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Arthroscopic treatment of osteochondral knee defects with resorbable biphasic synthetic scaffold: clinical and radiological results and long-term survival analysis

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Abstract

Purpose

The aim of our study is to evaluate the long-term results in patients treated with a fully arthroscopic TruFit system for osteochondral lesions of the femoral condyle, analyzing the clinical and radiological outcomes, survival rate, complications, and correlations.

Methods

The study included all patients treated with the TruFit system with a full-thickness focal lesion of the knee cartilage (grade IV according to the ICRS classification), entirely arthroscopically with a minimum follow-up of five years. All patients were evaluated clinically prior to surgery (T0) and at two consecutive follow-ups (T1 36.4 ± 17.03 months and T2 101.63 ± 19.02 months), using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Hospital for Special Surgery Score (HSS). At the final follow-up, the magnetic resonance imaging (MRI) was evaluated by two orthopaedists using the magnetic resonance observation of cartilage repair tissue (MOCART) score.

Results

The sample was formed of 21 patients, of which 14 were males (67%) and 7 females (33%), with a mean age of 51.29 ± 10.70. Of the 21 patients, two underwent prosthetic knee replacement at 24 and 65 months, respectively. At T0, the HSS and the KOOS score were, respectively, 60.71 ± 11.62 and 57.71 ± 6.11. For both clinical values, a significant improvement was noted between T0 and T1 (p < 0.05) and between T0 and T2 (p < 0.05). At the final follow-up, the MOCART value was found to be 45.78 ± 5.27.

Conclusions

The study results highlighted the safety and potential of the arthroscopic TruFit system procedure, which offered a good clinical outcome with stable results at long-term follow-up although we found no correlations between the MRI and clinical results.

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References

  1. Rodriguez-Merchan EC (2013) Regeneration of articular cartilage of the knee. Rheumatol Int 33:837–845

    Article  CAS  PubMed  Google Scholar 

  2. Singh A, Haris M, Cai K, Kogan F, Hariharan H, Reddy R (2014) High resolution T1ρ mapping of in vivo human knee cartilage at 7T. PLoS One 9:e97486

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Medvedeva EV, Grebenik EA, Gornostaeva SN, Telpuhov VI, Lychagin AV, Timashev PS, Chagin AS (2018) Repair of damaged articular cartilage: current approaches and future directions. Int J Mol Sci 19:2366

  4. Pereira DR, Reis RL, Oliveira JM (2018) Layered scaffolds for osteochondral tissue engineering. Adv Exp Med Biol 1058:193–218

    Article  CAS  PubMed  Google Scholar 

  5. Niederauer GG, Slivka MA, Leatherbury NC, Korvick DL, Harroff HH, Ehler WC, Dunn CJ, Kieswetter K (2000) Evaluation of multiphase implants for repair of focal osteochondral defects in goats. Biomaterials 21:2561–2574

    Article  CAS  PubMed  Google Scholar 

  6. Williams RJ, Gamradt SC (2008) Articular cartilage repair using a resorbable matrix scaffold. Instr Course Lect 57:563–571

    PubMed  Google Scholar 

  7. Melton JT, Wilson AJ, Chapman-Sheath P, Cossey AJ (2010) TruFit CB bone plug: chondral repair, scaffold design, surgical technique and early experiences. Expert Rev Med Devices 7:333–341

    Article  CAS  PubMed  Google Scholar 

  8. Brittberg M, Peterson L (1998) Introduction of an articular cartilage classification ICRS. Newsletter 1:5–8

    Google Scholar 

  9. Monticone M, Ferrante S, Salvaderi S, Rocca B, Totti V, Foti C, Roi GS (2012) Development of the Italian version of the knee injury and osteoarthritis outcome score for patients with knee injuries: cross-cultural adaptation, dimensionality, reliability, and validity. Osteoarthr Cartil 20:330–335

    Article  CAS  Google Scholar 

  10. Insall JN, Ranawat CS, Aglietti P, Shine J (1976) A comparison of four models of total knee-replacement prostheses. J Bone Joint Surg Am 58:754–765

    Article  CAS  PubMed  Google Scholar 

  11. Marlovits S, Singer P, Zeller P, Mandl I, Haller J, Trattnig S (2006) Magnetic resonance observation of cartilage repair tissue (MOCART) for the evaluation of autologous chondrocyte transplantation: determination of interobserver variability and correlation to clinical outcome after 2 years. Eur J Radiol 57:16–23

    Article  PubMed  Google Scholar 

  12. Stel VS, Dekker FW, Tripepi G, Zoccali C, Jager KJ (2011) Survival analysis I: the Kaplan-Meier method. Nephron Clin Pract 119:c83–c88

    Article  PubMed  Google Scholar 

  13. Khosla T, Lowe CR (1967) Indices of obesity derived from body weight and height. Br J Prev Soc Med 21:122–128

    CAS  PubMed  PubMed Central  Google Scholar 

  14. Bugelli G, Ascione F, Dell’Osso G, Zampa V, Giannotti S (2018) Biphasic bioresorbable scaffold (TruFit®) in knee osteochondral defects: 3-T MRI evaluation of osteointegration in patients with a 5-year minimum follow-up. Musculoskelet Surg 102:191–199

    Article  CAS  PubMed  Google Scholar 

  15. Joshi N, Reverte-Vinaixa M, Diaz-Ferreiro EW, Dominguez- Oronoz R (2012) Synthetic resorbable scaffolds for the treatment of isolated patellofemoral cartilage defects in young patients: magnetic resonance imaging and clinical evaluation. Am J Sports Med 40:1289–1295

    Article  PubMed  Google Scholar 

  16. Carmont MR, Carey-Smith R, Saithna A, Dhillon M, Thompson P, Spalding T (2009) Delayed incorporation of a TruFit plug: perseverance is recommended. Arthroscopy 25:810–814

    Article  PubMed  Google Scholar 

  17. Hindle P, Hendry JL, Keating JF, Biant LC (2014) Autologous osteochondral mosaicplasty or TruFit plugs for cartilage repair. Knee Surg Sports Traumatol Arthrosc 22:1235–1240

    Article  PubMed  Google Scholar 

  18. de Windt TS, Welsch GH, Brittberg M, Vonk LA, Marlovits S, Trattnig S, Saris DB (2013) Is magnetic resonance imaging reliable in predicting clinical outcome after articular cartilage repair of the knee? A systematic review and meta-analysis. Am J Sports Med 41:1695–1702

    Article  PubMed  Google Scholar 

  19. Verhaegen J, Clockaerts S, Van Osch GJ, Somville J, Verdonk P, Mertens P (2015) TruFit plug for repair of osteochondral defects-where is the evidence? Systematic review of literature. Cartilage 6:12–19

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Kijowski R, Chaudhary R (2014) Quantitative magnetic resonance imaging of the articular cartilage of the knee joint. Magn Reson Imaging Clin N Am 22:649–669

    Article  PubMed  Google Scholar 

  21. Akizuki S, Yasukawa Y, Takizawa T (1997) Does arthroscopic abrasion arthroplasty promote cartilage regeneration in osteoarthritic knees with eburnation? A prospective study of high tibial osteotomy with abrasion arthroplasty versus high tibialosteotomy alone. Arthroscopy 13:9–17

    Article  CAS  PubMed  Google Scholar 

  22. Maas O, Joseph GB, Sommer G, Wild D, Kretzschmar M (2015) Association between cartilage degeneration and subchondral bone remodeling in patients with knee osteoarthritis comparing MRI and (99m)Tc-DPD-SPECT/CT. Osteoarthr Cartil 23:1713–1720

    Article  CAS  Google Scholar 

  23. Guzman-Morales J, Lafantaisie-Favreau CH, Chen G, Hoemann CD (2014) Subchondral chitosan/blood implant-guided bone plate resorption and woven bone repair is coupled to hyaline cartilage regeneration from microdrill holes in aged rabbit knees. Osteoarthr Cartil 22:323–333

    Article  CAS  Google Scholar 

  24. Betsch M, Schneppendahl J, Thuns S, Herten M, Sager M, Jungbluth P, Hakimi M, Wild M (2013) Bone marrow aspiration concentrate and platelet rich plasma for osteochondral repair in a porcine osteochondral defect model. PLoS One 8:e71602

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Unità Operativa C.A.S.C.O, IRCCS Istituto Ortopedico Galeazzi, 20161, Milan, Italy

    Riccardo D’Ambrosi, Francesco Giacco & Nicola Ursino

  2. IRCCS Policlinico San Donato, San Donato Milanese, Italy

    Vincenza Ragone

Authors
  1. Riccardo D’Ambrosi
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  2. Francesco Giacco
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  3. Vincenza Ragone
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  4. Nicola Ursino
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Contributions

All authors equally contributed to this paper, in terms of the conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.

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Correspondence to Riccardo D’Ambrosi.

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The authors declare that they have no conflict of interest.

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D’Ambrosi, R., Giacco, F., Ragone, V. et al. Arthroscopic treatment of osteochondral knee defects with resorbable biphasic synthetic scaffold: clinical and radiological results and long-term survival analysis. International Orthopaedics (SICOT) 43, 2183–2189 (2019). https://doi.org/10.1007/s00264-018-4270-7

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  • DOI: https://doi.org/10.1007/s00264-018-4270-7

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