Results of ACL Reconstruction with Autologous Cartilage Transplantation (ACI)

Rainer Siebold, MD, Prof., Heidelberg GERMANY
International Center for Orthopaedics, ATOS Hospital, Heidelberg, GERMANY

Summary

The combination of ACL reconstruction and ACI leads to good clinical results with a success rate of more than 90%.


Abstract

Introduction

An ACL rupture with full size articular cartilage lesion is rare but a severe knee injury. The aim of this study was to evaluate the clinical outcome of combined ACL and ACI surgery.

Material And Methods

33 patients with combined ACL- and full size articular femoral cartilage lesion were included in this retrospective study. 20 patients had a primary ACL reconstruction, 13 patients ACL revision surgery. In 19 patients the ACI was performed simultaneously to the ACL reconstruction, in 14 patients 6-7 weeks after ACL reconstruction. 5 patients had an additional HTO. F/u consisted of a clinical examination, stability measurement and MRI.

Results

33 patients were available for f/u a minimum of 1 year postoperatively (range 1 to 10 years). 30 patients showed a stable knee with good cartilage healing on MRI. One patient sustained a new trauma 3 years postop and had revision ACL and ACI surgery. Two more patients had a Re-ACI 9 to 24 months after index surgery. The revision rate was 3% for ACL-R and 9% for ACI.

Discussion

The combination of ACL reconstruction and ACI leads to good clinical results. The additional ACI with 7-8 weeks of partial weight bearing seems not to compromise the result of the ACL reconstruction, nor the range of motion. ACI was successful in more than 90%, indicating a good healing environment with ACL reconstruction.