L. Solaro (Bologna, IT)
IRCCS Istituto Ortopedico RizzoliPresenter Of 1 Presentation
18.2.8 - Biomimetic Osteochondral Scaffold for the Treatment of Osteochondritis Dissecans of the Knee: Stable Results at 12 Years Follow-up.
Abstract
Purpose
Osteochondritis dissecans (OCD) is a disease of the entire osteochondral unit affecting young and active patients. In case of unstable and unfixable fragments, reconstructive cartilage procedures are a viable solution. During recent years, osteochondral scaffolds were introduced in clinical practice to address osteochondral pathologies, including knee OCD. The aim of this study is to evaluate long-term results offered by the implantation of a nanostructured biomimetic collagen-hydroxyapatite construct for the treatment of OCD of the knee.
Methods and Materials
Twenty-seven patients (19 men, 8 women; mean age, 25.5 ± 7.7 years) were treated for symptomatic unfixable OCD lesions International Cartilage Repair Society (ICRS) grade 3 to 4 with a mean size of 3.4 ± 2.2 cm2. All patients were prospectively evaluated at 2, 5, and at minimum 10 years follow-up (average 12 years) with IKDC scores, EQ-VAS, and Tegner score. Failures were also documented.
Results
A statistically significant improvement in all clinical scores was observed from baseline evaluation to 24 months and remained stable at the final follow-up (mean 148 ± 13.8 months). The mean IKDC subjective score improved from 48.4 ± 17.8 to 82.2 ± 12.2 at 2 years (p < 0.0005), and it then remained stable up to 12 years postoperatively (80.0 ± 13.5, p < 0.0005). EQ-VAS and Tegner scores presented similar trends. There were no clinical or surgical failures.
Conclusion
The biomimetic scaffold implantation is a valid treatment option for unfixable knee OCD lesions. The clinical improvement obtained is significant and stable, with good results maintained for up to long term follow-up.