Synthetic Resorbable Scaffolds for the Treatment of Isolated Patellofemoral Cartilage Defects in Young Patients

Joshi, Nayana; Reverte-Vinaixa, M M; Díaz-Ferreiro, Eugenio Wenceslao; Domínguez-Oronoz, Rosa

doi:10.1177/0363546512441585

Cited by 83 publications

(83 citation statements)

References 28 publications

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“…Clinical use of native autologous osteoperiosteal grafting has been reported for the filling of donor-site defects after mosaicplasty or for primary treatment of osteochondral defects [12]. Artificial "off-the-shelf" implants, recently showed a catastrophic clinical outcome with a revision rate up to 70 % [7,8]. Our data support the use of autologous protocols as autologous periosteum-bone grafts can provide a complete restoration of the subchondral cancellous bone defect.…”

Section: Growth Factor Treatmentsupporting

confidence: 68%

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No effect of subperiosteal growth factor application on periosteal neo-chondrogenesis in osteoperiosteal bone grafts for osteochondral defect repair

Gotterbarm

Breusch

Vilei³

et al. 2013

International Orthopaedics (SICOT)

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Section: Growth Factor Treatmentsupporting

confidence: 68%

“…But donor-site morbidity may compromise the clinical outcome [2,5,6]. Artificial scaffolds recently have shown less favourable results for the treatment of osteochondral defect in the knee [7,8].…”

Section: Introductionmentioning

confidence: 99%

No effect of subperiosteal growth factor application on periosteal neo-chondrogenesis in osteoperiosteal bone grafts for osteochondral defect repair

Gotterbarm

Breusch

Vilei³

et al. 2013

International Orthopaedics (SICOT)

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“…This difference in outcomes may relate to the overall differences in activity levels between patients given the difference in mean age, although the use of different outcome measurement tools precludes direct comparisons between these studies. Our results demonstrated improved clinical outcome scores, with maintained activity levels, although there was a decline in activity postoperatively, whereas patients in the study by Joshi et al 32 returned to running and highimpact activities by 12 months. This transient decrease in MAS noted in our patients at 1 year may be functionally significant; however, patients can be encouraged that their activity levels should gradually return to their preoperative baseline with longitudinal follow-up.…”

Section: Discussionsupporting

confidence: 42%

“…Synthetic scaffolds have been sparingly used to treat patellofemoral osteochondral lesions. The only reported study was that by Joshi et al 32 in 2012. They treated a cohort of 10 patients with full-thickness chondral defects of the patella, with an average age of 33 years, with the same synthetic scaffold plugs utilized in this study.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Patellofemoral Osteochondral Lesions Treated With Structural Grafts in Patients Older Than 40 Years

Degen

Coleman²,

Tetreault

et al. 2016

CARTILAGE

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Background. Chondral lesions in the patellofemoral compartment represent a difficult entity to treat among active patients, with no clear consensus on the optimal treatment strategy. The purpose of this study was to review the functional outcomes of patients >40 years old with primary patellofemoral osteochondral lesions who underwent a cartilage restoration procedure with a structural graft. Methods. Following institutional review board approval, 35 patients >40 years treated for patellofemoral chondral or osteochondral injuries were retrospectively identified. Seventeen (47%) had prior surgery (mean 1.4 procedures, range 1-4). Average follow-up was 3.6 ± 1.6 years. Average patient age was 51.5 years (range 40-72 years); 54% were male. Twenty-six (74%) had isolated trochlear lesions, 7 had isolated patellar lesions (20%), while 2 (6%) had bipolar lesions. Twenty patients (57%) were treated with synthetic biphasic scaffold plugs (SS), 9 (26%) with fresh osteochondral allograft (OCA) and 6 (17%) with osteochondral autograft transfer (OAT). Outcomes were measured with validated measures: Activity of Daily Living Score (ADL), International Knee Documentation Committee (IKDC) Subjective Evaluation form, and Marx Activity Scale (MAS). Results. The average lesion size for the entire cohort was 3.1 ± 1.7 cm 2 . Average defect size was 2.6 ± 1.7 cm 2 for the SS group, 4.3±1.5 cm 2 for the OCA group, and 2.9 ± 0.8 cm 2 for the OAT group (P > 0.051). Outcome scores for the entire population demonstrated significant improvement in ADL (P = 0.002) and IKDC scores (P = 0.004) between baseline and final follow-up, while MAS scores were maintained (P = 0.51). Conclusion. Structural grafts are a viable treatment option for symptomatic focal osteochondral lesions of the patellofemoral joint in patients 40 years and older, with anticipated improvements in pain and function and maintenance of preoperative activity levels.

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“…Some commercial bilayered scaffolds, e.g. Trufit Ò and MaioRegen Ò , have been applied clinically in acellular strategies [21][22][23]. Kon et al [21] showed that multilayer collagen/nanohydroxyapatite scaffolds promoted bone and cartilage tissue restoration.…”

Section: Introductionmentioning

confidence: 99%

Bilayered silk/silk-nanoCaP scaffolds for osteochondral tissue engineering: In vitro and in vivo assessment of biological performance

et al. 2015

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Novel porous bilayered scaffolds, fully integrating a silk fibroin (SF) layer and a silk-nano calcium phosphate (silk-nanoCaP) layer for osteochondral defect (OCD) regeneration, were developed. Homogeneous porosity distribution was achieved in the scaffolds, with calcium phosphate phase only retained in the silk-nanoCaP layer. The scaffold presented compressive moduli of 0.4MPa in the wet state. Rabbit bone marrow mesenchymal stromal cells (RBMSCs) were cultured on the scaffolds, and good adhesion and proliferation were observed. The silk-nanoCaP layer showed a higher alkaline phosphatase level than the silk layer in osteogenic conditions. Subcutaneous implantation in rabbits demonstrated weak inflammation. In a rabbit knee critical size OCD model, the scaffolds firmly integrated into the host tissue. Histological and immunohistochemical analysis showed that collagen II positive cartilage and glycosaminoglycan regeneration presented in the silk layer, and de novo bone ingrowths and vessel formation were observed in the silk-nanoCaP layer. These bilayered scaffolds can therefore be promising candidates for OCD regeneration.

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Synthetic Resorbable Scaffolds for the Treatment of Isolated Patellofemoral Cartilage Defects in Young Patients

Cited by 83 publications

References 28 publications

No effect of subperiosteal growth factor application on periosteal neo-chondrogenesis in osteoperiosteal bone grafts for osteochondral defect repair

No effect of subperiosteal growth factor application on periosteal neo-chondrogenesis in osteoperiosteal bone grafts for osteochondral defect repair

Outcomes of Patellofemoral Osteochondral Lesions Treated With Structural Grafts in Patients Older Than 40 Years

Bilayered silk/silk-nanoCaP scaffolds for osteochondral tissue engineering: In vitro and in vivo assessment of biological performance

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