{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:24:23Z","timestamp":1786123463778,"version":"build-2736575974"},"reference-count":26,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,11,11]],"date-time":"2023-11-11T00:00:00Z","timestamp":1699660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,11,11]],"date-time":"2023-11-11T00:00:00Z","timestamp":1699660800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2023,11,11]],"date-time":"2023-11-11T00:00:00Z","timestamp":1699660800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,11,11]],"date-time":"2023-11-11T00:00:00Z","timestamp":1699660800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005788","name":"Medical University of Vienna","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005788","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100005788","name":"Medizinische Universit\u00e4t Wien","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005788","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to analyze the risk of reoperation following autologous chondrocyte implantation (ACI) of the knee utilizing third\u2010generation ACI products in a time\u2010to\u2010event analysis and report on the associated patient\u2010reported outcome measures (PROM) in case of reoperation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients undergoing ACI were included from a longitudinal database. Patient age, sex, body mass index (BMI), number of previous surgeries, lesion localization, lesion size, symptom duration, as well as time and type of reoperation was extracted. A cox proportional\u2010hazards model was applied to investigate the influence of baseline variables on risk of reoperation. Reoperation was defined as any type of subsequent ipsilateral knee surgery, excluding hardware removal. The Knee Injury and Osteoarthritis Outcome Score (KOOS) was utilized to compare PROM between patients with and without reoperation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 2039 patients were included with 1359 (66.7%) having a minimum follow\u2010up of 24\u00a0months. There were overall 243 reoperations (prevalence 17.9%). Minor arthroscopic procedures (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200996, 39.5%) and revision cartilage repair procedures (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200978, 32.1%) were the most common reoperations. Nineteen patients (0.9%) reported conversion arthroplasty at 17.7 (10.4) months after ACI. Female sex (HR 1.5, 95% CI [1.2, 2.0],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and the presence of 1\u20132 previous surgeries (HR 1.5, 95% CI [1.1, 2.0],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010), or more than 2 previous surgeries (HR 1.9, 95% CI [1.2, 2.9],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) were significantly associated with increased risk of reoperation following ACI. Significantly less patients surpassed the minimal clinically important difference (MCID) in the reoperation group at 24\u00a0months regarding the KOOS subscores pain (OR 1.6, 95% CI [1.1, 2.2]), quality of life (OR 2.2, 95% CI [1.6, 3.2]), symptoms (OR 2.0 [1.4, 2.9]), and sports (OR 2.0 [1.4, 2.8]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Female patients and individuals with a history of previous surgeries face an elevated risk of requiring reoperation after undergoing ACI, which is associated with failure to attain clinically relevant improvements. A thorough evaluation of the indications for ACI is paramount, particularly when patients have a history of previous surgeries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00167-023-07615-5","type":"journal-article","created":{"date-parts":[[2023,11,11]],"date-time":"2023-11-11T06:01:33Z","timestamp":1699682493000},"page":"5837-5847","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Increased risk of reoperation and failure to attain clinically relevant improvement following autologous chondrocyte implantation of the knee in female patients and individuals with previous surgeries: a time\u2010to\u2010event analysis based on the German cartilage registry (KnorpelRegister DGOU)"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9438-0718","authenticated-orcid":false,"given":"Alexander","family":"Bumberger","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery Medical University of Vienna AKH Wien Waehringer Guertel 18\u201020 1090 Vienna Austria"},{"name":"OCM Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Christopher","family":"Rupp","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Sports Medicine Hospital Rechts Der Isar Technical University of Munich Munich Germany"},{"name":"The Steadman Philippon Research Institute 181 West Meadows Drive, Suite 400 Vail CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Lattermann","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Kleiner","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery Medical University of Vienna AKH Wien Waehringer Guertel 18\u201020 1090 Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Niemeyer","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery University Medical Center Freiburg Albert\u2010Ludwig University of Freiburg Freiburg Germany"},{"name":"OCM Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2022.08.041"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520928337"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.94B4.27495"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199410063311401"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518756976"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402\u2010022\u201004611\u20101"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1947603519870861"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/1947603520923137"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513480780"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465221111115"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2011.02.010"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/1947603519897290"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511423522"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010012\u20102280\u20103"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513489262"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967119877847"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264\u2010015\u20102792\u20109"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/1947603518799839"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518824600"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/1947603516630786"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010023\u201007371\u20106"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514528093"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507311095"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520968284"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465211070536"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2015.07.025"}],"container-title":["Knee 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Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00167-023-07615-5","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00167-023-07615-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1007\/s00167-023-07615-5","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-023-07615-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00167-023-07615-5","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T14:39:57Z","timestamp":1786113597000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1007\/s00167-023-07615-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,11]]},"references-count":26,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1007\/s00167-023-07615-5"],"URL":"https:\/\/doi.org\/10.1007\/s00167-023-07615-5","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,11]]},"assertion":[{"value":"6 June 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 September 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 November 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Philipp Niemeyer is an independent consultant for Arthrex, Stryker, Geistlich and Tetec. Christian Lattermann is an independent consultant for Vericel.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The current study was approved by the Ethics Commission of the Medical Center, University of Freiburg: EK-FR 105\/13_130795.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Written informed consent was obtained of every patient before inclusion.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}