CLINICAL RESULTS OBTAINED AFTER IMPLANTATION OF AUTOLOGOUS CHONDROCITES WITH HYALOGRAFT C©

Abstract

Introduction: Transplantation of autologous chondrocites offers promising results. A new technique is now gaining ground which uses a “scaffolding” of hyaluronic acid (Hyalograft C©, Fidia, Italy).

Materials and methods: Thirty-five patients have been treated with Hyalograft C© since 2000. 31 were operated on for a knee and 4 for an ankle. Clinical progression was documented both preoperatively and postoperatively by means of a clinical protocol (VAS-Scale, Lysholm, ICRS, IKDC; AOFAS, Cincinnati). Twenty-one patients with knee lesions (11 had particular circumscribed defects, 7 had complex lesions and/or related lesions, 3 patients were given this indication as a last resort in an effort to avoid the use of a prosthesis) and 4 with ankle lesions were followed up for over 6 months postop.

Results: Assessment by means of the VAS-Scale showed a reduction in pain. In addition, it was possible to show an improvement in function ranging from 51 points pre-op to 75 points post-op on the Lysholm Score. In patients with particular lesions an improvement of 57 to 97 points was achieved. All of the 3 patients where the indication was used as a last resort received a prosthesis. In ankles, the improvement ranged between 2,5 to 6.3 points on the modified Cincinnati-Score.

Conclusions: In the case of the classical indication for isolated femoral defects, the results obtained with Hyalograft C© show similar results to I.C.A. In complex lesions, results were considerably worse. Osteoarthritis has shown itself not to be an indication for this technique. On the other hand, the use of Hyalograft C© makes it possible to perform transplants with a smaller surgical incision as well as to fill defects without resorting to sutures.