Treatment of osteochondritis dissecans of the knee with a biomimetic scaffold. A prospective multicenter study

Delcogliano, Marco and Menghi, Amerigo and Placella, Giacomo and Speziali, Andrea and Cerulli, Giuliano and Carimati, Giulia and Pasqualotto, Stefano and Berruto, Massimo (2014) Treatment of osteochondritis dissecans of the knee with a biomimetic scaffold. A prospective multicenter study. Joints, 2 (3). pp. 102-108. ISSN 2282-4324

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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.

Item Type: Article
Uncontrolled Keywords: Cartilage, knee, osteochondral lesions, ostechondritis dissecans, scaffold
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia > 617.5 Medicina regionale; Chirurgia regionale
Depositing User: Chiara D'Arpa
Date Deposited: 09 Apr 2015 13:35
Last Modified: 09 Apr 2015 13:35

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