I. Romandini (Bologna, IT)

IRCCS Istituto Ortopedico Rizzoli Clinica Ortopedica e Traumatologica II

Presenter Of 2 Presentations

Podium Presentation Biomaterials and Scaffolds

18.2.3 - Cell-free Biomimetic Osteochondral Scaffold for the Treatment of Isolated Knee Lesions: 2-Year Results in a Large Cohort of 110 Patients

Presentation Topic
Biomaterials and Scaffolds
Date
14.04.2022
Lecture Time
14:33 - 14:42
Room
Potsdam 3
Session Name
Session Type
Free Papers
Disclosure
No Significant Commercial Relationship

Abstract

Purpose

Cell-free biomaterials have been developed to restore defects of the articular surface, avoiding the problems related to cell-based procedures. Among these, an osteochondral scaffold made of type I collagen and hydroxyapatite has been introduced in the clinical practice. Aim of this study was to evaluate the clinical outcome after the implantation of this osteochondral scaffold for the treatment of isolated knee lesions.

Methods and Materials

One hundred and ten patients (80 men, 30 women), affected by grade III-IV acute or chronic chondral/osteochondral lesions or osteochondritis dissecans (OCD) lesions were consecutively treated. The mean age was 27.5±10.7 years, the mean lesion size was 3.0±1.9 cm2. Fifty-five patients had undergone previous surgeries, whereas minor concurrent procedures (i.e. partial meniscectomy) were necessary in 14 cases. Patients were prospectively followed at baseline and at 6, 12, and 24 months for the primary outcome, the IKDC Subjective Score, and secondary outcomes including the IKDC objective score and Tegner score.

Results

All the scores significantly improved: IKDC score increased from the baseline to 12 months of follow-up (44.8±16.1 to 68.4±18.4, p<0.005), with a slight further increase up to 24 months’ follow-up (75.3±17.1). The Tegner score also increased significantly, but the pre-injury activity level did not recover. Patients who were operated for the first time had basal IKDC values of 47.4±14.4 and improved to 79.6±14.1, while patients with previous surgery passed from 41.9±16.8 to 71.3±18.9. Thirty-seven patients reported an adverse event (6% major) after the procedure, and 3 were considered surgical failures.

Conclusion

This one-step cell-free biomimetic approach developed to favor osteochondral tissue regeneration is effective in treating isolated knee lesions, leading to a significant clinical improvement, with few failures and complications at short-term follow-up.

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Poster Platelet Rich Plasma and Growth factors

P209 - Leukocyte-rich PRP vs Leukocyte-poor PRP in the Treatment of Knee OA: Preliminary Results of a Double-blind Randomized Trial.

Presentation Topic
Platelet Rich Plasma and Growth factors
Date
13.04.2022
Lecture Time
09:30 - 09:30
Room
Exhibition Foyer
Session Name
7.3 - Poster Viewing / Coffee Break / Exhibition
Session Type
Poster Session
Disclosure
No Significant Commercial Relationship

Abstract

Purpose

Platelet-rich plasma injections are one of the most common conservative strategies for the management of knee osteoarthritis (OA). However, there are different formulations of PRP, and there is no clarity on which are the ideal characteristics of PRP. The aim of this study was to compare safety and effectiveness of fresh Leukocyte-Rich PRP (LR-PRP) and Leukocyte-Poor PRP (LP-PRP) for the treatment of knee OA.

Methods and Materials

The study design includes 132 patients with symptomatic knee OA. Randomly, 66 patients receive 3 weekly injections of LR-PRP and 66 patients receive 3 weekly injections of LP-PRP. Patients are prospectively followed at baseline and at 2, 6, and 12 months for the primary outcome, the International Knee Documentation Committee (IKDC) Subjective Score, and secondary outcomes including the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales, EuroQol VAS (EQ-VAS), and Tegner score. Up-to-date 25 for LR-PRP and 27 for LP-PRP were evaluated up to 6 months and included in the current analysis.

Results

All the scores significantly improved: the primary outcome improved from 39.9±19.6 to 52.5±25.6 at 6 months in the LR-PRP group compared to 45.7±17.2 to 61.0±13.9 in the LP-PRP group (p<0.005). No differences between groups were observed in terms of improvement of the clinical scores across all follow-up intervals. No severe adverse events were described in either group, while a total of 14 mild adverse events (knee pain or swelling) were reported: 8 for the LR-PRP and 6 for the LP-PRP group. One patient was considered as treatment failure.

Conclusion

The preliminary results of this study suggested that three intra-articular LR-PRP or LP-PRP injections produced similar clinical improvement at 6 months of follow-up in patients with symptomatic knee OA with no inter-group difference in clinical results and adverse events. The presence of leukocytes did not influence PRP effects.

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Presenter Of 1 Presentation

Platelet Rich Plasma and Growth factors

P209 - Leukocyte-rich PRP vs Leukocyte-poor PRP in the Treatment of Knee OA: Preliminary Results of a Double-blind Randomized Trial.

Abstract

Purpose

Platelet-rich plasma injections are one of the most common conservative strategies for the management of knee osteoarthritis (OA). However, there are different formulations of PRP, and there is no clarity on which are the ideal characteristics of PRP. The aim of this study was to compare safety and effectiveness of fresh Leukocyte-Rich PRP (LR-PRP) and Leukocyte-Poor PRP (LP-PRP) for the treatment of knee OA.

Methods and Materials

The study design includes 132 patients with symptomatic knee OA. Randomly, 66 patients receive 3 weekly injections of LR-PRP and 66 patients receive 3 weekly injections of LP-PRP. Patients are prospectively followed at baseline and at 2, 6, and 12 months for the primary outcome, the International Knee Documentation Committee (IKDC) Subjective Score, and secondary outcomes including the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales, EuroQol VAS (EQ-VAS), and Tegner score. Up-to-date 25 for LR-PRP and 27 for LP-PRP were evaluated up to 6 months and included in the current analysis.

Results

All the scores significantly improved: the primary outcome improved from 39.9±19.6 to 52.5±25.6 at 6 months in the LR-PRP group compared to 45.7±17.2 to 61.0±13.9 in the LP-PRP group (p<0.005). No differences between groups were observed in terms of improvement of the clinical scores across all follow-up intervals. No severe adverse events were described in either group, while a total of 14 mild adverse events (knee pain or swelling) were reported: 8 for the LR-PRP and 6 for the LP-PRP group. One patient was considered as treatment failure.

Conclusion

The preliminary results of this study suggested that three intra-articular LR-PRP or LP-PRP injections produced similar clinical improvement at 6 months of follow-up in patients with symptomatic knee OA with no inter-group difference in clinical results and adverse events. The presence of leukocytes did not influence PRP effects.

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