Treatment of Large Knee Osteochondral Lesions With a Biomimetic Scaffold

Berruto, Massimo; Delcogliano, Marco; de, Francesca; Carimati, Giulia; Uboldi, Francesco; Ferrua, Paolo; Ziveri, Giovanni; Biase, Carlo Felice De

doi:10.1177/0363546514530292

Cited by 74 publications

(32 citation statements)

References 36 publications

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“…Development of cell-free scaffolds (chondrocytes) has arisen with the purpose of inducing tissue regeneration through the proliferation and migration of mesenchyme cells 15) . Also, scaffolds would be able to sustain the clot created after microfractures or nanofractures and increase the success rate in medial condyle lesions 16) .…”

Section: Discussionmentioning

confidence: 99%

Treatment of Osteochondritis Dissecans of the Knee with Autologous Iliac Bone Graft and Hyaluronic Acid Scaffold

Hinzpeter

Zamorano

Barahona

et al. 2019

Knee Surg Relat Res

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Section: Discussionmentioning

confidence: 99%

Treatment of Osteochondritis Dissecans of the Knee with Autologous Iliac Bone Graft and Hyaluronic Acid Scaffold

Hinzpeter

Zamorano

Barahona

et al. 2019

Knee Surg Relat Res

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“…It has shown promising clinical results in osteochondral defects of up to 3 to 8 cm 2 on the femoral condyles, trochlea, and tibial plateau; however, the biological repair potential of the scaffold has recently been questioned. 35 Authors have reported preoperative to 1 year IKDC increases from 36 ± 6 to 68 ± 13, 36 45 ± 19 to 71 ± 18, 37 and 48 ± 18 to 76 ± 13 38 (mean IKDC increase 32, 26, and 28 respectively). In the present study, the ADTT treatment resulted in an IKDC increase from preoperative to 1 year of 36 ± 20 to 68 ± 15—a statistically and clinically significant increase of 32 points, which is similar to or better than previously published studies investigating methods for osteochondral repair.…”

Section: Discussionmentioning

confidence: 99%

Autologous Dual-Tissue Transplantation for Osteochondral Repair

et al. 2015

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BackgroundNumerous treatment methods for osteochondral repair have been implemented, including auto- and allogeneic osteochondral transplantations, combined bone and chondrocyte transplantations, and synthetic implants, but no gold standard treatment has been established. We present preliminary data on a combined autologous bone and cartilage chips: autologous dual-tissue transplantation (ADTT); an easily applicable, low-cost treatment option for osteochondral repair. The aim of this study was to investigate the early biological and clinical outcome of ADTT.MaterialsEight patients (age 32 ± 7.5 years) suffering from osteochondritis dissecans (OCD) in the knee were enrolled. The OCD lesion was debrided and the osteochondral defect was filled with autologous bone, to a level at the base of the adjacent cartilage. Cartilage biopsies from the intercondylar notch were chipped and embedded within fibrin glue in the defect. Evaluation was performed using magnetic resonance imaging, computed tomography, and clinical scores, preoperative and 1 year postoperative.ResultsCartilage tissue repair evaluated using MOCART score improved from 22.5 to 52.5 (P < 0.01). Computed tomography imaging demonstrated very good subchondral bone healing with all 8 patients having a bone filling of >80%. We found improvements 1 year postoperative in the International Knee Documentation Committee score (from 35.9 to 68.1, P < 0.01), Tegner score (from 2.6 to 4.7, P < 0.05), and Knee injury and Osteoarthritis Outcome Score pain, symptoms, sport/recreation and quality of life (P < 0.05).ConclusionTreatment of OCD with ADTT resulted in very good subchondral bone restoration and good cartilage repair. Significant improvements in patient reported outcome was found at 1 year postoperative. This study suggests ADTT as a promising, low-cost, treatment option for osteochondral injuries.

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“…Berruto et al 29 described the use of MaioRegen (Fin-Ceramica Faenza SpA, Faenza, Italy) in the treatment of large knee osteochondral lesions. They enrolled 49 patients in the study (mean defect size, 4.35 cm 2 ).…”

Section: Resultsmentioning

confidence: 99%

“… 28 Conversely, the treatment of osteochondral lesions with MaioRegen showed promising results in terms of survivorship at short term. 29 …”

Section: Discussionmentioning

confidence: 99%

How to Manage a Failed Cartilage Repair: A Systematic Literature Review

Rosa

Donato

Balato

et al. 2017

Joints

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Purpose The aims of this paper are to report the rate and risk factors for the failure of the most common cartilage repair technique, and analyze the most important factors that could influence the choice of a specific surgical treatment to revise a failed cartilage repair. Methods A review of the literature was performed focusing on failed cartilage repair and related treatments. Two of the authors independently screened articles. Conflicts about the inclusion of a paper was resolved by further evaluation by the senior author. Review articles, articles written in languages different from/other than English, case reports, and papers that did not evaluate the outcomes of interest were excluded. Full-text version of each included paper was obtained and relevant data were extracted and collected in a database. Results At the end of the screening process, 31 articles were included. Microfractures and mosaicplasty showed a nonnegligible failure rate at short- and midterm. Better results, especially in terms of time to failure or revision, were reported with the use of autologous chondrocyte implantation (ACI) and osteochondral allograft (OCA) transplantation. Regarding the treatment of failed cartilage repair, the use of OCA transplantation in patients with previous failed cartilage repair may be a safe option. The revision of failed OCA transplantation with further OCA seems to have a greater failure rate. Patients with previous failed ACI or matrix-induced autologous chondrocyte implantation (MACI) who underwent further MACI or ACI reported acceptable results. Otherwise, ACI in patients with history of previous subchondral marrow stimulation (SMS) demonstrated a greater failure rate. Conclusion From the analysis of the literature, OCA transplantation seems to be the most reliable treatment of a failed SMS. ACI or MACI showed acceptable results in patients with previously failed MACI or ACI. Level of Evidence Level IV, systematic review of level I-IV studies.

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Treatment of Large Knee Osteochondral Lesions With a Biomimetic Scaffold

Cited by 74 publications

References 36 publications

Treatment of Osteochondritis Dissecans of the Knee with Autologous Iliac Bone Graft and Hyaluronic Acid Scaffold

Treatment of Osteochondritis Dissecans of the Knee with Autologous Iliac Bone Graft and Hyaluronic Acid Scaffold

Autologous Dual-Tissue Transplantation for Osteochondral Repair

How to Manage a Failed Cartilage Repair: A Systematic Literature Review

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