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01.06.2014 | Knee | Ausgabe 6/2014

Knee Surgery, Sports Traumatology, Arthroscopy 6/2014

Cartilage repair in the knee with subchondral drilling augmented with a platelet-rich plasma-immersed polymer-based implant

Zeitschrift:
Knee Surgery, Sports Traumatology, Arthroscopy > Ausgabe 6/2014
Autoren:
Alberto Siclari, Gennaro Mascaro, Chiara Gentili, Christian Kaps, Ranieri Cancedda, Eugenio Boux
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s00167-013-2484-1) contains supplementary material, which is available to authorized users.

Abstract

Purpose

The aim of our study was to analyse the clinical and histological outcome after the treatment of focal cartilage defects in non-degenerative and degenerative knees with bone marrow stimulation and subsequent covering with a cell-free resorbable polyglycolic acid–hyaluronan (PGA-HA) implant immersed with autologous platelet-rich plasma (PRP).

Methods

Fifty-two patients (mean age 44 years) with focal chondral defects in radiologically confirmed non-degenerative or degenerative knees were subjected to subchondral drilling arthroscopically. Subsequently, defects were covered with the PGA-HA implant immersed with autologous PRP. At 2-year follow-up, the patients’ situation was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and compared to the pre-operative situation and 3–12-month follow-up. Biopsies (n = 4) were harvested at 18–24 months after implantation and were analysed by histology and collagen type II immune staining.

Results

At 1- and 2-year follow-up, the KOOS showed clinically meaningful and significant (p < 0.05) improvement in all subcategories compared to baseline and to 3-month follow-up. There were no differences in KOOS data obtained after 2 years compared to 1 year after the treatment. Histological analysis of the biopsy tissue showed hyaline-like to hyaline cartilage repair tissue that was rich in cells with a chondrocyte morphology, proteoglycans and type II collagen.

Conclusions

Covering of focal cartilage defects with the PGA-HA implant and PRP after bone marrow stimulation improves the patients’ situation and has the potential to regenerate hyaline-like cartilage.

Level of evidence

Case series, Level IV.

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Zusatzmaterial
Supplementary material 1 (TIFF 2898 kb)
167_2013_2484_MOESM1_ESM.tif
Supplementary material 2 (MPG 10505 kb)
Supplementary material 3 (MPG 9779 kb)
Literatur
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