Patient specific instrumentation (PSI) for total knee arthroplasty (TKA) may improve component position and sizing. However, little has been reported about the accuracy of the default plan created by the manufacturer. The purpose of the study was to evaluate the reliability of the manufacturer plan and the impact of surgeon's changes on the final accuracy of the cutting guide sizes. The planned sizes of 45 TKAs were prospectively recorded from the in the initial manufacturer's proposal and from the final plan modified after surgeon's evaluation and compared to the actually implanted sizes. The manufacturer's initial proposal differed from the final implant in 20% of the femoral and 51.11% of the tibial components, while the surgeon's plan in 13.33% of the femoral and 26.67% of the tibial components. Surgeon's modifications in the pre-operative were carried out for 11.11% of the femoral components and 51.11% of the tibial ones (p = 0.0299). Appropriate modification occurred in of 88% and 76% of femoral and tibial changes respectively. The surgeon's accuracy to predict the final component size was significantly different from that of the manufacturer and changes on the manufacturer's plan were necessary to get an accurate preoperative plan of the implant sizes. Careful evaluation by an experienced knee surgeon is mandatory when planning TKA with PSI. Collaboration between surgeons and manufacturers may help obtain improved accuracy in PSI size planning.
To assess the reliability of a biomimetic osteochondral scaffold Maioregen (Finceramica Faenza SpA, Faenza, Italt) as a salvage and joint-preserving procedure in the treatment of late stages of osteonecrosis of the knee. Nine active patients aged under 65 year presenting with clinical and radiological signs of SPONK were treated with a biomimetic osteochondral scaffold. All patients were clinically evaluated preoperatively and yearly with a minimum follow-up of 2 years. Subjective IKDC and Lysholm Knee Scale were used to assess clinical outcome. Pre-operative and post-operative pain was quantified with VAS scale. Activity level were evaluated pre-operatively and at follow-up according to Tegner Activity Scale.Purpose
Methods
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. 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).Purpose
Methods and Materials
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. 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 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).INTRODUCTION
MATERIALS AND METHODS
Different surgical approaches have been proposed for the treatment of chondral lesions. However surgical management of osteochondral defects of the knee joint involving subchondral bone are still under debate. The aim of this prospective non-randomized uncontrolled clinical investigation is to confirm the effectiveness of a commercially available biomimetic osteochondral scaffold in regenerating cartilage and subchondral bone of severe osteochondral lesions of the knee joint with one step surgery.Background:
Purpose:
