Tibial plateau lesions. Surface reconstruction with a biomimetic osteochondral scaffold: Results at 2 years of follow-up

Elizaveta Kon, Giuseppe Filardo, Giulia Venieri, Francesco Perdisa, Maurilio Marcacci

Research output: Contribution to journalArticle

Abstract

Introduction Tibial plateau articular pathology caused by post-traumatic or degenerative lesions is a challenge for the orthopaedic surgeon and can lead to early osteoarthritis. The aim of the present study was to evaluate the results of treatment of these complex defects with implantation of an osteochondral scaffold, which is designed to target the cartilage surface and to reconstruct joint anatomy by addressing the entire osteochondral unit.

Materials and methods Eleven patients (5 female and 6 male) with a mean age of 37.3 ± 11.0 years and osteochondral lesions of the tibial plateau (mean 5.1 ± 2.7 cm2; range 3.0-12.5 cm2) were treated with the implantation of an osteochondral biomimetic collagen-hydroxyapatite scaffold (Maioregen®, Fin-Ceramica, Faenza, Italy). Comorbidities were addressed taking care to restore the correct limb alignment. Patients were evaluated pre-operatively and prospectively followed-up for 2 years using the International Knee Documentation Committee (IKDC) subjective and objective scores; activity level was documented using the Tegner score.

Results Three patients experienced minor adverse events. No patients required further surgery for treatment failure during the study follow-up period, and 8 patients (72.7%) reported a marked improvement. The IKDC subjective score improved from 42.5 ± 10.2 before treatment to 69.8 ± 19.0 at 12 months (p <0.05), with stable results at 24 months. The IKDC objective score increased from 27.3% normal and nearly normal knees before treatment to 85.7% normal and nearly normal knees at 24 months of follow-up. The Tegner score increased from 2.3 ± 2.1 before treatment to 4.8 ± 2.4 at 12 months (p <0.05), and was stable at the final follow-up.

Conclusion The present study on the implantation of an osteochondral scaffold for the treatment of tibial plateau lesions showed a promising clinical outcome at short-term follow-up, which indicates that this procedure can be considered as a possible treatment option, even in these complex defects, when comorbidities are concomitantly addressed.

Original languageEnglish
Pages (from-to)S121-S125
JournalInjury
Volume45
Issue numberS6
DOIs
Publication statusPublished - Dec 1 2014

Fingerprint

Biomimetics
Knee
Documentation
Comorbidity
Therapeutics
Joints
Durapatite
Treatment Failure
Osteoarthritis
Italy
Cartilage
Anatomy
Collagen
Extremities
Pathology

Keywords

  • Biomimetic scaffold
  • Cartilage
  • Joint reconstruction
  • Osteochondral lesion
  • Tibial plateau

ASJC Scopus subject areas

  • Emergency Medicine
  • Orthopedics and Sports Medicine
  • Medicine(all)

Cite this

Tibial plateau lesions. Surface reconstruction with a biomimetic osteochondral scaffold : Results at 2 years of follow-up. / Kon, Elizaveta; Filardo, Giuseppe; Venieri, Giulia; Perdisa, Francesco; Marcacci, Maurilio.

In: Injury, Vol. 45, No. S6, 01.12.2014, p. S121-S125.

Research output: Contribution to journalArticle

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abstract = "Introduction Tibial plateau articular pathology caused by post-traumatic or degenerative lesions is a challenge for the orthopaedic surgeon and can lead to early osteoarthritis. The aim of the present study was to evaluate the results of treatment of these complex defects with implantation of an osteochondral scaffold, which is designed to target the cartilage surface and to reconstruct joint anatomy by addressing the entire osteochondral unit.Materials and methods Eleven patients (5 female and 6 male) with a mean age of 37.3 ± 11.0 years and osteochondral lesions of the tibial plateau (mean 5.1 ± 2.7 cm2; range 3.0-12.5 cm2) were treated with the implantation of an osteochondral biomimetic collagen-hydroxyapatite scaffold (Maioregen{\circledR}, Fin-Ceramica, Faenza, Italy). Comorbidities were addressed taking care to restore the correct limb alignment. Patients were evaluated pre-operatively and prospectively followed-up for 2 years using the International Knee Documentation Committee (IKDC) subjective and objective scores; activity level was documented using the Tegner score.Results Three patients experienced minor adverse events. No patients required further surgery for treatment failure during the study follow-up period, and 8 patients (72.7{\%}) reported a marked improvement. The IKDC subjective score improved from 42.5 ± 10.2 before treatment to 69.8 ± 19.0 at 12 months (p <0.05), with stable results at 24 months. The IKDC objective score increased from 27.3{\%} normal and nearly normal knees before treatment to 85.7{\%} normal and nearly normal knees at 24 months of follow-up. The Tegner score increased from 2.3 ± 2.1 before treatment to 4.8 ± 2.4 at 12 months (p <0.05), and was stable at the final follow-up.Conclusion The present study on the implantation of an osteochondral scaffold for the treatment of tibial plateau lesions showed a promising clinical outcome at short-term follow-up, which indicates that this procedure can be considered as a possible treatment option, even in these complex defects, when comorbidities are concomitantly addressed.",
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AU - Perdisa, Francesco

AU - Marcacci, Maurilio

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N2 - Introduction Tibial plateau articular pathology caused by post-traumatic or degenerative lesions is a challenge for the orthopaedic surgeon and can lead to early osteoarthritis. The aim of the present study was to evaluate the results of treatment of these complex defects with implantation of an osteochondral scaffold, which is designed to target the cartilage surface and to reconstruct joint anatomy by addressing the entire osteochondral unit.Materials and methods Eleven patients (5 female and 6 male) with a mean age of 37.3 ± 11.0 years and osteochondral lesions of the tibial plateau (mean 5.1 ± 2.7 cm2; range 3.0-12.5 cm2) were treated with the implantation of an osteochondral biomimetic collagen-hydroxyapatite scaffold (Maioregen®, Fin-Ceramica, Faenza, Italy). Comorbidities were addressed taking care to restore the correct limb alignment. Patients were evaluated pre-operatively and prospectively followed-up for 2 years using the International Knee Documentation Committee (IKDC) subjective and objective scores; activity level was documented using the Tegner score.Results Three patients experienced minor adverse events. No patients required further surgery for treatment failure during the study follow-up period, and 8 patients (72.7%) reported a marked improvement. The IKDC subjective score improved from 42.5 ± 10.2 before treatment to 69.8 ± 19.0 at 12 months (p <0.05), with stable results at 24 months. The IKDC objective score increased from 27.3% normal and nearly normal knees before treatment to 85.7% normal and nearly normal knees at 24 months of follow-up. The Tegner score increased from 2.3 ± 2.1 before treatment to 4.8 ± 2.4 at 12 months (p <0.05), and was stable at the final follow-up.Conclusion The present study on the implantation of an osteochondral scaffold for the treatment of tibial plateau lesions showed a promising clinical outcome at short-term follow-up, which indicates that this procedure can be considered as a possible treatment option, even in these complex defects, when comorbidities are concomitantly addressed.

AB - Introduction Tibial plateau articular pathology caused by post-traumatic or degenerative lesions is a challenge for the orthopaedic surgeon and can lead to early osteoarthritis. The aim of the present study was to evaluate the results of treatment of these complex defects with implantation of an osteochondral scaffold, which is designed to target the cartilage surface and to reconstruct joint anatomy by addressing the entire osteochondral unit.Materials and methods Eleven patients (5 female and 6 male) with a mean age of 37.3 ± 11.0 years and osteochondral lesions of the tibial plateau (mean 5.1 ± 2.7 cm2; range 3.0-12.5 cm2) were treated with the implantation of an osteochondral biomimetic collagen-hydroxyapatite scaffold (Maioregen®, Fin-Ceramica, Faenza, Italy). Comorbidities were addressed taking care to restore the correct limb alignment. Patients were evaluated pre-operatively and prospectively followed-up for 2 years using the International Knee Documentation Committee (IKDC) subjective and objective scores; activity level was documented using the Tegner score.Results Three patients experienced minor adverse events. No patients required further surgery for treatment failure during the study follow-up period, and 8 patients (72.7%) reported a marked improvement. The IKDC subjective score improved from 42.5 ± 10.2 before treatment to 69.8 ± 19.0 at 12 months (p <0.05), with stable results at 24 months. The IKDC objective score increased from 27.3% normal and nearly normal knees before treatment to 85.7% normal and nearly normal knees at 24 months of follow-up. The Tegner score increased from 2.3 ± 2.1 before treatment to 4.8 ± 2.4 at 12 months (p <0.05), and was stable at the final follow-up.Conclusion The present study on the implantation of an osteochondral scaffold for the treatment of tibial plateau lesions showed a promising clinical outcome at short-term follow-up, which indicates that this procedure can be considered as a possible treatment option, even in these complex defects, when comorbidities are concomitantly addressed.

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