Prior Surgery Negatively Affects Cell Culture Identity in Patients Undergoing Autologous Chondrocyte Implantation.

Abstract

Recently, a cell identity assay has been introduced to evaluate the identity of cultured chondrocytes before autologous chondrocyte implantation (ACI), which was shown to be associated with graft survival after ACI. To identify the influence of several patient- and lesion-specific factors on cell identity and viability assays. Cross-sectional study; Level of evidence, 3. A total of 187 patients with second-generation ACI were included in this study. Patient and lesion characteristics, cell viability, cell identity, and biopsy specimen weight were recorded for each patient. A binomial logistic regression model was utilized to determine patient-specific predictive factors for cell product quality. The implanted ACI cell products showed a cell viability of 93% ± 2.4% (mean ± SD; range, 84-98) with an identity score of 5.8 ± 2.1 (range, -0.08 to 9.46). Patients with multiple previous surgical procedures on the index knee had significantly lower cell identity scores when compared with patients without previous surgery (odds ratio = 0.31; 95% CI, 0.16-0.59; <i>P</i> < .001). Patients without surgical history had significantly higher cell identity scores than patients with 1 and ≥2 previous surgical procedures on the index knee (6.32 vs 5.32 vs 5.05; <i>P</i> = .006 and <i>P</i> < .001, respectively). Cell viability was not predicted by any preoperative variable (<i>P</i> > .05). Cell identity and viability were not associated with each other or with biopsy specimen weight (<i>P</i> > .05). Cartilage biopsy specimens from patients with ≥1 previous surgical procedures resulted in implants with lower cell identity scores when compared with patients without previous operations. None of the other patient- or lesion-specific factors were correlated, specifically biopsy specimen weight.