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Archives of Orthopaedic and Trauma Surgery

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Open Access 14-09-2021 | Osteoarthrosis | Knee Arthroplasty

Good subjective outcome and low risk of revision surgery with a novel customized metal implant for focal femoral chondral lesions at a follow-up after a minimum of 5 years

Authors: Mohanad Al-Bayati, Nicolas Martinez-Carranza, David Roberts, Magnus Högström, Anders Stålman

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 10/2022

Abstract

Background and purpose

Patients with focal cartilage lesions experience functional impairment. Results for biological treatments in the middle-aged patient is poor. Previous studies with focal prosthetic inlay resurfacing have shown a higher risk of conversion to total knee replacement at mid-term follow-up. A novel customized implant (Episealer, Episurf, Stockholm, Sweden) has been proposed to improve implant positioning and survival. The primary objective was to assess subjective-, objective function and implant survival at a minimum of five years after surgery.

Materials and methods

The inclusion criteria were patients aged 30–65 years with symptomatic focal chondral defects in the medial femoral condyle, International Cartilage Research Society grade 3 or 4 and failed conservative or surgical treatment. Minimum follow-up of 5 years. Clinical and radiologic assessments were made. Patient-reported outcome measurements at the latest follow-up were compared with the baseline data for the Knee injury and Osteoarthritis Outcome Score (KOOS), the EuroQoL (EQ-5D), the Tegner Activity Scale and a Visual Analog Scale of pain (VAS 0–10).

Results

Ten patients with the mean follow-up period of 75 months (60–86 months, SD 10) were included. Signs of osteoarthritis were seen in one patient (Ahlbäck 1). No cases with revision to knee replacement. VAS for pain and KOOS showed improvements that reached significance for VAS (p ≤ 0.001) and the KOOS subscores Pain (p = 0.01), ADL (p = 0.003), Sport and Recreation (p = 0.024) and Quality of Life (p = 0.003).

Conclusion

A good subjective outcome, a low risk of progression to degenerative changes and the need for subsequent surgery were seen at the mid-term follow-up with this customized focal knee-resurfacing implant.

Level of evidence

Prospective case series, level 4.

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Title: Good subjective outcome and low risk of revision surgery with a novel customized metal implant for focal femoral chondral lesions at a follow-up after a minimum of 5 years
Authors: Mohanad Al-Bayati
Nicolas Martinez-Carranza
David Roberts
Magnus Högström
Anders Stålman
Publication date: 14-09-2021
Publisher: Springer Berlin Heidelberg
Keywords: Osteoarthrosis
Osteoarthrosis
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 10/2022
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-021-04160-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Good subjective outcome and low risk of revision surgery with a novel customized metal implant for focal femoral chondral lesions at a follow-up after a minimum of 5 years

Abstract

Background and purpose

Materials and methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and purpose

Materials and methods

Results

Conclusion

Level of evidence

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