Antonio Altenor Bessa de Queiroz1, Pedro Debieux2, Joicemar Amaro1, Mario Ferretti1, Moises Cohen1. 1. Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Rua Borges Lagoa, 783 5° Andar, São Paulo, SP, CEP 04038-031, Brazil. 2. Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Rua Borges Lagoa, 783 5° Andar, São Paulo, SP, CEP 04038-031, Brazil. pedrod.ortop@gmail.com.
Abstract
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.
RCT Entities:
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.
Authors: Amit Lahav; Robert T Burks; Patrick E Greis; Andrew W Chapman; Gregory M Ford; Barbara P Fink Journal: J Knee Surg Date: 2006-07 Impact factor: 2.757
Authors: Konstantinos S Intzoglou; Dimitrios S Mastrokalos; Dimitrios S Korres; Kleo Papaparaskeva; Dimitrios Koulalis; George C Babis Journal: World J Orthop Date: 2014-09-18
Authors: László Hangody; Gábor K Ráthonyi; Zsófia Duska; Gábor Vásárhelyi; Péter Füles; László Módis Journal: J Bone Joint Surg Am Date: 2004-03 Impact factor: 5.284
Authors: Ozório De Almeida Lira Neto; Carlos Eduardo Da Silveira Franciozi; Geraldo Sérgio De Mello Granata Júnior; Antonio Altenor Bessa De Queiroz; Mario Carneiro Filho; Ricardo Dizioli Navarro Journal: Rev Bras Ortop Date: 2015-11-16
Authors: Bryan Michael Saltzman; Michael L Redondo; Adam Beer; Eric J Cotter; Rachel M Frank; Adam B Yanke; Brian J Cole Journal: Cartilage Date: 2018-10-31 Impact factor: 4.634