(Fig 5-C.11) Graft Hypertrophy of Autologous Chondrocyte Implantation

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📌Graft Hypertrophy

 

• Graft hypertrophy occurs when the repair cartilage exceeds the space of the native defect, leading to protrusion from the chondral surface. 
• This is characterized by a fill percentage greater than 100%.

 

• Brown et al. identified graft hypertrophy in 63% of cases, often necessitating revision arthroscopic debridement. 
• When graft hypertrophy exceeds 150%, surgical intervention is typically required, whereas lower amounts can be monitored.
• While graft hypertrophy may be asymptomatic, severe cases can cause symptomatic "catching" and require resection.

 

✅ Characteristic Complications after ACI Surgery

• Graft hypertrophy is a known complication after ACI (Autologous Chondrocyte Implantation) surgery, occurring in up to 30% of patients. 
• It is considered a transient excessive growth of regenerative cartilage tissue rather than true chondrocyte hypertrophy.

 

Potential Causes

• The high cell density in pellets and active extracellular matrix (ECM) synthetic activity may contribute to excessive growth. 
• Another possibility is the implantation of an excess number of pellets during surgery, leading to hypertrophy.

✅ Recommendations

• Hypertrophy greater than 150% may necessitate debridement to relieve symptoms.

 

References

1. J Knee Surg. 2021 Jan;34(1):2-10
2. Semin Musculoskelet Radiol. 2011;15:69–88
3. Am J Sports Med. 2020 Apr;48(5):1236-1245

 

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#grafthyperthrophy, #cartilagerepair, #ACI, #arthroscopy, #kneesurgery, #orthopedics, #regenerativecartilage, #chondrocytes, #debridement, #sportsmedicine