TY - JOUR
T1 - Treatment of osteochondritis dissecans of the knee with a biomimetic scaffold. A prospective multicenter study
AU - Delcogliano, Marco
AU - Menghi, Amerigo
AU - Placella, Giacomo
AU - Speziali, Andrea
AU - Cerulli, Giuliano Giorgio
AU - Carimati, Giulia
AU - Pasqualotto, Stefano
AU - Berruto, Massimo
PY - 2014
Y1 - 2014
N2 - Purpose
the aim of the present study was to evaluate the clinical outcome of the treatment of osteochondritis dissecans (OCD) of the knee with a type-I collagen-hydroxyapatite nanostructural biomimetic osteochondral scaffold.
Methods
twenty-three patients affected by symptomatic knee OCD of the femoral condyles, grade 3 or 4 of the International Cartilage Repair Society (ICRS) scale, underwent biomimetic scaffold implantation. The site of the defect was the medial femoral condyle in 14 patients, whereas in 9 patients the lateral femoral condyle was involved. The average size of the defects was 3.5±1.43 cm2. All patients were clinically evaluated using the ICRS subjective score, the IKDC objective score, the EQ-VAS and the Tegner Activity Score. Minimum follow-up was two years. MRI was performed at 12 and 24 months after surgery and then every 12 months thereafter.
Results
the ICRS subjective score improved from the baseline value of 50.93±20.6 to 76.44±18.03 at the 12 months (p<0.0005) and 82.23± 17.36 at the two-year follow-up (p<0.0005). The IKDC objective score confirmed the results. The EQ-VAS showed a significant improvement from 3.15±1.09 to 8.15±1.04 (p<0.0005) at two years of follow-up. The Tegner Activity Score improvement was statistically significant (p<0.0005).
Conclusions
biomimetic scaffold implantation was a good procedure for treating grade 3 and 4 OCD, in which other classic techniques are burdened by different limitations. This open one-step surgery gave promising stable results at short-term follow-up.
Level of evidence
Level IV, therapeutic case series.
AB - Purpose
the aim of the present study was to evaluate the clinical outcome of the treatment of osteochondritis dissecans (OCD) of the knee with a type-I collagen-hydroxyapatite nanostructural biomimetic osteochondral scaffold.
Methods
twenty-three patients affected by symptomatic knee OCD of the femoral condyles, grade 3 or 4 of the International Cartilage Repair Society (ICRS) scale, underwent biomimetic scaffold implantation. The site of the defect was the medial femoral condyle in 14 patients, whereas in 9 patients the lateral femoral condyle was involved. The average size of the defects was 3.5±1.43 cm2. All patients were clinically evaluated using the ICRS subjective score, the IKDC objective score, the EQ-VAS and the Tegner Activity Score. Minimum follow-up was two years. MRI was performed at 12 and 24 months after surgery and then every 12 months thereafter.
Results
the ICRS subjective score improved from the baseline value of 50.93±20.6 to 76.44±18.03 at the 12 months (p<0.0005) and 82.23± 17.36 at the two-year follow-up (p<0.0005). The IKDC objective score confirmed the results. The EQ-VAS showed a significant improvement from 3.15±1.09 to 8.15±1.04 (p<0.0005) at two years of follow-up. The Tegner Activity Score improvement was statistically significant (p<0.0005).
Conclusions
biomimetic scaffold implantation was a good procedure for treating grade 3 and 4 OCD, in which other classic techniques are burdened by different limitations. This open one-step surgery gave promising stable results at short-term follow-up.
Level of evidence
Level IV, therapeutic case series.
KW - cartilage
KW - knee
KW - ostechondritis dissecans
KW - osteochondral lesions
KW - scaffold
KW - cartilage
KW - knee
KW - ostechondritis dissecans
KW - osteochondral lesions
KW - scaffold
UR - http://hdl.handle.net/10807/65450
UR - http://www.ncbi.nlm.nih.gov/pmc/articles/pmc4295684/
U2 - 10.11138/jts/2014.2.3.102
DO - 10.11138/jts/2014.2.3.102
M3 - Article
SN - 2282-4324
VL - 2014
SP - 102
EP - 108
JO - Joints
JF - Joints
ER -