Abstract
Introduction and Aim
The management of grade 4 articular cartilage defects of the knee is a great challenge and surgical techniques are evolving. This single surgeon series evaluated the results of articular cartilage implantation using matrix assisted autologous cartilage implantation (B Braun, Tetec, Reutlingen Germany) in 28 patients who had failed previous micro-fracture or chondroplasty.
Material and methods
Patients with a single chronic symptomatic full thickness defect either on the femoral condyle, trochlea or the patella were included. The defect size varied from 2.5 cm2 to 9.6 cm2. The mean age was 41.3 years and the mean duration of symptoms prior to surgery was 27 months (6–96).
Functional outcome was evaluated using the IKDC, KOOS, Tegner Lysholm and VAS pain scores. Patients also quantified their improvement in percentage or descriptive terms. Radiological assessment was carried out using MRI.
Results
At a mean follow up of 14 months (12 to 39) there was significant improvement in the IKDC from median 32.2 to 89.2 (p<0.001); KOOS from median 32.20 to 91.2 (p <0.001); Tegner-Lysholm from median 36 to 89 (p<0.001). VAS improved from a median of 1 to 9 post surgery. All patients had subjective improvement of a minimum of 85%. There were no complications in this study
Conclusion
The study shows that articular cartilage implantation using this technique yields excellent results in symptomatic patients following failed micro-fracture or chondroplasty. Careful patient selection and rehabilitation are however paramount in achieving success.
