Gunnar Knutsen

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$Research paper thumbnail of with Microfracture. Findings at Five Years A Randomized Trial Comparing Autologous Chondrocyte Implantation$

with Microfracture. Findings at Five Years A Randomized Trial Comparing Autologous Chondrocyte Implantation

Background: The optimal treatment for cartilage lesions has not yet been established. The objecti... more Background: The optimal treatment for cartilage lesions has not yet been established. The objective of this randomized trial was to compare autologous chondrocyte implantation with microfracture. This paper represents an update, with presentation of the clinical results at five years. Methods: Eighty patients who had a single chronic symptomatic cartilage defect on the femoral condyle in a stable knee without general osteoarthritis were included in the study. Forty patients were treated with autologous chondrocyte implantation, and forty were treated with microfracture. We used the International Cartilage Repair Society, Lysholm, Short Form-36, and Tegner forms to collect clinical data, and radiographs were evaluated with use of the Kellgren and Lawrence grading system. Results: At two and five years, both groups had significant clinical improvement compared with the preoperative status. At the five-year follow-up interval, there were nine failures (23%) in both groups compared with two failures of the autologous chondrocyte implantation and one failure of the microfracture treatment at two years. Younger patients did better in both groups. We did not find a correlation between histological quality and clinical outcome. However, none of the patients with the best-quality cartilage (predominantly hyaline) at the two-year mark had a later failure. One-third of the patients in both groups had radiographic evidence of early osteoarthritis at five years. Conclusions: Both methods provided satisfactory results in 77% of the patients at five years. There was no significant difference in the clinical and radiographic results between the two treatment groups and no correlation between the histological findings and the clinical outcome. One-third of the patients had early radiographic signs of osteoarthritis five years after the surgery. Further long-term follow-up is needed to determine if one method is better than the other and to study the progression of osteoarthritis.

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Autologous Chondrocyte Implantation and Osteochondral Cylinder Transplantation in Cartilage Repair of the Knee Joint

The Journal of Bone and Joint Surgery-American Volume, 2003

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The Long-Term Risk of Knee Arthroplasty in Patients with Arthroscopically Verified Focal Cartilage Lesions

Journal of Bone and Joint Surgery

Background: Focal cartilage lesions are common in the knee. The risk of later ipsilateral knee ar... more Background: Focal cartilage lesions are common in the knee. The risk of later ipsilateral knee arthroplasty remains unknown. The purposes of the present study were to evaluate the long-term cumulative risk of knee arthroplasty after arthroscopic identification of focal cartilage lesions in the knee, to investigate the risk factors for subsequent knee arthroplasty, and to estimate the subsequent cumulative risk of knee arthroplasty compared with that in the general population. Methods: Patients who had undergone surgical treatment of focal cartilage lesions at 6 major Norwegian hospitals between 1999 and 2012 were identified. The inclusion criteria were an arthroscopically classified focal cartilage lesion in the knee, an age of ≥18 years at the time of surgery, and available preoperative patient-reported outcomes (PROMs). The exclusion criteria were osteoarthritis or “kissing lesions” at the time of surgery. Demographic data, later knee surgery, and PROMs were collected with use of ...

A Randomized Trial of Autologous Chondrocyte Implantation Versus Alternative Forms of Surgical Cartilage Management in Patients With a Failed Primary Treatment for Chondral or Osteochondral Defects in the Knee

The American Journal of Sports Medicine

Background: There are limited randomized controlled trials with long-term outcomes comparing auto... more Background: There are limited randomized controlled trials with long-term outcomes comparing autologous chondrocyte implantation (ACI) versus alternative forms of surgical cartilage management within the knee. Purpose: To determine at 5 years after surgery whether ACI was superior to alternative forms of cartilage management in patients after a failed previous treatment for chondral or osteochondral defects in the knee. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: In total, 390 participants were randomly assigned to receive either ACI or alternative management. Patients aged 18 to 55 years with one or two symptomatic cartilage defects who had failed 1 previous therapeutic surgical procedure in excess of 6 months prior were included. Dual primary outcome measures were used: (1) patient-completed Lysholm knee score and (2) time from surgery to cessation of treatment benefit. Secondary outcome measures included International Knee Documentation Committee and...

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Additional file 2: of Quality of care for remote orthopaedic consultations using telemedicine: a randomised controlled trial

Questionnaire for RMS allocated patients, English translation. English translation of questionnai... more

Additional file 4: of Quality of care for remote orthopaedic consultations using telemedicine: a randomised controlled trial

Follow up questionnaire for patients participating in the study, at 3 and 12 months, English tran... more

Additional file 2: of In vitro chondrogenic potency of surplus chondrocytes from autologous transplantation procedures does not predict short-term clinical outcomes

Figure S2. Comparison of selected genes between chondrogenic groups. Analysis of genes of interes... more Figure S2. Comparison of selected genes between chondrogenic groups. Analysis of genes of interest by qPCR revealed their relative expression in the high (n = 8) and low (n = 5) chondrogenic groups. Plotted values represent each donor, and the error bar represents standard deviation. Significance level, p (*)

Additional file 1: of In vitro chondrogenic potency of surplus chondrocytes from autologous transplantation procedures does not predict short-term clinical outcomes

Figure S1. Chondrogenesis of culture-expanded chondrocytes in 3D pellets propagated in chondrogen... more Figure S1. Chondrogenesis of culture-expanded chondrocytes in 3D pellets propagated in chondrogenic medium. Representative bright light microscopy images of histological sections (nâ =â 14) and Bern scores. Proteoglycans stained with Alcian blue and the nuclei counterstained with Sirius red. (TIF 33702 kb)

Knee Surg Sports Traumatol Arthrosc (2010) 18:434–447 DOI 10.1007/s00167-010-1072-x KNEE

The subchondral bone in articular cartilage repair: current problems in the surgical management

Oddmund Johannes Johansen

Tidsskrift for Den norske legeforening, 2021

Det var med stor sorg vi mo ok budskapet om at professor emeritus Oddmund Johannes Johansen (f. 1... more Det var med stor sorg vi mo ok budskapet om at professor emeritus Oddmund Johannes Johansen (f. 1948) døde 1. juli 2021 på en av sine mange fiske-og ellturer. Han var svaert glad i den nordnorske naturen. Som gu unge og ungdom ble han ta med både ut på havet og opp i ellene på fiske-og jak urer, blant annet av mange av sine slektninger.

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ASPECTS OF CURRENT MANAGEMENT A clinical review of cartilage repair techniques

$Research paper thumbnail of with Microfracture. Findings at Five Years A Randomized Trial Comparing Autologous Chondrocyte Implantation$

with Microfracture. Findings at Five Years A Randomized Trial Comparing Autologous Chondrocyte Implantation

This information is current as of October 5, 2007 Supplementary material at http://www.ejbjs.org/... more This information is current as of October 5, 2007 Supplementary material at http://www.ejbjs.org/cgi/content/full/89/10/2105/DC1 translated abstracts are available for this article. This information can be accessed Commentary and Perspective, data tables, additional images, video clips and/orReprints and Permissions Permissions] link. article, or locate the article citation on jbjs.org and click on the [Reprints andClick here to order reprints or request permission to use material from thisPublisher Information www.jbjs.org 20 Pickering Street, Needham, MA 02492-3157The Journal of Bone and Joint Surgery

$Research paper thumbnail of A Randomized Multicenter Trial Comparing Autologous Chondrocyte Implantation with Microfracture: Long-Term Follow-up at 14 to 15 Years$

A Randomized Multicenter Trial Comparing Autologous Chondrocyte Implantation with Microfracture: Long-Term Follow-up at 14 to 15 Years

The Journal of bone and joint surgery. American volume, Jan 17, 2016

The management of cartilage and osteochondral lesions in the knee remains problematic and controv... more The management of cartilage and osteochondral lesions in the knee remains problematic and controversial. Our group reported the 2-year and 5-year results of a randomized controlled trial comparing autologous chondrocyte implantation (ACI) and microfracture in patients with focal femoral cartilage injuries. The objective of the present study was to report the long-term results. Eighty patients with a single symptomatic chronic cartilage defect on the femoral condyle without general osteoarthritis were included in the study at the time of the index operation (January 1999 to February 2000). We used the International Cartilage Repair Society (ICRS), Lysholm, Short Form-36 (SF-36), and Tegner forms to collect data at the time of inclusion and at follow-up evaluations. Standing weight-bearing radiographs were evaluated for evidence of osteoarthritis according to the method described by Kellgren and Lawrence. For the long-term follow-up in 2014, we used the Synaflexer frame to standardize...

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Cartilage repair

Tidsskrift for den Norske laegeforening

Chondrocytes in adult human cartilage have little mitotic capacity even after injuries. Deep inju... more Chondrocytes in adult human cartilage have little mitotic capacity even after injuries. Deep injuries penetrating the subchondral bone plate lead to the release of pluripotent mesenchymal stem cells which have the potential to differentiate into different types of connective tissue, including bone and cartilage. The release and stimulation of these stem cells can also be achieved by drilling or microfracture of the subchondral bone of cartilage lesions. When stimulated, periosteal cells may also differentiate into chondrocytes. However, non-chondrocyte determined cells seem to induce mainly fibrocartilage. In 1987 autologous chondrocyte implantation was introduced by a team in Gothenburg. This resulted in clinical improvement and the development of hyaline-like cartilage in patients who had undergone treatment. We first used the method in 1996 in a clinical trial. At a 6-month follow-up of our first 12 patients we found reduced symptoms and improved knee function. This method is pro...

[Treatment of focal cartilage injuries in the knee]

Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, Jan 20, 1998

[Accessory soleus muscle as a tumor in the ankle region]

Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, Jan 10, 1993

We report the case of a 21-year ice hockey player with an accessory soleus muscle located mediall... more We report the case of a 21-year ice hockey player with an accessory soleus muscle located medially in the ankle region. The swelling made it increasingly difficult for him to fit his skating boots and caused some pain during play. He was successfully treated by excising the muscle. Previously, the diagnosis was verified surgically in most reported cases. Like most recent authors, we believe that the diagnosis can be confirmed by CT-scan and/or MRI-scan. Surgical excision of the muscle should be reserved for symptomatic cases.

Autologous chondrocyte implantation for hip osteochondritis functioning 15 years after operation

Global Surgery, 2016

Background: The autologous implantation technique (ACI) was first introduced in studies on cartil... more Background: The autologous implantation technique (ACI) was first introduced in studies on cartilage defects in knees. It has later been used for the treatment of osteochondral knee lesions. The patient presented here had a hip osteochondral defect measuring 4 cm in diameter. He was a candidate for hip prosthesis because of serious pain and reduced function. Being young and highly motivated for alternatives to prosthesis he was to our knowledge the first patient treated with ACI to the hip in 1999. Methods: Autologous chondrocytes obtained from knee cartilage biopsies were grown at a laboratory in Gothenburg. The operation was done at The University Hospital North Norway where removal of damaged cartilage and loose bony fragments was done on an operatively luxated hip. In the cleaned area implantation of chondrocytes under a periosteal covering was done. Gradual increased weight bearing was allowed postoperatively. Results: Immediately postoperatively the patient reported significant relief of pain, and in the period of more than 15 following years he generally estimated pain to be 70 % reduced from the preoperative value. Frequent MR examinations the first postoperative year showed gradual filling of the defect in bone and cartilage. Contrast MRI at 22 months depicted the surface of the repaired area quite smooth. At the last control more than 15 years following ACI he reported limited pain, walked without a limp; and moderate osteoarthritis seen previously had developed further. Knowing the result, he was happy to have gone through the procedure. Conclusion: The patient has gained more than fifteen prosthesis-free years because of the ACI operation. Quite normal cartilage adjacent to the large defect was carrying weight, and the repair area was not destroyed, as probably would have been the case in osteoarthritis. A success on the various attempts to produce normal cartilage in vitro, able to carry some weight immediately after implantation, could in the future open up for improved biological treatment of large defects, both chondral and osteochondral, in hip and knee. Investigations Initial radiographs showed a severe osteochondritis dissecans in

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Collagen-Covered Autologous Chondrocyte Implantation Versus Autologous Matrix-Induced Chondrogenesis: A Randomized Trial Comparing 2 Methods for Repair of Cartilage Defects of the Knee

Orthopaedic Journal of Sports Medicine, 2019

Background:Autologous matrix-induced chondrogenesis (AMIC) is a single-stage alternative to autol... more Background:Autologous matrix-induced chondrogenesis (AMIC) is a single-stage alternative to autologous chondrocyte implantation for treatment of localized cartilage defects of the knee. To our knowledge, no randomized controlled trial exists comparing the 2 methods.Purpose:To evaluate any difference in the outcome of AMIC as compared with collagen-covered autologous chondrocyte implantation (ACI-C).Study Design:Randomized controlled trial; Level of evidence, 2.Methods:A prospective randomized controlled clinical trial was designed to assess any differences in the outcomes between ACI-C and AMIC for the treatment of ≥1 chondral or osteochondral defects of the distal femur and/or patella. The inclusion period was set to 3 years, and the aim was to include 80 patients (40 in each group). Patient inclusion was broad, with few exclusion criteria. The primary outcome was change in Knee injury and Osteoarthritis Outcome Score (KOOS) at 2 years as compared with baseline. The secondary outco...

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Additional file 3: of Quality of care for remote orthopaedic consultations using telemedicine: a randomised controlled trial

Questionnaire for the orthopaedic surgeon performing the consultation, English translation. Engli... more

Additional file 1: of Quality of care for remote orthopaedic consultations using telemedicine: a randomised controlled trial

Questionnaire for UNN allocated patients, English translation. English translation of questionnai... more

$Research paper thumbnail of with Microfracture. Findings at Five Years A Randomized Trial Comparing Autologous Chondrocyte Implantation$

with Microfracture. Findings at Five Years A Randomized Trial Comparing Autologous Chondrocyte Implantation

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Autologous Chondrocyte Implantation and Osteochondral Cylinder Transplantation in Cartilage Repair of the Knee Joint

The Journal of Bone and Joint Surgery-American Volume, 2003

Add to CiteULike Add to Connotea Add to Del.icio.us Add to Facebook Add to Technorati Add to Twit... more

The Long-Term Risk of Knee Arthroplasty in Patients with Arthroscopically Verified Focal Cartilage Lesions

Journal of Bone and Joint Surgery

The American Journal of Sports Medicine

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Additional file 2: of Quality of care for remote orthopaedic consultations using telemedicine: a randomised controlled trial

Questionnaire for RMS allocated patients, English translation. English translation of questionnai... more

Additional file 4: of Quality of care for remote orthopaedic consultations using telemedicine: a randomised controlled trial

Follow up questionnaire for patients participating in the study, at 3 and 12 months, English tran... more

Additional file 2: of In vitro chondrogenic potency of surplus chondrocytes from autologous transplantation procedures does not predict short-term clinical outcomes

Additional file 1: of In vitro chondrogenic potency of surplus chondrocytes from autologous transplantation procedures does not predict short-term clinical outcomes

Knee Surg Sports Traumatol Arthrosc (2010) 18:434–447 DOI 10.1007/s00167-010-1072-x KNEE

The subchondral bone in articular cartilage repair: current problems in the surgical management

Oddmund Johannes Johansen

Tidsskrift for Den norske legeforening, 2021

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ASPECTS OF CURRENT MANAGEMENT A clinical review of cartilage repair techniques

$Research paper thumbnail of with Microfracture. Findings at Five Years A Randomized Trial Comparing Autologous Chondrocyte Implantation$

with Microfracture. Findings at Five Years A Randomized Trial Comparing Autologous Chondrocyte Implantation

$Research paper thumbnail of A Randomized Multicenter Trial Comparing Autologous Chondrocyte Implantation with Microfracture: Long-Term Follow-up at 14 to 15 Years$

A Randomized Multicenter Trial Comparing Autologous Chondrocyte Implantation with Microfracture: Long-Term Follow-up at 14 to 15 Years

The Journal of bone and joint surgery. American volume, Jan 17, 2016

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Cartilage repair

Tidsskrift for den Norske laegeforening

[Treatment of focal cartilage injuries in the knee]

Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, Jan 20, 1998

[Accessory soleus muscle as a tumor in the ankle region]

Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, Jan 10, 1993

Autologous chondrocyte implantation for hip osteochondritis functioning 15 years after operation

Global Surgery, 2016

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Collagen-Covered Autologous Chondrocyte Implantation Versus Autologous Matrix-Induced Chondrogenesis: A Randomized Trial Comparing 2 Methods for Repair of Cartilage Defects of the Knee

Orthopaedic Journal of Sports Medicine, 2019

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Additional file 3: of Quality of care for remote orthopaedic consultations using telemedicine: a randomised controlled trial

Questionnaire for the orthopaedic surgeon performing the consultation, English translation. Engli... more

Additional file 1: of Quality of care for remote orthopaedic consultations using telemedicine: a randomised controlled trial

Questionnaire for UNN allocated patients, English translation. English translation of questionnai... more

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