Hydrogel implant is as effective as osteochondral autologous transplantation for treating focal cartilage knee injury in 24 months

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 26; no. 10; pp. 2934 - 2941
• Main Authors: de Queiroz, Antonio Altenor Bessa, Debieux, Pedro, Amaro, Joicemar, Ferretti, Mario, Cohen, Moises
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2018; Springer Nature B.V
• Subjects: Activities of Daily Living; Adult; Autografts; Biocompatibility; Bone implants; Bone Transplantation; Cartilage; Cartilage, Articular - surgery; Complications; Female; Humans; Hydrogels; Knee; Knee Injuries - surgery; Knee Joint - surgery; Lesions; Male; Medicine; Medicine & Public Health; Middle Aged; Orthopedics; Pain; Pain Measurement; Patients; Prostheses and Implants; Quality of Life; Surgery; Transplantation; Transplantation, Autologous; Transplants & implants; Treatment Outcome; Autologous osteochondral transplantation; Focal cartilage lesion; Hydrogel
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-018-4834-5

Purpose The treatment approach for a patient with knee joint focal cartilage lesion is a difficult decision. To date, there has been no randomized clinical trial involving Hydrogel (Cartiva™). This study evaluated and compared the results of a hydrogel implant (Cartiva™) with autologous osteochondral transplantation (AOT) for treating knee joint focal cartilage lesions. Methods Thirty-eight symptomatic patients, with a focal cartilage lesion of Outerbridge grades III or IV, were randomized into one of two groups according to the inclusion and exclusion criteria. Group I underwent AOT, and Group II was treated with a Hydrogel implant. Patients were evaluated preoperatively and again postoperatively at 6, 12, and 24 months using the subjective International Knee Documentation Committee (IKDC) scores, Visual Analog Scale for Pain (VAS Pain), Activities of Daily Living Scale (ADLS) and Lysholm score. Results Both groups showed significant improvements from baseline (pre-surgery) to post-surgery (6, 12, and 24 months; p  < 0.05), but there was no difference between the groups. Regarding complications, prolonged pain was observed in four patients (10.5%), two from each group, with a regression of symptoms within 1 year. Conclusion The Hydrogel implant showed similar efficiency as the autologous osteochondral graft for treating knee joint focal cartilage lesions. Both techniques showed satisfactory results compared to preoperative status. The Hydrogel implant was safe and effective, and it provided good stability and joint function at 2-year follow-up. Level of evidence I.