Good Clinical Results but Moderate Osseointegration and Defect Filling of a Cell-free Multi-layered Nano-composite Scaffold for Treatment of Osteochondral Lesions of the Knee

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2017 Jul 17

PMID 28712029

Citations 10

Authors

Dominic T Mathis

Raphael Kaelin

Helmut Rasch

Markus P Arnold

Michael T Hirschmann

Affiliations

Soon will be listed here.

Abstract

Purpose: The aim of this retrospective study was to evaluate the clinical and radiological results of a nano-composite multi-layered three-dimensional biomaterial scaffold for treatment of osteochondral lesions (OCL) of the knee. It was a particular radiological interest to analyse the osseointegration, filling of the defects and the bone tracer uptake (BTU), and it was hypothesised that this scaffold, which was created to mimic the entire osteo-cartilaginous unit, is integrated within the bone 12 months postoperatively and comes along with improved patients symptoms and function.

Methods: Fourteen patients (male:female = 11:3, mean age ± SD 33.1 ± 10.7 years) treated for OCL (size 1.0-3.5 cm) were clinically and radiologically evaluated at 1 year postoperatively. The data were prospectively collected including SPECT/CT, Tegner and Lysholm scores. BTU was anatomically localised and volumetrically quantified in SPECT/CT. Defect filling was analysed in CT. Spearman's rho and Wilcoxon test were used for correlation of BTU in SPECT/CT and clinical scores (p < 0.05).

Results: A significant improvement in Lysholm knee score (p < 0.001) and slight deterioration in Tegner score were found (p < 0.01). A complete filling of the defect was shown in 14%, a partial filling in 14% and only minor filling was seen in 72%. A significant correlation (p < 0.001) was found between location of osteochondral lesions and increased BTU. At the lesion sites pre- and postoperative BTU was markedly increased and did not show any decrease at 12-month follow-up. Median Tegner and mean Lysholm scores did not correlate with BTU at any time.

Conclusions: Treatment of OCL in the knee joint with a nano-composite multi-layered three-dimensional biomaterial scaffold resulted in a significant clinical improvement at 1-year follow-up. However, osseointegration was still ongoing at 12-month follow-up.

Level Of Evidence: Case series, Level IV.

Citing Articles

Subchondral bone: An emerging target for the treatment of articular surface lesions of the knee.

Sangiorgio A, Andriolo L, Gersoff W, Kon E, Nakamura N, Nehrer S J Exp Orthop. 2024; 11(3):e12098.

PMID: 39040436 PMC: 11260998. DOI: 10.1002/jeo2.12098.

Multi-layer cell-free scaffolds for osteochondral defects of the knee: a systematic review and meta-analysis of clinical evidence.

Boffa A, Solaro L, Poggi A, Andriolo L, Reale D, Di Martino A J Exp Orthop. 2021; 8(1):56.

PMID: 34331140 PMC: 8324705. DOI: 10.1186/s40634-021-00377-4.

Influence of the Mechanical Environment on the Regeneration of Osteochondral Defects.

Davis S, Roldo M, Blunn G, Tozzi G, Roncada T Front Bioeng Biotechnol. 2021; 9:603408.

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Studies of Articular Cartilage Repair from 2009 to 2018: A Bibliometric Analysis of Articles.

Duan W, Huang L, Dong Z, Li H, Guo L, Song W Orthop Surg. 2021; 13(2):608-615.

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The MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) 2.0 Knee Score and Atlas.

Schreiner M, Raudner M, Marlovits S, Bohndorf K, Weber M, Zalaudek M Cartilage. 2019; 13(1_suppl):571S-587S.

PMID: 31422674 PMC: 8725373. DOI: 10.1177/1947603519865308.

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