P106 - (Osteo)chondral lesions in the knee joint treated with a coralline scaffold (Cartiheal®): 2 year outcomes of a prospective case series.
Abstract
Purpose
Cartilage lesions in the knee remain a challenging pathology for many orthopaedic surgeons. This study wants to evaluate both clinical and MRI outcome of a novel cell-free biphasic scaffold (AgiliC, Cartiheal®) based on natural coral aragonite plugs in patients with an isolated (osteo)chondral lesion of the knee joint.
Methods and Materials
Twelve patients were enrolled in this single-centre case series (Age 31.4±8.0; Female 25%; BMI 25.2±3.5). Clinical outcome was assessed by the KOOS (symptoms, pain, ADL, sport/recreation, QoL), Lysholm score, IKDC and Tegner activity scale at baseline, 6 months, 12 months, 18 months and 24 months after surgery. Defect healing (%) was evaluated on MRI at 6, 12, 18 and 24 months postoperatively. Wilcoxon signed ranks test was conducted for paired-sample outcome analysis covering the 24 month follow-up period. Significance level was set at α=0.05.
Results
Seven patients were treated for an (osteo)chondral lesion in a femoral condyle (5 medial, 3 lateral), the trochlea was the site of injury in 5 patients. Secure implantation of a single scaffold plug (6 with implant size 10, 3 with size 12.5 and 3 with size 15) was obtained in each case. Overall KOOS score (fig. 1) improved significantly from 47.3±13.6 baseline to 70.3±17.9 at 6 months (p=0.005), to 78.0±15.5 at 12 months (p=0.002) and to 85.6±11.7 at 24 months (p=0.003) after surgery. Similar trends were observed for the Lysholm and IKDC score. Patients activity level increased from 2.75±1.6 at baseline to 4.8±1.2 at 24 months (p=0.027). The osteochondral defect was filled for 80,2%±19,4 at 12 months (fig.2) and 96.4%±5.7 at 24 months postoperatively.
Conclusion
In young symptomatic patients suffering from a small or medium sized (osteo)chondral knee lesion, this acellular scaffold offers evident and early clinical improvement, a substantially elevated activity level and almost complete defect filling 2 years after surgery.
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