Francesco Perdisa1, Giuseppe Filardo2, Andrea Sessa1, Maurizio Busacca3, Stefano Zaffagnini4, Maurilio Marcacci1, Elizaveta Kon1,2. 1. I Orthopaedic and Traumatologic Clinic-University of Bologna, Rizzoli Orthopaedic Institute, Bologna, Italy. 2. Nano-biotechnology Laboratory, Rizzoli Orthopaedic Institute, Bologna, Italy. 3. Radiology Department, Rizzoli Orthopaedic Institute, Bologna, Italy. 4. Sicily Department, Rizzoli Orthopaedic Institute, Bagheria, Italy.
Abstract
BACKGROUND: The treatment of symptomatic cartilage defects of the patella is particularly challenging, and no gold standard is currently available. PURPOSE: To evaluate the clinical results of a biphasic cell-free collagen-hydroxyapatite scaffold and to evaluate osteochondral tissue regeneration with magnetic resonance imaging (MRI). STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Thirty-four patients (18 men and 16 women; mean ± SD: age, 30.0 ± 10 years) were treated by scaffold implantation for knee chondral or osteochondral lesions of the patella (area, 2.1 ± 1 cm2). The clinical evaluation was performed prospectively at 12 and 24 months via the IKDC (International Knee Documentation Committee; objective and subjective) and Tegner scores. MRI evaluation was performed at both follow-ups in 18 lesions through the MOCART score (magnetic resonance observation of cartilage repair tissue) and specific subchondral bone parameters. RESULTS: A statistically significant improvement in all the scores was observed at 12- and 24-month follow-up as compared with the basal evaluation. The IKDC subjective score improved from 39.5 ± 14.5 to 61.9 ± 14.5 at 12 months ( P > .0005) with a further increase to 67.6 ± 17.4 at 24 months of follow-up (12-24 months, P = .020). The MRI evaluation showed a stable value of the MOCART score between 12 and 24 months, with a complete filling of the cartilage in 87.0% of the lesions, complete integration of the graft in 95.7%, and intact repair tissue surface in 69.6% at final follow-up. The presence of osteophytes or more extensive bony overgrowth was documented in 47.8% of the patients of this series, but no correlation was found between MRI findings and clinical outcome. CONCLUSION: The implantation of a cell-free collagen-hydroxyapatite osteochondral scaffold provided a clinical improvement at short-term follow-up for the treatment of patellar cartilage defects. Women had lower outcomes, and the need for realignment procedures led to a slower recovery. MRI evaluation showed some abnormal findings with the presence of bone overgrowth, but no correlation has been found with the clinical outcome.
BACKGROUND: The treatment of symptomatic cartilage defects of the patella is particularly challenging, and no gold standard is currently available. PURPOSE: To evaluate the clinical results of a biphasic cell-free collagen-hydroxyapatite scaffold and to evaluate osteochondral tissue regeneration with magnetic resonance imaging (MRI). STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Thirty-four patients (18 men and 16 women; mean ± SD: age, 30.0 ± 10 years) were treated by scaffold implantation for knee chondral or osteochondral lesions of the patella (area, 2.1 ± 1 cm2). The clinical evaluation was performed prospectively at 12 and 24 months via the IKDC (International Knee Documentation Committee; objective and subjective) and Tegner scores. MRI evaluation was performed at both follow-ups in 18 lesions through the MOCART score (magnetic resonance observation of cartilage repair tissue) and specific subchondral bone parameters. RESULTS: A statistically significant improvement in all the scores was observed at 12- and 24-month follow-up as compared with the basal evaluation. The IKDC subjective score improved from 39.5 ± 14.5 to 61.9 ± 14.5 at 12 months ( P > .0005) with a further increase to 67.6 ± 17.4 at 24 months of follow-up (12-24 months, P = .020). The MRI evaluation showed a stable value of the MOCART score between 12 and 24 months, with a complete filling of the cartilage in 87.0% of the lesions, complete integration of the graft in 95.7%, and intact repair tissue surface in 69.6% at final follow-up. The presence of osteophytes or more extensive bony overgrowth was documented in 47.8% of the patients of this series, but no correlation was found between MRI findings and clinical outcome. CONCLUSION: The implantation of a cell-free collagen-hydroxyapatite osteochondral scaffold provided a clinical improvement at short-term follow-up for the treatment of patellar cartilage defects. Women had lower outcomes, and the need for realignment procedures led to a slower recovery. MRI evaluation showed some abnormal findings with the presence of bone overgrowth, but no correlation has been found with the clinical outcome.
Authors: Gareth Turnbull; Jon Clarke; Frédéric Picard; Philip Riches; Luanluan Jia; Fengxuan Han; Bin Li; Wenmiao Shu Journal: Bioact Mater Date: 2017-12-01
Authors: Renato Andrade; Joni Nunes; Betina B Hinckel; Jordan Gruskay; Sebastiano Vasta; Ricardo Bastos; J Miguel Oliveira; Rui L Reis; Andreas H Gomoll; João Espregueira-Mendes Journal: Cartilage Date: 2019-12-17 Impact factor: 3.117
Authors: Jorge Chahla; Betina B Hinckel; Adam B Yanke; Jack Farr; William D Bugbee; James L Carey; Brian J Cole; Dennis C Crawford; James E Fleischli; Alan Getgood; Andreas H Gomoll; Simon Gortz; Allan E Gross; Deryk G Jones; Aaron J Krych; Christian Lattermann; Bert R Mandelbaum; Peter R Mandt; Tom Minas; Raffy Mirzayan; Timothy S Mologne; John D Polousky; Matthew T Provencher; Scott A Rodeo; Oleg Safir; Seth Lawrence Sherman; Eric D Strauss; Sabrina M Strickland; Christopher J Wahl; Riley J Williams Journal: Orthop J Sports Med Date: 2020-03-26