A one-step treatment for chondral and osteochondral knee defects: clinical results of a biomimetic scaffold implantation at 2 years of follow-up

• Published in: Journal of materials science. Materials in medicine Vol. 25; no. 10; pp. 2437 - 2444
• Main Authors: Kon, Elizaveta, Filardo, Giuseppe, Perdisa, Francesco, Di Martino, Alessandro, Busacca, Maurizio, Balboni, Federica, Sessa, Andrea, Marcacci, Maurilio
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Boston Springer US 01.10.2014; Springer; Springer Nature B.V
• Subjects: Adult; Arthroplasty, Replacement - methods; Arthroplasty, Replacement, Knee - methods; Bioengineering; Biological and medical sciences; Biomaterials; Biomedical Engineering and Bioengineering; Biomedical materials; Biomimetic Materials - therapeutic use; Bone Diseases - therapy; Cartilage, Articular - injuries; Ceramics; Chemistry and Materials Science; Composites; Durapatite - chemistry; Female; Glass; Humans; Knee; Knee Injuries - therapy; Knee Joint; Magnesium - chemistry; Male; Materials Science; Medical sciences; Natural Materials; Orthopedics; Osteochondritis Dissecans - therapy; Polymer Sciences; Regenerative Medicine/Tissue Engineering; Surfaces and Interfaces; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Technology. Biomaterials. Equipments; Thin Films; Tissue Scaffolds - chemistry; Transplants & implants; Young Adult; Subchondral Bone; MOCART Score; Tegner Score; Scaffold Implantation; Osteochondritis Dissecans; Knee; Implantation; Treatment; Scaffold; Biomedical engineering
• ISSN: 0957-4530; 1573-4838
• DOI: 10.1007/s10856-014-5188-2

The increasing interest in the role of subchondral bone with regard to articular surface disease led to the development of new bioengineered strategies. Aim of this study is to evaluate the clinical and MRI outcome after the implantation of a nanostructured biomimetic three-phasic collagen–hydroxyapatite construct for the treatment of chondral and osteochondral defects of the knee in a large cohort of patients. Seventy-nine patients (63 M, 16 W), affected by grade III–IV femoral condyle or trochlea chondral lesions or osteochondritis dissecans (OCD) were consecutively treated. Mean age was 31.0 ± 11.3 years, mean lesion size was 3.2 ± 2.0 cm 2 . Fifty patients underwent previous surgeries, concurrent procedures were necessary in 39 cases. The clinical outcome was evaluated using the IKDC and Tegner scores at 12 and 24 months of follow-up. At follow-up times an MRI was performed and evaluated with the MOCART score. All the scores improved significantly from the baseline. IKDC subjective score showed a further increase between 12 and 24 months of follow-up, and 82.2 % of the patients improved their symptoms at the final evaluation. Patients affected by OCDs had better results than those with degenerative lesions. Some abnormal MRI findings were present, even though no correlation was found with the clinical outcome. This one-step biomimetic approach developed to favor osteochondral tissue regeneration is effective in treating knees affected by damages of the articular surface, leading to a significant clinical improvement. However, abnormal MRI findings were present, even if not correlated with the clinical outcome.