Summary: Long-term follow-up of patients treated with a biomimetic collagen-hydroxyapatite scaffold for chondral and osteochondral knee lesions showed significant clinical improvement, with stable subjective and objective outcomes and a low rate of failures and revisions over a minimum of 10 years.

Purpose

Articular cartilage lesions represent a challenging scenario for the orthopaedic surgeon. During recent years biomimetic cell-free osteochondral scaffolds have shown good promising results for the treatment of chondral and osteochondral lesions up to 10 years follow-up. The purpose of this study is to evaluate long-term results offered by the implantation of a biomimetic collagen-hydroxyapatite construct for the treatment of chondral and osteochondral lesions of the knee at minimum 10 years follow-up.

Methods

A series of 56 consecutive patients (38 men, 18 women; means age 32.5 ± 11.8 years) affected by symptomatic chondral or osteochondral lesions International Cartilage Repair Society (ICRS) grade 3 to 4 were treated with the implantation of osteochondral scaffold. All patients were prospectively evaluated at 2, 5, and at minimum 10 years follow-up with International Knee Documentation Committee (IKDC) subjective and objective scores, l’EQ-VAS and Tegner score. Failures were documented.

Results

A statistically significant improvement in all clinical scores was observed from baseline evaluation up to minimum 10 years follow-up (mean 139.8 ± 13.0 months). The mean IKDC subjective score improved from 45.9 ± 16.9 to 75.3 ± 18.3 at 2 years (p < 0.0005), and it then remained stable at 5 years (74.7 ± 23.2) and at final follow-up (69.7 ± 22.3). Tegner score improved from pre-operative value (mean 2.3 ± 1.7) to 2 years (4.3 ± 1.6) and final follow-up (3.7 ± 1.7), without reaching pre-injury value (6.0 ± 2.1). Six patients underwent revision surgery with removal of the scaffold, with a cumulative surgical failure rate of 10.7%.

Conclusion

The treatment of chondral and osteochondral lesions with biomimetic osteochondral scaffold implantation is a safe and effective procedure, providing satisfactory clinical results and low failure rate up to long term follow-up.

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Biomimetic Scaffold for the Treatment of Chondral and Osteochondral Lesions of the Knee: Clinical Results at Long Term Follow-up.

Biomimetic Scaffold for the Treatment of Chondral and Osteochondral Lesions of the Knee: Clinical Results at Long Term Follow-up.

Purpose

Methods

Results

Conclusion

Knee Cartilage ePosters

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Biomimetic Scaffold for the Treatment of Chondral and Osteochondral Lesions of the Knee: Clinical Results at Long Term Follow-up.

Biomimetic Scaffold for the Treatment of Chondral and Osteochondral Lesions of the Knee: Clinical Results at Long Term Follow-up.

Purpose

Methods

Results

Conclusion