P169 - Novel Solution Using Viable Cartilage Allograft for Focal Cartilage Defects
- D. Jones (New Orleans, US)
- D. Jones (New Orleans, US)
- B. Desai (Jefferson, US)
- G. Jacobs (Jefferson, US)
- A. Dasgupta (Edison, US)
- W. Choate (Jefferson, US)
- S. Montgomery (Jefferson, US)
- M. Suri (Jefferson, US)
- B. Godshaw (Jefferson, US)
Abstract
Purpose
Viable Cartilage Allograft (VCA) is a cartilage tissue matrix that contains cryopreserved viable allogeneic cartilage fibers mixed with chondrogenic matrix. This study aimed to assess safety and benefits in treating focal knee cartilage defects with VCA. We hypothesized VCA is a safe single stage procedure in isolated chondral defects with results comparable or better than other single stage procedures.
Methods and Materials
Symptomatic International Cartilage Repair Society (ICRS) grade 3/4A lesions of the femoral condyle or patella were implanted with VCA. International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome (KOOS) subscales, Lysholm, Short Form-12 (SF-12), visual analog scale (VAS) and pain frequency levels were assessed. Radiographic and magnetic resonance imaging (MRI) was performed at regular intervals post-operatively.
Results
19 patients were implanted, mean age 28.3 (16-56), mean BMI 27.9 ± 5.6, mean follow-up 24.1 months (range 12.0–36.0 months). Lesions were in either the femoral condyle (n=7) or patella (n=12). Lesion sizes ranged from 1.5-6.0 cm2 (mean defect size was 4.58 cm2). Outcome scores at 6 months increased from pre-operative baseline (POB) and were maintained at 12 months: IKDC (72.2), Lysholm (58.9), KOOS: Pain (75.6), Symptoms (61.1), ADL (83.1), Sports (58.3), and QOL (32.3). MRI imaging at 3-, 6- and 12-month timepoints showed viable preliminary cartilage tissue with no significant bone edema or graft delamination. Second look arthroscopy (2 patients) demonstrated complete fill and incorporation (Brittberg Scores 11/12). Functional scores improved at 24(M): IKDC (84.9), Lysholm (59.5), KOOS: Pain (76.9), Symptoms (64.8), ADLs (79.1), Sports (67.9), QOL (48.8).
Conclusion
VCA is an off-the-shelf, single- stage, conformable allogeneic graft that treats chondral defects with no additional fixation. Pre-clinical and short-term prospective clinical studies show VCA can safely treat chondral defects with potential advantages to existing options.