2021 ISAKOS Biennial Congress Paper
Good Subjective Outcome And Low Risk Of Revision Surgery With A Novel Customized Metal Implant For Focal Femoral Chondral Lesions At A Minimum Of Five Years Follow-Up
Anders Stalman, MD, PhD, associate professor, Saltsjobaden, Sweden SWEDEN
Mohanad Al-Bayati, MD, Skövde SWEDEN
David Roberts, MD, PhD, Malmö SWEDEN
Magnus Hogstrom, MD, PhD, Umea SWEDEN
Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, SWEDEN
The FDA has not cleared the following pharmaceuticals and/or medical device for the use described in this presentation. The following pharmaceuticals and/or medical device are being discussed for an off-label use: Episurf AB,
Summary
Good subjective outcome and low risk of progression of degenerative changes and need for subsequent surgery were seen at mid-term follow-up with a customized focal knee resurfacing implant.
Abstract
Focal prosthetic inlay resurfacing has been proposed as a bridge between biological treatment and conventional joint arthroplasty. Promising short-term outcome is described but a high rate of revision to knee arthroplasty has been reported at mid-term follow-up It has been suggested that a more accurate implant positioning would enhance implant survival.
A customized prosthesis and guide system was designed to precisely fit the cartilage defect in location and size has the potential to improve implant positioning and thereby avoid damage to the opposing cartilage. We hypothesize that good subjective outcome is preserved and that risk of osteoarthritis development and need for revision to knee arthroplasty is low at a minimum 5-year follow-up.
Methods
Ten patients, focal chondral femoral injury and previous failed biological treatment.
Surgery with a customized Cr-Co femoral condyle implant. Minimum 5-year follow-up with clinical and radiological examination. Subjective outcome, KOOS. Data on re-surgery.
Results
Mean age at surgery 53 years. Mean 75 months follow-up (range 60-86 months). Two patients experienced limitation in range of motion. In one patient standing weight-bearing showed OA, Ahlbäck 1 at 84 months. Significant improvement in KOOS subscores pain (60-85), ADL (66-91), Sports (23-48), QoL (28-55) compared to pre-op. Tegner score from 3 to 4.
Conclusion
Good subjective outcome and low risk of progression of degenerative changes and need for subsequent surgery were seen at mid-term follow-up with this customized focal knee resurfacing implant.