Abstract 27

HISTOLOGICAL CLASSIFICATION OF 58 PATIENTS WITH PLASTIC - EMBEDDED FULL THICKNESS CORE BIOPSIES 2.6-53.1 MONTHS FOLLOWING AUTOLOGOUS CHONDROCYTE IMPLANTATION (ACI) .

Barry W. Oakes and Sue Connell

Department of Anatomy and Cell Biology, Monash University,Melbourne and Ian Henderson, St. Vincents and Mercy Private Hospitals Melbourne, Australia.

58 patients with a mean age of 38 years at ACI implantation (range 14 - 62 years) had full thickness (including subchondral bone) central (C) and/or marginal (M) core biopsies using a Giebel needle (approx.2.00mm internal diameter) of their repairing lesions at a mean of 12.2 months post-implantation (range 2.6-53.1 months) due to clinical symptoms requiring a second -look arthroscopy. All patients had the classic Brittberg and Peterson ACI surgery using a periosteal patch. The biopsy tissues were classified as hyaline articular cartilage (HAC), 'hyaline-like' articular cartilage (HLC), fibrocartilage (FC), periosteum and mixtures of the above eg. HLC/FC.

Overall in the knee 64% were either HAC or HLC. In most biopsies examined at >12 months post- ACI the periosteal layer was intact with a gradation from periosteal tissue to HLC to HAC in the deep layer adjacent to subchondral bone. After 12 months the periosteal layer was usually absent but in four MFC patients periosteal remodelling was observed. In one patient calcification was present. Of interest in this study was the large number of FC biopsies within the central trochlea (60%) compared to central MFC biopsies (30%) suggesting perhaps an inadequate loading regimen during their rehabilitation program. Interface sections at the margins demonstrated 'seamless' integration with normal HAC.

These results are the largest collection of full thickness core biopsies to be reported to date and are similar to those of Richardson (n=2), Knutsen et al (n=14),2001, Mainil-Varlet et al. 2003 Briggs et al (n=14),2003 and Knutzen et al, (n=32),2004.

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