{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T05:52:42Z","timestamp":1793425962062,"version":"4.5.0"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,10,7]],"date-time":"2022-10-07T00:00:00Z","timestamp":1665100800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,10,7]],"date-time":"2022-10-07T00:00:00Z","timestamp":1665100800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2022,10,7]],"date-time":"2022-10-07T00:00:00Z","timestamp":1665100800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,10,7]],"date-time":"2022-10-07T00:00:00Z","timestamp":1665100800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,10,1]],"date-time":"2022-10-01T00:00:00Z","timestamp":1664582400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007307","name":"Arthrex","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007307","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008894","name":"Stryker","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008894","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["arthroscopyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The primary purpose of this study was to assess the use of autologous chondrocyte implantation (ACI) procedures in the knee during last decade, and the secondary aims of the study were to determine reoperation rates after ACI and to identify associated risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective cohort study from 2010\u20132020 was performed using the PearlDiver database. The database was queried for the Current Procedural Terminology (CPT) code for ACI performed in any knee location, including the patellofemoral and tibiofemoral joints. Reoperation was defined as interventional knee procedures or total knee arthroplasty after ACI. Reoperations were identified using CPT and International Classification of Diseases codes. Univariate and multivariate logistic regression were used to identify risk factors for reoperation. Significance was defined as\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 2010 patients included in this study, there were 90\u2010day and overall reoperation rates of 2.24% and 30.4%, respectively, with an average follow up of 4.8 \u00b1 3.3 years. The most common reoperations included chondroplasty, meniscectomy, and microfracture. There was an increased rate of ACI performed from 2017\u20132019 (5.53\/100,000) compared to 2014\u20132016 (4.16\/100,000;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). ACI surgeries performed in\u00a02017\u20132019 were associated with decreased risk of reoperation within 2 years relative to 2014\u20132016 (odds ratio [OR]\u00a0= 0.70; 95% confidence interval [CI], 0.52\u20100.94;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .019). In the entire ACI cohort, older age (OR\u00a0= 1.07; 95% CI, 1.05\u20101.09;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) and tobacco use (OR\u00a0= 2.13; 95% CI, 1.06\u20103.94;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .022) were associated with increased risk of conversion to arthroplasty. Male sex was associated with decreased overall reoperation rates (OR\u00a0= 0.73; 95% CI, 0.60\u20100.89;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There has been increasing use of ACI in the knee with decreased risk of reoperation since 2017 and the introduction of matrix\u2010associated autologous chondrocyte implantation. Older age and tobacco use were predictors of increased risk of conversion to arthroplasty. Male sex was associated with decreased risk of reoperation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, retrospective cohort design; database study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2022.08.041","type":"journal-article","created":{"date-parts":[[2022,10,7]],"date-time":"2022-10-07T11:38:54Z","timestamp":1665142734000},"page":"1464","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":15,"title":["Utilization of Autologous Chondrocyte Implantation in the Knee Is Increasing While Reoperation Rates Are Decreasing Despite Increasing Preoperative Comorbidities"],"prefix":"10.1002","volume":"39","author":[{"given":"Christopher","family":"Anigwe","sequence":"first","affiliation":[{"name":"School of Medicine University of California San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie K.","family":"Kucirek","sequence":"additional","affiliation":[{"name":"School of Medicine University of California San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian T.","family":"Feeley","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of California San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Benjamin","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of California San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan L.","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of California San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drew A.","family":"Lansdown","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of California San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,7]]},"reference":[{"key":"e_1_2_4_2_2","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.1998.28.4.192"},{"key":"e_1_2_4_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/ldn025"},{"key":"e_1_2_4_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2010.082321"},{"key":"e_1_2_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-8063(97)90124-9"},{"key":"e_1_2_4_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546503259345"},{"key":"e_1_2_4_7_2","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2002.32839"},{"key":"e_1_2_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2013.11.001"},{"key":"e_1_2_4_9_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1712946"},{"key":"e_1_2_4_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-018-5139-4"},{"key":"e_1_2_4_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520928337"},{"key":"e_1_2_4_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/1947603519870861"},{"key":"e_1_2_4_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509332258"},{"key":"e_1_2_4_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/1947603516630786"},{"key":"e_1_2_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2011.02.010"},{"key":"e_1_2_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2015.07.025"},{"key":"e_1_2_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_4_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509351499"},{"issue":"10","key":"e_1_2_4_19_2","doi-asserted-by":"crossref","DOI":"10.1177\/2325967119877847","article-title":"Matrix\u2010associated chondrocyte implantation is associated with fewer reoperations than microfracture: Results of a population\u2010representative, matched\u2010pair claims data analysis for cartilage defects of the knee","volume":"7","author":"Niemeyer P.","year":"2019","journal-title":"Orthop J Sports Med"},{"key":"e_1_2_4_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/1947603520967065"},{"key":"e_1_2_4_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520949849"},{"key":"e_1_2_4_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513480780"},{"key":"e_1_2_4_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-012-2280-3"},{"key":"e_1_2_4_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513489262"},{"key":"e_1_2_4_25_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.88B1.16796"},{"key":"e_1_2_4_26_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511423522"},{"key":"e_1_2_4_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kel243"},{"key":"e_1_2_4_28_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.91B12.22879"},{"key":"e_1_2_4_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518800713"},{"key":"e_1_2_4_30_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.90B12.21198"},{"key":"e_1_2_4_31_2","unstructured":"Kucirek NK Anigwe C Zhang AL Ma CB Feeley BT Lansdown DA. 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Published by Elsevier on behalf of the Arthroscopy Association of North America.","name":"copyright","label":"Copyright"}]}}