Abstract
Purpose
Osteochondral lesions of the knee are relatively common both in young and senior population. The very disabling clinical symptoms, in association to the scarce regenerative capacity of the articular cartilage and the increased risk of developing a secondary osteoarthritis make an effective treatment mandatory.
Methods and Materials
From December 2008 to January 2013, 34 patients (35 knees), 24 males and 10 females (mean age 36.2 years range 14–66) underwent implant of Maioregen® (Finceramica Faenza S.P.A, Italy) biomimetic tri-layer osteochondral scaffold. In 17 cases the osteochondral lesion was cause by an osteochondritis dissecans (acute or sequela), in 13 cases by a spontaneous osteonecrosis and in 4 cases the etiology was traumatic. Patients were evaluated with subjective IKDC and Tegner Lysholm scores, VAS and Tegner Activity Scale before surgery and at regular follow up (mean follow up 38.4 months, range 13 months max 63 months).
Results
Both Lysholm and IKDC Subjective scores significantly increased from 57.5 and 48.2 before surgery to 89.7 and 76.3 at 1 year follow up. Mean VAS scale score decreased from 6.3 to 2 at 1 year follow up. At 3 years follow up 20 evaluated patients showed an increment on both scales (Lysholm 92.38, IKDC 84.7). Only 4 patients were evaluated at 5 years follow up with mean subjective IKDC 92.5, Lysholm 98.75 and VAS 1.
Conclusion
Maioregen® biomimetic osteochondral scaffold showed very good results as surgical treatment option in treating ICRS grade 3–4 osteochondral lesions whatever the etiology. In particular, the implant showed good results also in treatment of osteonecrosis and could provide an alternative to unicompartimental arthroplasty in young and active patients.
