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Novel Solution Using Viable Cartilage Allograft For Focal Cartilage Defects

Novel Solution Using Viable Cartilage Allograft For Focal Cartilage Defects

Deryk G. Jones, MD, UNITED STATES Bhumit Desai, MD, UNITED STATES Emmanuel Koli, MD, UNITED STATES Michael Warren, MD, UNITED STATES Gerard Karl Williams Jr., MD, UNITED STATES Graylin Jacobs, CRC, UNITED STATES Walter Stephen Choate, MD, UNITED STATES Scott C Montgomery, MD, UNITED STATES Misty Suri, MD, UNITED STATES

Ochsner Sports Medicine Institute, New Orleans, Louisiana, UNITED STATES


2021 Congress   Abstract Presentation   5 minutes   rating (1)

 

Anatomic Location

Anatomic Structure

Diagnosis / Condition

Treatment / Technique

Diagnosis Method

MRI

Sports Medicine

Cartilage

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Summary: Clinical studies show VCA can safely treat chondral defects with potential advantages to existing options.


Background

Viable Cartilage Allograft (VCA) contains cryopreserved viable allogeneic cartilage fibers mixed with chondrogenic matrix. In-vitro and animal studies and a prospective case series were completed with VCA to assess safety and benefits in treating focal knee cartilage defects. Our hypothesis is that VCA is a safe single stage procedure in isolated chondral defects with results comparable or better than other single stage procedures.

Methods

Cell viability and functionality of VCA was evaluated in-vitro. VCA was also evaluated in a goat cartilage repair model. 19 patients (7/12 M/F) were implanted, mean age 26.77 (15-56), mean BMI 27.59 ± 6.1, mean follow-up 19 months (range 12.0–26.3 months). Symptomatic International Cartilage Repair Society (ICRS) grade 3 / 4A lesions of the femoral condyle (n=4) or patella (n=14) were treated. Lesion sizes ranged from 1.4-6.0 cm2 (mean defect size was 5.025 cm2). International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome (KOOS) subscales, Lysholm, Short Form-12 (SF-12), visual analog scale (VAS) and pain frequency levels were assessed. Radiographs and magnetic resonance imaging (MRI) were performed at 3 and 6 months (M).

Results

In vitro assessment confirmed VCA contains viable and functional chondrocytes. The goat study confirmed VCA is effective for cartilage repair. Lysholm (25.3), KOOS: Pain (12.2), Symptoms (19.6), ADLs (14.5), Sports (13.7), and QOL (28.9) at 6 months increased from pre-operative baseline (POB) and were maintained at 12 months: IKDC (72.2), Lysholm (84.2), KOOS: Pain (87.8), Symptoms (80.7), ADL (97.6), Sports (72), and QOL (61.2). MRI imaging at 6 and 12 months showed viable preliminary cartilage tissue with no significant bone edema or graft delamination. Second look arthroscopy (2 patients) demonstrated complete fill and incorporation (Brittberg Scores 11/12). Functional scores improved at 24(M): IKDC (87.3), Lysholm (87.7), KOOS: Pain (92.5), Symptoms (86.2), ADLs (95.6), Sports (82.9), QOL (82.1).

Conclusion

VCA is an off-the-shelf, single stage, conformable allogeneic graft that treats chondral defects with no additional fixation. Pre-clinical and short-term prospective clinical studies show VCA can safely treat chondral defects with potential advantages to existing options.


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