Matteo Baldassarri1, Roberto Buda2, Luca Perazzo3,4, Diego Ghinelli1, Ricciardello Sarino5, Brunella Grigolo6, Cesare Faldini7. 1. Villa Maria Hospital, Viale Matteotti, 4 - 47921, Rimini, Italy. 2. Orthopaedic and Traumatology Clinic, Ospedale "SS. Annunziata" - Università degli Studi Gabriele d'Annunzio - Chieti e Pescara, Via dei Vestini, 31 - 66100, Chieti, Italy. 3. Villa Maria Hospital, Viale Matteotti, 4 - 47921, Rimini, Italy. lucaperazzo@me.com. 4. UNIZKM: Università Cattolica Nostra Signora del Buon Consiglio, Tirana - Albania, Via A. Poliziano, 2 - 40129, Bologna (BO), Italy. lucaperazzo@me.com. 5. Casa di Cura Villa Laura, Via Emilia Levante, 137 - 40139, Bologna, Italy. 6. RAMSES Laboratory, Rizzoli Orthopaedic Institute, Via Giulio Cesare Pupilli 1 - 40136, Bologna, Italy. 7. I Orthopaedic and Traumatology Clinic, Rizzoli Orthopaedic Institute - Bologna, Viale G. C. Pupilli, 1 - 40100, Bologna, Italy.
Abstract
BACKGROUND: Osteochondritis dissecans (OCD) is a common cartilage disorder that specifically affects the knees of skeletally immature and young adult patients. There have been a few treatments that have been proposed: fixation of the fragment, drilling, microfractures. The aim of this study was to analyze retrospectively clinical and imaging results obtained by treating it with one-step bone marrow-derived cells Transplantation (BMDCT) technique. METHODS: From 2007 to 2014, 18 patients (mean-age 19.1 ± 5.0 years) affected by OCD were treated with one-step BMDC transplantation. In our observational study, clinical evaluation was performed at a scheduled follow-up through IKDC, Tegner, KOOS and EQ-VAS. X-rays and MRI were conducted preoperatively and at 12 months. At final follow-up, MRI MOCART Score was evaluated. RESULTS: IKDC and KOOS clinical scores showed a progressive increase. Tegner Score at final follow-up (5.3 ± 2.7) was significantly lower compared to the pre-injury level (6.5 ± 2.1); however, these results showed a statistically significant improvement that remained over time. EQ-VAS showed a significant improvement in every follow-up measure. MRI Mocart Score showed a complete or almost complete filling of the lesion in 13 patients. CONCLUSIONS: "One-step" technique allows articular surface restoration with viable physiologic osteochondral tissue with a high clinical efficacy and imaging results. The number of cases is still limited, and further studies with larger sample sizes and greater follow-up evaluations are required to confirm our results. Nevertheless, we believe that BMDCT may represent a suitable option to treat OCD lesion in young adults.
BACKGROUND: Osteochondritis dissecans (OCD) is a common cartilage disorder that specifically affects the knees of skeletally immature and young adult patients. There have been a few treatments that have been proposed: fixation of the fragment, drilling, microfractures. The aim of this study was to analyze retrospectively clinical and imaging results obtained by treating it with one-step bone marrow-derived cells Transplantation (BMDCT) technique. METHODS: From 2007 to 2014, 18 patients (mean-age 19.1 ± 5.0 years) affected by OCD were treated with one-step BMDC transplantation. In our observational study, clinical evaluation was performed at a scheduled follow-up through IKDC, Tegner, KOOS and EQ-VAS. X-rays and MRI were conducted preoperatively and at 12 months. At final follow-up, MRI MOCART Score was evaluated. RESULTS: IKDC and KOOS clinical scores showed a progressive increase. Tegner Score at final follow-up (5.3 ± 2.7) was significantly lower compared to the pre-injury level (6.5 ± 2.1); however, these results showed a statistically significant improvement that remained over time. EQ-VAS showed a significant improvement in every follow-up measure. MRI Mocart Score showed a complete or almost complete filling of the lesion in 13 patients. CONCLUSIONS: "One-step" technique allows articular surface restoration with viable physiologic osteochondral tissue with a high clinical efficacy and imaging results. The number of cases is still limited, and further studies with larger sample sizes and greater follow-up evaluations are required to confirm our results. Nevertheless, we believe that BMDCT may represent a suitable option to treat OCD lesion in young adults.