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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-10-2012 | Experimental Study

Cell-free collagen type I matrix for repair of cartilage defects—clinical and magnetic resonance imaging results

Authors: Turgay Efe, Christina Theisen, Susanne Fuchs-Winkelmann, Thomas Stein, Alan Getgood, Marga B. Rominger, Jürgen R. J. Paletta, Markus D. Schofer

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 10/2012

Abstract

Purpose

Several well-described techniques are available for the treatment of chondral and osteochondral defects. The aim of the study was to assess the efficacy of a single-stage procedure incorporating a new cell-free collagen type I gel for the treatment of small chondral and osteochondral defects in the knee evaluated at 2-year follow-up.

Methods

Fifteen patients were treated with a cell-free collagen type I gel matrix of 11 mm diameter. The grafts were implanted in the debrided cartilage defect and fixed by press-fit only. The clinical outcome was assessed preoperatively and at 6 weeks, and 6, 12 and 24 months after surgery using the International Knee Documentation Committee (IKDC) score, Tegner activity scale and visual analogue scale (VAS). Graft attachment rate was assessed 6 weeks postoperatively using magnetic resonance imaging (MRI). Cartilage regeneration was evaluated using the Magnetic Observation of Cartilage Repair Tissue (MOCART) score at 6, 12 and 24 months after implantation. Clinical results were correlated with MRI findings.

Results

Six male and nine female patients were included in this study, with a mean age of 26 (range: 19–40). No complications were reported. The mean VAS values after 6 weeks and the mean IKDC patient values after 6 months were significantly improved from the preoperative values (P = 0.005 and P = 0.009, respectively). This improvement remained up to the latest follow-up. There were no significant differences between the median preoperative and postoperative Tegner values (n.s.). Significant improvement of the mean MOCART score was observed after 12 months and remained by 24 months (P < 0.001). MR images showed that in 14 of the 15 patients, the graft was completely attached by 6 weeks postoperatively. At 24 months after implantation, MRI demonstrated complete filling in all cases with a mainly smooth surface, complete integration of the border zone, homogenous structure of the repaired tissue and nearly normal signal intensity. No correlation between any variables of the MOCART score and the clinical scores was observed.

Conclusions

The present study reveals that the new method produces both good clinical and magnetic resonance imaging results. Use of press-fit only implanted grafts of a smaller diameter leads to a high attachment rate at 24-month follow-up.

Level of evidence

IV.

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Title: Cell-free collagen type I matrix for repair of cartilage defects—clinical and magnetic resonance imaging results
Authors: Turgay Efe
Christina Theisen
Susanne Fuchs-Winkelmann
Thomas Stein
Alan Getgood
Marga B. Rominger
Jürgen R. J. Paletta
Markus D. Schofer
Publication date: 01-10-2012
Publisher: Springer-Verlag
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 10/2012
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-011-1777-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cell-free collagen type I matrix for repair of cartilage defects—clinical and magnetic resonance imaging results

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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