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The combination of microfracture and a cell-free polymer-based implant immersed with autologous serum for cartilage defect coverage

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this short-term pilot study was to determine the clinical and MRI outcome of a combination of microfracture with a cell-free polymer-based matrix for the treatment of cartilage defects in the knee.

Methods

The technique was used for treatment of symptomatic cartilage defects in the knee. Five patients were prospectively evaluated during 2 years with use of the Knee injury and Osteoarthritis Outcome Score (KOOS), the Tegner activity scale and the visual analog scale (VAS). MRI data were analyzed based on the original and modified MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) scoring system at 6, 12 and 24 months of follow-up.

Results

A gradual clinical improvement was observed during the follow-up. Adverse reactions to the matrix were not observed. The scaffold was firmly fixed with the use of bioresorbable pins. Both MOCART scoring systems revealed no significant deterioration or improvement in the repair tissue during the follow-up period. However, the majority of the patients exhibited subchondral lamina and bone changes. The formation of an intralesional osteophyte was observed in one case.

Conclusions

The key finding in this study was that this procedure is safe for the treatment of cartilage defects in the knee. The patients showed a gradual clinical improvement postoperatively. Sixty percent (3/5) of the defects were adequately (complete or hypertrophic) filled with repair tissue at 2 years of follow-up.

Level of evidence

IV.

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Acknowledgments

The authors would like to thank W. Huysse of the Department of Radiology (Prof. Dr. K. Verstraete, Chief of the Department), Ghent University for his support concerning the application of the Magnetic Resonance Imaging facilities.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium

    A. A. M. Dhollander, P. C. M. Verdonk, K. F. Almqvist & R. Verdonk

  2. Laboratory of Connective Tissue Biology, Department of Rheumatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium

    A. A. M. Dhollander, S. Lambrecht, D. Elewaut & G. Verbruggen

  3. Department of Orthopaedic Surgery, Stedelijk Ziekenhuis Roeselare, Brugsesteenweg 90, Roeselare, Belgium

    P. C. M. Verdonk

Authors
  1. A. A. M. Dhollander
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  2. P. C. M. Verdonk
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  3. S. Lambrecht
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  4. K. F. Almqvist
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  5. D. Elewaut
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  6. G. Verbruggen
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  7. R. Verdonk
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Corresponding author

Correspondence to A. A. M. Dhollander.

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Dhollander, A.A.M., Verdonk, P.C.M., Lambrecht, S. et al. The combination of microfracture and a cell-free polymer-based implant immersed with autologous serum for cartilage defect coverage. Knee Surg Sports Traumatol Arthrosc 20, 1773–1780 (2012). https://doi.org/10.1007/s00167-011-1763-y

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  • DOI: https://doi.org/10.1007/s00167-011-1763-y

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