{
  "abstract": "Objective: The primary aim was to characterize cartilage repair following autologous chondrocyte implantation (ACI) with knee osteotomy in middle-aged patients, hypothesizing favorable histological repair and a chondrogenic transcriptomic profile. Secondary comparisons with isolated osteotomy were exploratory.\n\nDesign: This prospective case series with a nonrandomized comparison group included 12 patients aged 50–65 years with International Cartilage Repair Society (ICRS) grade 3–4 cartilage defects (>4 cm2) and varus malalignment. Six underwent two-stage ACI with osteotomy and six underwent osteotomy alone; allocation followed Japanese insurance indications for ACI. Patient-reported outcomes were assessed preoperatively and at 1 year. Both groups underwent second-look arthroscopy, ICRS II histological assessment, and RNA sequencing. Graft biochemical properties were compared between younger and older cohorts.\n\nResults: The ACI group had higher macroscopic repair scores (10.3 ± 1.0 versus 6.0 ± 4.4; P = 0.04) and histological scores (median, 75 versus 50; P = 0.03). Lysholm scores improved in both groups (both P = 0.031); KOOS, IKDC, and VAS changes were not significant. No between-group differences in changes from baseline were significant for any patient-reported outcome. COL2A1, ACAN, and COMP expression was higher in the ACI group. Graft sGAG content and cell number did not differ significantly between age groups.\n\nConclusion: ACI with osteotomy showed favorable histological repair and a chondrogenic transcriptomic profile. The small sample, nonrandomized allocation, and short follow-up make between-group findings exploratory. Larger, longer-term studies are needed to establish clinical significance and durability.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Orthopedic Surgery, Hyogo Medical University, Nishinomiya, Japan",
    "Nishinomiya Kaisei Hospital, Nishinomiya, Japan",
    "Japan Tissue Engineering Co., Ltd., Gamagori, Aichi, Japan"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Tomoya Iseki",
      "orcid": "0000-0003-0954-6125"
    },
    {
      "affs": [
        0
      ],
      "name": "Shintaro Onishi"
    },
    {
      "affs": [
        1
      ],
      "name": "Ryo Kanto"
    },
    {
      "affs": [
        0
      ],
      "name": "Yoshitaka Nakao"
    },
    {
      "affs": [
        0
      ],
      "name": "Shunsuke Akai",
      "orcid": "0009-0004-0989-5506"
    },
    {
      "affs": [
        0
      ],
      "name": "Akira Kawai"
    },
    {
      "affs": [
        1
      ],
      "name": "Shinichi Yoshiya"
    },
    {
      "affs": [
        2
      ],
      "name": "Shunsuke Takeuchi"
    },
    {
      "affs": [
        0
      ],
      "name": "Toshiya Tachibana"
    },
    {
      "affs": [
        0
      ],
      "name": "Hiroshi Nakayama"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/14emfxc893444.bib",
  "cited_by": 0,
  "doi": "10.1177/19476035261501621",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13713900/",
  "id": "14emfxc893444",
  "issns": [
    "1947-6035",
    "1947-6043"
  ],
  "landing_url": "https://doi.org/10.1177/19476035261501621",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Clinical Research Article"
    ],
    [
      "openalex",
      "2745|Osteoarthritis Treatment and Mechanisms"
    ]
  ],
  "openalex": "W7223838127",
  "pdf_url": null,
  "pmcid": "PMC13713900",
  "pmid": "42937289",
  "published": "2026-10-27",
  "publisher": "SAGE Publications",
  "ris": "https://research.draconitic.com/paper/14emfxc893444.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T12:21:29Z",
      "native_id": "PMC13713900",
      "source": "pmc",
      "url": "https://doi.org/10.1177/19476035261501621"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2745|Osteoarthritis Treatment and Mechanisms",
      "subfield": "general"
    }
  ],
  "title": "Autologous Chondrocyte Implantation With Knee Osteotomy in Middle-Aged Patients Demonstrates a Chondrogenic Transcriptomic Profile and Favorable Histological Repair",
  "title_text": "Autologous Chondrocyte Implantation With Knee Osteotomy in Middle-Aged Patients Demonstrates a Chondrogenic Transcriptomic Profile and Favorable Histological Repair",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:21:29Z",
  "url": "https://research.draconitic.com/paper/14emfxc893444",
  "venue": "Cartilage",
  "versions": []
}