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Femoral condyle resurfacing using an inlay metal implant: low revision rate of 266 patients in a 5–10 years follow-up

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

To assess the clinical outcome and survival of an inlay resurfacing prosthesis for focal femoral condyle chondral and osteochondral defects.

Methods

Two hundred sixty-six patients (mean age, 38.25 years; range 25–56 years) with symptomatic femoral condyle chondral and osteochondral defects were reviewed. The mean follow-up period was 7.3 years (range 5–10 years). The medial femoral condyle was involved in 229 and the lateral condyle in 37 patients. Previous cartilage surgery was done in 235 patients. All patients were treated with focal femoral condyle resurfacing with the HemiCAP® device. The preoperative and the last follow-up values of the Knee Injury and Osteoarthritis Outcome Score (KOOS), Oxford Knee Score (OKS), 36-item Short Form Survey (SF-36) and Visual Analogue Scale (VAS) were examined. Complications, reoperation rate and survival were analyzed.

Results

At the last follow-up, all clinical score values showed significant improvement as compared with the corresponding preoperative values (p < 0.001). Age presented a negative correlation with KOOS (p = 0.03) and SF-36 improvement (p = 0.014). Kellgren-Lawrence grade influenced OKS (p = 0.036). BMI, gender, side, medial or lateral condyle and size did not affect the outcome. Patients who had previous biological cartilage procedures demonstrated better clinical improvement in comparison with those that did not have prior surgery (p < 0.05). Survival was 96.2% at 10 years, using as endpoint implant revision or/and progression of osteoarthritis. The cumulative hazard for any-reason reoperation was 12.0%.

Conclusions

Femoral condyle resurfacing using the HemiCAP® device is an effective treatment option to address focal chondral and osteochondral defects. It can be successfully used either as a primary procedure or after prior biological cartilage reconstruction. Subjective clinical outcomes are expected to be good to excellent in mid- to long term, while reoperation and revision rates are low. Progression of osteoarthritis is the most common mode of failure; thus, patient selection is very important.

Level of evidence

Level IV, retrospective case series.

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Authors and Affiliations

  1. International Centre for Orthopedics, ATOS Clinic Heidelberg, Bismarckstr. 9-15, 69115, Heidelberg, Germany

    Panayiotis D. Megaloikonomos & Christoph Becher

  2. Department of Orthopedics, Beacon Hospital, Dublin, Ireland

    Johan Van der Stok & Turlough O’Donnell

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  1. Panayiotis D. Megaloikonomos
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  2. Christoph Becher
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Correspondence to Christoph Becher.

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This study was performed in line with the principles of the Declaration of Helsinki.

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Megaloikonomos, P.D., Becher, C., Van der Stok, J. et al. Femoral condyle resurfacing using an inlay metal implant: low revision rate of 266 patients in a 5–10 years follow-up. Arch Orthop Trauma Surg 143, 1243–1251 (2023). https://doi.org/10.1007/s00402-021-04251-x

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