International Orthopaedics

, Volume 40, Issue 3, pp 625–632 | Cite as

Successful osteoconduction but limited cartilage tissue quality following osteochondral repair by a cell-free multilayered nano-composite scaffold at the knee

  • Martin Brix
  • Martin Kaipel
  • Richard Kellner
  • Markus Schreiner
  • Sebastian Apprich
  • Harald Boszotta
  • Reinhard Windhager
  • Stephan Domayer
  • Siegfried Trattnig
Original Paper



The treatment of larger osteochondral lesions in the knee is still a clinical challenge. One promising strategy to overcome this problem could be surgical repair by using a cell-free multilayered nano-composite scaffold.


In this prospective cohort study eight consecutive patients which suffered from a single osteochondral lesion (≥1.5 cm2) on the femoral condyle were enrolled. The repair potential of the implant was assessed by using MRI based biochemical MR sequences (T2 mapping) as well as semi-quantitative morphological analyses (MOCART score) at 18 months after the surgery. The clinical outcome was determined at six, 12, 18, and 24 month follow ups by using IKDC, Tegner-Lysholm, and Cincinnati knee scores.


Seven out of eight patients showed a complete integration of the scaffold into the border zone and five out of eight patients excellent or good subchondral ossification of the implant at 18 months following implantation. The surface of the repair tissue was found to be intact in all eight patients. T2 mapping data and the zonal T2 index significantly differed in the repair tissue compared to the healthy control cartilage (P < 0.001) which indicates a limited quality of the repair cartilage. The clinical outcome scores consistently improved during the follow up period without reaching statistical significance.


Osteochondral repair by implanting the MaioRegen® scaffold provides a successful osteoconduction and filling of the cartilage defect. However there is evidence for a limited repair cartilage tissue quality at 18 months after the surgery.


Osteochondral lesions Knee Osteochondral repair Scaffold 



The authors deeply appreciate Michael Weber (MD) for his help with statistics.

Compliance with ethical standards

Conflicts of interests

The authors declare that there are no existing conflicts of interest.


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Copyright information

© SICOT aisbl 2016

Authors and Affiliations

  • Martin Brix
    • 1
  • Martin Kaipel
    • 2
  • Richard Kellner
    • 2
  • Markus Schreiner
    • 1
  • Sebastian Apprich
    • 3
  • Harald Boszotta
    • 2
  • Reinhard Windhager
    • 3
  • Stephan Domayer
    • 1
  • Siegfried Trattnig
    • 1
  1. 1.Centre of Excellence “High-field Magnetic Resonance (MR)”Medical University ViennaViennaAustria
  2. 2.Department of Orthopaedic and Trauma SurgeryBarmherzige Brüder HospitalEisenstadtAustria
  3. 3.Department of OrthopaedicsMedical University ViennaViennaAustria

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