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Published in: International Orthopaedics 3/2016

01-03-2016 | Original Paper

Successful osteoconduction but limited cartilage tissue quality following osteochondral repair by a cell-free multilayered nano-composite scaffold at the knee

Authors: Martin Brix, Martin Kaipel, Richard Kellner, Markus Schreiner, Sebastian Apprich, Harald Boszotta, Reinhard Windhager, Stephan Domayer, Siegfried Trattnig

Published in: International Orthopaedics | Issue 3/2016

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Abstract

Introduction

The treatment of larger osteochondral lesions in the knee is still a clinical challenge. One promising strategy to overcome this problem could be surgical repair by using a cell-free multilayered nano-composite scaffold.

Method

In this prospective cohort study eight consecutive patients which suffered from a single osteochondral lesion (≥1.5 cm2) on the femoral condyle were enrolled. The repair potential of the implant was assessed by using MRI based biochemical MR sequences (T2 mapping) as well as semi-quantitative morphological analyses (MOCART score) at 18 months after the surgery. The clinical outcome was determined at six, 12, 18, and 24 month follow ups by using IKDC, Tegner-Lysholm, and Cincinnati knee scores.

Results

Seven out of eight patients showed a complete integration of the scaffold into the border zone and five out of eight patients excellent or good subchondral ossification of the implant at 18 months following implantation. The surface of the repair tissue was found to be intact in all eight patients. T2 mapping data and the zonal T2 index significantly differed in the repair tissue compared to the healthy control cartilage (P < 0.001) which indicates a limited quality of the repair cartilage. The clinical outcome scores consistently improved during the follow up period without reaching statistical significance.

Conclusions

Osteochondral repair by implanting the MaioRegen® scaffold provides a successful osteoconduction and filling of the cartilage defect. However there is evidence for a limited repair cartilage tissue quality at 18 months after the surgery.
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Metadata
Title
Successful osteoconduction but limited cartilage tissue quality following osteochondral repair by a cell-free multilayered nano-composite scaffold at the knee
Authors
Martin Brix
Martin Kaipel
Richard Kellner
Markus Schreiner
Sebastian Apprich
Harald Boszotta
Reinhard Windhager
Stephan Domayer
Siegfried Trattnig
Publication date
01-03-2016
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 3/2016
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-016-3118-2

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