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Introduction: In this work we describe the use of high-density autologous chondrocyte implantation (HD-ACI) to treat 2 patients with chondral defects in the hip. Case Presentation: Two male, 35- and 37-year-old, with chondral lesions and femoroacetabular impingement (FAI) were included. Chondrocytes were isolated expanded in vitro and then implanted at a density of 5 million cells per cm2 onto a type I/III porcine collagen membrane. None of the patients had surgery-derived complications. Pain disappeared in both cases at 6 months after surgery and was maintained until follow-up end (36 months). International Hip Outcome Tool (iHOT) score increased at 6 and 12 months and then leveled off until month 36.Three-year arthro-MRI showed the cartilage defects had been filled with a material similar to the surrounding healthy cartilage. Conclusion: HD-ACI is a safe and effective technique for focal cartilage lesion treatment in patients affected by evolved FAI.

Purpose: To study clinical outcome of patients with bilateral ankle chondral defects treated with High-Density Autologous Chondrocyte Implantation (HD-ACI) in the same surgical act. Cases presentation: Two men (27 and 48 years-old) with chondral defects in both ankles evidenced by MRI. Chondral lesions were treated with HD-ACI in the same surgical act and anesthesia, consecutively. Patients were evaluated 2, 6 and 12 months after surgery to check for treatment safety and efficacy. Pain, evaluated by the Visual Analogic Scale (VAS), decreased from very high values (8.5 – 9) to normal or almost normal scores one year after surgery (0 – 1). Ankle functionality measured by the American Orthopedic Foot & Ankle Society score (AOFAS) and quality of life evaluated by the EuroQol five-dimensional five-level questionnaire (EQ-5D-5L) behaved similarly to pain. Thus, both parameters increased and/or slightly decreased at 2 months (AOFAS score: 53 and 51; EQ-5D-5L score: 0.42 and 0.33) and reached their maximum value at 12 months (AOFAS score: 90 and 89; EQ-5D-5L score: 0.89 and 0.91). MRI from both ankles revealed that chondral defects were filled with a material of similar aspect to the surrounding cartilage. Conclusion: Treatment of both ankles with HD-ACI in the same surgical act in patients with bilateral chondral lesions is a safe procedure, providing positive results from the clinical and patients’ quality of life points of view.

ABSTRACT: Introduction: Bilateral knee chondral defects can be treated in one or two surgical acts. Objectives: To study clinical outcome of patients with bilateral knee chondral defects treated with High-Density Autologous Chondrocyte Implantation (HD-ACI) during the same surgery. Methods: Study on eight patients (4 women and 4 men) with chondral defects in both knees treated with HD-ACI during the same surgical act. Patients were evaluated 2, 6, 12 and 24 months post-op for treatment safety and efficacy: visual analogic scale (VAS) for pain, International Knee Documentation Committee (IKDC) for subjective patient's perception of both knees and EuroQol five-dimensional five-level questionnaire (EQ-5D-5 L) for quality of life. Integrity of neoformed tissue at 12 and 24-month follow-up was assessed by the magnetic resonance observation of cartilage repair tissue (MOCART) score. Results: VAS decreased from baseline to 24 months from a median of 8 (6 – 9) to a median of 0 (0 – 5) (P < .001). IKDC increased from a median value of 39.0 (17.2 – 48.3) in the basal visit to a median of 83.7 (24.0 – 98.0) in the 24-month visit (P < .001). EQ-5D-5 L decreased at 2 months post-op and increased throughout the follow-up visits thereafter, needing 24 months after surgery to reach a value higher than the basal one. Median MOCART at 12 months was 80.3 (58.0 – 89.7) and 81.3 (54.0 – 89.9) at 24 months. Conclusions: Treatment of both knees with HD-ACI during the same surgical act in patients with bilateral chondral lesions is a safe procedure, providing good clinical results.