Skip to main content
SpringerLink
Log in

Avascular necrosis complicating chondral resurfacing techniques

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Autologous chondrocyte implantation (ACI) and mosaicplasty have become established operations used to treat full-thickness chondral lesions in the knee and elsewhere. Although complications of both have been documented, there are no previous reports of avascular necrosis (AVN) complicating these procedures. Awareness of AVN as a complication of ACI might have prompted an earlier diagnosis, with possible non-surgical treatment or more minor surgery being possible. At the very least, an appropriate form of management could have been initiated earlier, so shortening the period of disability and suffering for the patient.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Beris AE, Lykissas MG, Kostas-Agnantis I, Manoudis GN (2012) Treatment of full-thickness chondral defects of the knee with autologous chondrocyte implantation: a functional evaluation with long-term follow-up. Am J Sports Med 40(3):562–567

    Article  PubMed  Google Scholar 

  2. Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L (1994) Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med 331(14):889–895

    Article  CAS  PubMed  Google Scholar 

  3. de Windt TS, Concaro S, Lindahl A, Saris DBF, Brittberg M (2012) Strategies for patient profiling in articular cartilage repair of the knee: a prospective cohort of patients treated by one experienced cartilage surgeon. Knee Surg Sports Traumatol Arthrosc 20(11):2225–2232

    Article  PubMed  PubMed Central  Google Scholar 

  4. Ebert JR, Smith A, Edwards PK, Ackland TR (2014) The progression of isokinetic knee strength after matrix-induced autologous chondrocyte implantation: implications for rehabilitation and return to activity. J Sport Rehabil 23(3):244–258

    Article  PubMed  Google Scholar 

  5. Edwards PK, Ackland TR, Ebert JR (2013) Accelerated weightbearing rehabilitation after matrix-induced autologous chondrocyte implantation in the tibiofemoral joint: early clinical and radiological outcomes. Am J Sports Med 41(10):2314–2324

    Article  PubMed  Google Scholar 

  6. Edwards PK, Ebert JR, Janes GC, Wood D, Fallon M, Ackland T (2014) Arthroscopic versus open matrix-induced autologous chondrocyte implantation: results and implications for rehabilitation. J Sport Rehabil 23(3):203–215

    Article  PubMed  Google Scholar 

  7. Hangody L, Kish G, Karpati Z, Udvarhelyi I, Szigeti I, Bely M (1998) Mosaicplasty for the treatment of articular cartilage defects: application in clinical practice. Orthopedics 21:751–756

    CAS  PubMed  Google Scholar 

  8. Hangody L, Fules P (2003) Autologous osteochondral mosaicplasty for the treatment of full-thickness defects of weight-bearing joints: ten years of experimental and clinical experience. J Bone Joint Surg Am 85(Suppl 2):25–32

    PubMed  Google Scholar 

  9. Harris JD, Siston RA, Brophy RH, Lattermann C, Carey JL, Flanigan DC (2011) Failures, re-operations, and complications after autologous chondrocyte implantation: a systematic review. Osteoarthr Cartil 19(7):779–791

    Article  CAS  PubMed  Google Scholar 

  10. Kalson NS, Gikas PD, Briggs TW (2010) Current strategies for knee cartilage repair. Int J Clin Pract 64(10):1444–1452

    Article  CAS  PubMed  Google Scholar 

  11. Karnes JM, Harris JD, Griesser MJ, Flanigan DC (2013) Continuous passive motion following cartilage surgery: Does a common protocol exist? Phys Sportsmed 41(4):53–63

    Article  PubMed  Google Scholar 

  12. Lim HC, Bae JH, Song SH, Park YE, Kim SJ (2012) Current treatments of isolated articular cartilage lesions of the knee achieve similar outcomes. Clin Orthop Relat Res 470(8):2261–2267

    Article  PubMed  PubMed Central  Google Scholar 

  13. Lynch TS, Patel RM, Benedick A, Amin NH, Jones MH, Miniaci A (2015) Systematic review of autogenous osteochondral transplant outcomes. Arthroscopy 31(4):746–754

    Article  PubMed  Google Scholar 

  14. Memon AR, Quinlan JF (2012) Surgical treatment of articular cartilage defects in the knee: Are we winning? Adv Orthop 2012:528423

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Niemeyer P, Pestka JM, Kreuz PC, Erggelet C, Schmal H, Suedkamp NP, Steinwachs M (2008) Characteristic complications after autologous chondrocyte implantation for cartilage defects of the knee joint. Am J Sports Med 36(11):2091–2099

    Article  PubMed  Google Scholar 

  16. Redler LH, Caldwell JM, Schulz BM, Levine WN (2012) Management of articular cartilage defects of the knee. Phys Sportsmed 40(1):20–35

    Article  PubMed  Google Scholar 

  17. Sekiya I, Muneta T, Horie M, Koga H (2015) Arthroscopic transplantation of synovial stem cells improves clinical outcomes in knees with cartilage defects. Clin Orthop Relat Res 473(7):2316–2326

    Article  PubMed  PubMed Central  Google Scholar 

  18. Sellards RA, Nho SJ, Cole BJ (2002) Chondral injuries. Curr Opin Rheumatol 14(2):134–141

    Article  PubMed  Google Scholar 

  19. Seo SS, Kim CW, Jung DW (2011) Management of focal chondral lesion in the knee joint. Knee Surg Relat Res 23(4):185–196

    Article  PubMed  PubMed Central  Google Scholar 

  20. Simon T, Douglas J (2006) Articular cartilage: injury pathways and treatment options. Sports Med Arthrosc 14(3):146–154

    Article  PubMed  Google Scholar 

  21. Strauss EJ, Fonseca LE, Shah MR, Yorum T (2011) Management of focal cartilage defects in the knee—Is ACI the answer? Bull NYU Hosp Jt Dis 69(1):63–72

    PubMed  Google Scholar 

  22. Vasiliadis HS, Wasiak J, Salanti G (2010) Autologous chondrocyte implantation for the treatment of cartilage lesions of the knee. A systematic review of randomized studies. Knee Surg Sports Traumatol Arthrosc 18(12):1645–1655

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Imperial College London, Exhibition Rd, London, UK

    Anja Saso & Parag Raval

  2. Fortius Clinic London, London, UK

    Simon M. Thompson, Mary Jones & Andrew M. Williams

Authors
  1. Simon M. Thompson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anja Saso
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Parag Raval
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mary Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Andrew M. Williams
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Simon M. Thompson.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Thompson, S.M., Saso, A., Raval, P. et al. Avascular necrosis complicating chondral resurfacing techniques. Knee Surg Sports Traumatol Arthrosc 24, 1660–1664 (2016). https://doi.org/10.1007/s00167-015-3708-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-015-3708-3

Keywords

Search

Navigation