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General Orthopaedics

Focal Femoral Condyle Inlay Resurfacing: A Bridging Procedure Between Biological And Arthroplasty Procedures

The South African Orthopaedic Association (SAOA) 57th Annual Congress



Abstract

Full thickness cartilage defects of the femoral condyles are frequent, can be highly symptomatic, and pose treatment challenges when encountered in middle-aged patients. A history of biological repair procedures is frequent and patient management is complex in order to delay joint replacement procedures in active patients. Focal metallic resurfacing provides a joint preserving bridging procedure with a clinical exit into primary arthroplasty.

Methods.

This study presents a review of several multicenter investigations exploring the clinical benefits and validity of focal resurfacing in 78 patients, ages 35–67, with a follow-up ranging from 2 to 6 years.

All patients were treated with a 15 or 20 mm contoured resurfacing implant on the medial or lateral femoral condyle.

Results.

At 2 years follow up, average scores for WOMAC domains improved by over 100% (40 preop to 86 postop where 100 = best). At 3 year follow-up KOOS scores were within 88 to 102% of a normal aged matched population (domain range 72–91 where 100 = best). At a minimum of 5 years, the KOOS domains were close to normative reference levels on pain relief, symptoms, and activities of daily living (range 83–89% of normal). Radiographic results demonstrated solid fixation, preservation of joint space, and no change in the osteoarthritic stage.

Conclusion.

The procedure adds a new layer to reconstructive treatment options in the long-term management of knee arthrosis and arthritis and allows for a clinical alternative to lifestyle changes required by many patients who failed cartilage procedures and continue to have an isolated symptomatic defect precluding them from joint arthroplasty.