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

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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 cm2. 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.

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Acknowledgments

G. Altadonna, L. Andriolo, S. Bassini: II Clinic - Biomechanics Laboratory, Rizzoli Orthopaedic Institute, Bologna, Italy, E. Pignotti, K. Smith: Task Force, Rizzoli Orthopaedic Institute, Bologna, Italy.The study was performed at the Rizzoli Orthopaedic Institute, Bologna, Italy.

Conflict of interest

All but two authors declare that they have no conflict of interest. Elizaveta Kon is paid consultant for CartiHeal (2009) Ltd, Israel and has stocks of CartiHeal (2009) Ltd, Israel, and she received fees for paid presentation from Finceramica SpA, Italy, and Fidia, Italy. Maurilio Marcacci has royalties and received research institutional support from Finceramica SpA, Italy.

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Authors and Affiliations

  1. II Clinic - Biomechanics Laboratory, Rizzoli Orthopaedic Institute, Via Di Barbiano 1/10, 40136, Bologna, Italy

    Elizaveta Kon, Giuseppe Filardo, Francesco Perdisa, Alessandro Di Martino, Maurizio Busacca, Federica Balboni, Andrea Sessa & Maurilio Marcacci

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  1. Elizaveta Kon
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  2. Giuseppe Filardo
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  3. Francesco Perdisa
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  4. Alessandro Di Martino
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  6. Federica Balboni
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  8. Maurilio Marcacci
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Correspondence to Elizaveta Kon.

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Kon, E., Filardo, G., Perdisa, F. et al. A one-step treatment for chondral and osteochondral knee defects: clinical results of a biomimetic scaffold implantation at 2 years of follow-up. J Mater Sci: Mater Med 25, 2437–2444 (2014). https://doi.org/10.1007/s10856-014-5188-2

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  • DOI: https://doi.org/10.1007/s10856-014-5188-2

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