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Asymptomatic focal calcium pyrophosphate crystal deposition within partially failed repair tissue after matrix-assisted autologous chondrocyte implantation

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Possible failures of autologous chondrocyte implantation (ACI), a cell-based technique for articular cartilage repair, are not always clinically apparent and the underlying mechanisms largely remain unknown. This case report presents the first scenario in the literature highlighting an association of a medium-term partial failure of an advanced ACI procedure (matrix-assisted ACI) in the knee with focal asymptomatic calcium pyrophosphate deposition disease, a common inflammatory pyrophosphate arthropathy. The specific presence of CPPDs, resulting from increased biomechanical stresses in the repair tissue–cartilage and repair tissue–subchondral bone integration sites, together with the absence of cartilage regeneration was identified and possibly contributed to the partial failure.

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No financial support was received for this study.

Author information

HM performed all the surgery and contributed to study design and manuscript writing; LG contributed to sample analysis, data evaluation, and manuscript writing; TO contributed to data evaluation and graphic illustration. MC contributed to study design and manuscript writing.

Correspondence to Henning Madry.

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None of the authors reported any conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from the patient in this study.

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Gao, L., Oláh, T., Cucchiarini, M. et al. Asymptomatic focal calcium pyrophosphate crystal deposition within partially failed repair tissue after matrix-assisted autologous chondrocyte implantation. Knee Surg Sports Traumatol Arthrosc 27, 1939–1942 (2019).

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  • Matrix-assisted autologous chondrocyte implantation
  • Calcium pyrophosphate deposition disease
  • Asymptomatic failure
  • Mid-term outcome
  • Knee