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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
- J Knee Surg. 2021 Jan;34(1):2-10
- Semin Musculoskelet Radiol. 2011;15:69–88
- Am J Sports Med. 2020 Apr;48(5):1236-1245
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#grafthyperthrophy, #cartilagerepair, #ACI, #arthroscopy, #kneesurgery, #orthopedics, #regenerativecartilage, #chondrocytes, #debridement, #sportsmedicine
