001) improved from baseline to 10 years, with 88 (61.5%) patients ‘very satisfied’ with their outcome. A lower number of prior surgical procedures, greater knee extensor strength, and a better 10-year MRI score contributed significantly to a higher KOOS-QOL. For the KOOS-Sport/Rec, a lower number of prior surgical procedures, undergoing tibiofemoral (versus patellofemoral) MACI, greater preoperative physical health and a better 10-year MRI score contributed significantly to a better score. Finally, a lower number of prior procedures and greater preoperative physical health contributed to a patient being ‘very satisfied’. Conclusion: Factors including the number of prior procedures, defect location, preoperative physical health, postoperative quadriceps strength and MRI-based graft integrity were associated with improved 10-year clinical scores. This information will permit more tailored patient discussion, along with the setting of realistic, longer-term expectations for outcomes. Level of Evidence: Level IV.
AB - Purpose: To investigate factors associated with 10-year clinical scores after matrix-induced autologous chondrocyte implantation (MACI). Methods: This retrospective case series included 143 MACI patients with 10-year clinical and radiological follow-up. Clinical assessment included the Knee Injury and Osteoarthritis Outcome Score (KOOS) quality of life (KOOS-QOL) and sport and recreation (KOOS-Sport/Rec) subscales, and patient satisfaction. Regression analysis investigated the contribution of patient (age, sex, body mass index and preoperative physical health), surgical (symptom duration, prior surgeries, defect size and location) and postoperative variables, such as knee extensor strength and a magnetic resonance imaging (MRI) composite graft score, to 10-year clinical scores and being ‘very satisfied’. Results: The KOOS-QOL (p < 0.001) and KOOS-Sport/Rec (p < 0.0001) improved from baseline to 10 years, with 88 (61.5%) patients ‘very satisfied’ with their outcome. A lower number of prior surgical procedures, greater knee extensor strength, and a better 10-year MRI score contributed significantly to a higher KOOS-QOL. For the KOOS-Sport/Rec, a lower number of prior surgical procedures, undergoing tibiofemoral (versus patellofemoral) MACI, greater preoperative physical health and a better 10-year MRI score contributed significantly to a better score. Finally, a lower number of prior procedures and greater preoperative physical health contributed to a patient being ‘very satisfied’. Conclusion: Factors including the number of prior procedures, defect location, preoperative physical health, postoperative quadriceps strength and MRI-based graft integrity were associated with improved 10-year clinical scores. This information will permit more tailored patient discussion, along with the setting of realistic, longer-term expectations for outcomes. Level of Evidence: Level IV.
KW - clinical outcomes
KW - matrix-induced autologous chondrocyte implantation
KW - patient satisfaction
KW - predictors
UR - https://www.scopus.com/pages/publications/105009915264
U2 - 10.1002/ksa.12699
DO - 10.1002/ksa.12699
M3 - Article
C2 - 40622107
AN - SCOPUS:105009915264
SN - 0942-2056
VL - 34
SP - 509
EP - 519
JO - Knee Surgery, Sports Traumatology, Arthroscopy
JF - Knee Surgery, Sports Traumatology, Arthroscopy
IS - 2
ER -