Biological, Functional And Radiographic Evaluation Of Autologous Chondrocyte Implantation
Funder
National Health and Medical Research Council
Funding Amount
$307,400.00
Summary
We will test the hypothesis that autologous chondrocyte implantation (ACI) and extensor realignment produces superior clinical, biological and radiographic results when compared with conventional treatment of realignment and debridement. We will specifically address the following aims: 1. Quantify the clinical outcome of ACI compared to the traditionally used treatment of debridement through the use of functional evaluation in a blinded randomised controlled clinical trial; 2. Evaluate the radio ....We will test the hypothesis that autologous chondrocyte implantation (ACI) and extensor realignment produces superior clinical, biological and radiographic results when compared with conventional treatment of realignment and debridement. We will specifically address the following aims: 1. Quantify the clinical outcome of ACI compared to the traditionally used treatment of debridement through the use of functional evaluation in a blinded randomised controlled clinical trial; 2. Evaluate the radiographic changes in the patellofemoral joint that occur as a result of ACI, using high resolution magnetic resonance imaging (MRI) to quantify the regeneration of hyaline articular cartilage; 3. Using the new technique of confocal arthroscopy, we will compare the histologic appearances of the ACI graft and its interface with adjacent articular cartilage; 4. Evaluate patient, surgical and explant chondrocyte characteristics in relation to functional, radiographic and biological outcomes. With respect to the matrix-induced autologous chondrocyte implantation (MACI) technique, we wish to clarify the clinical practice as a definitive treatment for articular cartilage defects. This will be the first randomised, controlled clinical trial of the MACI technique compared to that used by other groups. A positive clinical outcome from this trial will help promote the three cornerstones of this procedure – successful cell culture, efficient surgical procedures, and complimentary postoperative rehabilitation. Furthermore, this research will: a) Enhance the expansion of the MACI technique; b) Encourage development of endoscopic techniques of implantation using a combination of – • Preoperative defect registration with MRI • pre-cut custom patches, implanted with • Computer-assisted navigation techniques: c) Increase the potential to cater for a larger number of patients requiring articular cartilage repair; d) Confirm the long-term durability of regenerated cartilage in the 4th year and beyond; e) Add further commercial value by demonstrating MACI may prevent the onset of osteoarthritis.Read moreRead less
Randomized Controlled Trial Of Hip Arthroscopy For Femoroacetabular Impingement
Funder
National Health and Medical Research Council
Funding Amount
$1,010,588.00
Summary
Femoroacetabular impingement (FAI) occurs as a consequence of abnormal contact between the pelvis and femoral head–neck junction, resulting in damage to the hip joint. Because FAI is associated with symptoms and may play a role in predisposing to osteoarthritis, new surgical techniques have been developed to correct this anatomic abnormality. However, the disease modifying benefits of surgery are unknown. We therefore propose a randomized controlled trial to evaluate its efficacy and to determin ....Femoroacetabular impingement (FAI) occurs as a consequence of abnormal contact between the pelvis and femoral head–neck junction, resulting in damage to the hip joint. Because FAI is associated with symptoms and may play a role in predisposing to osteoarthritis, new surgical techniques have been developed to correct this anatomic abnormality. However, the disease modifying benefits of surgery are unknown. We therefore propose a randomized controlled trial to evaluate its efficacy and to determine the mechanisms of effect.Read moreRead less