A one-step treatment for chondral and osteochondral knee defects: clinical results of a biomimetic scaffold implantation at 2 years of follow-up

Abstract

The increasing interest in the role of subchondral bone with regard to articular surface disease led to the development of new bioengineered strategies. Aim of this study is to evaluate the clinical and MRI outcome after the implantation of a nanostructured biomimetic three-phasic collagen-hydroxyapatite construct for the treatment of chondral and osteochondral defects of the knee in a large cohort of patients. Seventy-nine patients (63 M, 16 W), affected by grade III-IV femoral condyle or trochlea chondral lesions or osteochondritis dissecans (OCD) were consecutively treated. Mean age was 31.0 ± 11.3 years, mean lesion size was 3.2 ± 2.0 cm(2). Fifty patients underwent previous surgeries, concurrent procedures were necessary in 39 cases. The clinical outcome was evaluated using the IKDC and Tegner scores at 12 and 24 months of follow-up. At follow-up times an MRI was performed and evaluated with the MOCART score. All the scores improved significantly from the baseline. IKDC subjective score showed a further increase between 12 and 24 months of follow-up, and 82.2% of the patients improved their symptoms at the final evaluation. Patients affected by OCDs had better results than those with degenerative lesions. Some abnormal MRI findings were present, even though no correlation was found with the clinical outcome. This one-step biomimetic approach developed to favor osteochondral tissue regeneration is effective in treating knees affected by damages of the articular surface, leading to a significant clinical improvement. However, abnormal MRI findings were present, even if not correlated with the clinical outcome.

Functionally graded additive manufacturing to achieve functionality specifications of osteochondral scaffolds

“…Similar positive conclusion was confirmed by the visual analogue scale and Tegner scores at 24 months after implantation [8]. These results showed that this was a good strategy for OCD treatment but abnormal magnetic resonance imaging findings were presented [9]. Another study was carried out in 11 patients for the treatment of tibial plateau lesions.…”

Focal Defects of the Knee Articular Surface: Evidence of a Regenerative Potential Pattern in Osteochondritis Dissecans and Degenerative Lesions

“…However, the outcome is heterogeneous and rather unpredictable [9–11]. Understanding the etiopathological patterns leading to the alteration of the articular tissues might shed some light into the healing potential of such lesions, explaining the heterogeneous results observed in osteochondral regeneration and giving possible indications to better target and further develop treatments in the future [11–13]. An accurate knowledge of cellular osteochondral tissue patterns is mandatory to improve current therapies as well as to contribute to increasing the knowledge concerning different etiologies.…”

Current Applications of Mesenchymal Stem Cells for Cartilage Tissue Engineering

“…Its composition is based on a collagen type-I hydroxyapatite gradient. MaioRegen® has demonstrated throughout its clinical studies that its technique is safe and that the clinical results in the short-and medium-term follow-up are efective in a large population of patients [144][145][146][147][148], even atributed beter results than other commercial scafolds ChondroMimetic TM [149] and TruFit CB TM [11,[150][151][152]. Despite the encouraging in vitro results of a wide variety of osteochondral scafolds, most are in the early stages of development.…”