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Knee Surgery, Sports Traumatology, Arthroscopy

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01-07-2016 | Experimental Study

Poor osteochondral repair by a biomimetic collagen scaffold: 1- to 3-year clinical and radiological follow-up

Authors: Bjørn Borsøe Christensen, Casper Bindzus Foldager, Jonas Jensen, Niels Christian Jensen, Martin Lind

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 7/2016

Abstract

Introduction

Treatment of osteochondral injuries is challenging, and no gold standard has been established. Layered cell-free scaffolds are a new treatment option for these defects. The aim of this study was to evaluate the osteochondral repair in patients treated with the MaioRegen^® scaffold, a cell-free biomimetic scaffold consisting of type I collagen and hydroxyapatite. Treatment using this scaffold has previously shown promising clinical results.

Methods

Ten patients with osteochondral lesions in the knee (n = 6) or in the talus (n = 4) were enrolled. The patients underwent pre-operative MRI and CT scans and were assessed at 1- and 2.5-year timescales post-operatively. The cartilage and bone formations were evaluated semi-quantitatively using the MOCART score. Knee patients were clinically evaluated using KOOS, subjective IKDC and Tegner scores, whereas ankle patients were evaluated using AOFAS Hindfoot and Tegner scores.

Results

Two patients were re-operated and excluded from further follow-up due to treatment failure. None of the patients had complete regeneration of the subchondral bone evaluated using CT. At 2.5 years, 6/8 patients had no or very limited (<10 %) bone formation in the defects and 2/8 had 50–75 % bone formation in the treated defect. MRI showed no improvement in the MOCART score at any time point. The IKDC score improved from 41.3 to 80.7, and the KOOS pain subscale improved from 63.8 to 90.8 at 2.5-year follow-up. No improvement was found with the remaining KOOS subscales, the Tegner or AOFAS Ankle-Hindfoot score.

Conclusion

Treatment of osteochondral defects in the ankle and knee joint with a biomimetic scaffold resulted in incomplete cartilage repair and poor subchondral bone repair at 1- and 2.5-year follow-up. Clinical significant improvements were observed. These results raise serious concerns about the biological repair potential of the MaioRegen^® scaffold, and we advise to use the MaioRegen^® scaffold with caution.

Level of evidence

Prospective therapeutic study, Level IV.

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Title: Poor osteochondral repair by a biomimetic collagen scaffold: 1- to 3-year clinical and radiological follow-up
Authors: Bjørn Borsøe Christensen
Casper Bindzus Foldager
Jonas Jensen
Niels Christian Jensen
Martin Lind
Publication date: 01-07-2016
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 7/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-015-3538-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Poor osteochondral repair by a biomimetic collagen scaffold: 1- to 3-year clinical and radiological follow-up

Abstract

Introduction

Methods

Results

Conclusion

Level of evidence

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Level of evidence

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