2017 ISAKOS Biennial Congress ePoster #222
Bone Marrow Autologous Concentrate and Collagenic Scaffold for Patellofemoral Joint Chondral Lesions. Clinical and Mri Evaluation
Vincenzo Condello, MD, Negrar, Verona ITALY
Luca Dei Giudici, MD, Ancona ITALY
Vincenzo Madonna, MD, Verona ITALY
Daniele Screpis, Resident, Verona, Verona ITALY
Antonio Gigante, Ancona, IT ITALY
Claudio Zorzi, MD, Verona, Veneto ITALY
Department of Orthopaedics, Sacro Cuore Don Calabria, Negrar, VR, ITALY
FDA Status Cleared
Summary
Clinical and radiological outcomes after BMAC and collagenic scaffold in the treatment of patellofemoral joint articular defects
ePosters will be available shortly before Congress
Abstract
Introduction
Patellofemoral chondral lesions often affect young active patients, representing a challenge for the surgeon. The use of bone marrow concentrate, which contains multipotent stem cells and growth factors, has been proposed. Aim of this study is to evaluate clinical results of symptomatic chondral lesions in the patella or in the trochlea, treated with bone marrow concentrate conveyed via a new matrix support.
Material And Methods
16 patients affected by chondral lesions in the patellofemoral joint were treated. Inclusion criteria were: type III or IV according to ICRS classification, patellofemoral localization, and MRI imaging confirmation. An arthroscopy was performed in all cases, as first step for a global evaluation and for the treatment of other intrarticular pathologies; second step was a mini arthrotomic incision to expose the chondral lesion and to implant a collagenic matrix filled with bone marrow concentrate. A follow-up evaluation was performed at a mean 18 months after surgery. VAS, IKDC, Lysholm, and KOOS score were submitted at hospital admittance and at the follow-up.
Results
Study group had a mean age of 35.5 (SD=9.2) years, and a mean BMI of 25.7 (SD=4.8). Patients outcome showed a significant improvement: IKDC increased from 34.6 (SE=4.1) to 64.7 (5.0); KOOS, increased from 55.1 (SE=5.5) to 76.0 (SE=3.8); Lysholm score, increased from 55.9 (SE=5.7) to 76.1 (SE=5.0); and VAS decreased from 7.1 (SE=0.3) to 2.8 (SE=0.4). Nine patients were also treated for concomitant lesions. Quintile regression demonstrated that the association of the technique with a concomitant Fulkerson Osteotomy provides a significant improvement in the outcomes (p-value=0.031). Two complications were noted: a case of stiffness and a case of hemarthrosis.
Conclusions
Patellofemoral chondral treatment with bone marrow autologous concentrate and the collagenic scaffold is a promising one stage procedure, appearing effective and providing good outcomes in the short term.