Biomimetic osteochondral scaffold for the treatment of complex tibial plateau defects: results at 2 years of follow up

Objectives: The management of post-traumatic and degenerative osteochondral defects of the proximal tibia represents a challenge for the orthopedic surgeon. In fact, some studies reported how this kind of injuries often imply in the long term an early secondary post-traumatic osteoarthritis,which requires a total knee replacement. In this context and given the young age of patients affected by these lesions, treatments should have as main objective to restore the articular surface thus permitting a complete restoration of the joint functionality.With this aimwe treated patients affected by complex defects of the tibial plateau with an osteochondral three-layer biomimetic scaffold. Methods: 11 patients (13 lesions) enrolled between 2007 and 2010 affected by post-traumatic osteochondral lesion of the tibial plateau and treated with the implantation of an osteochondral three-layer biomimetic scaffold. Patients were evaluated clinically up to 24 months of follow-up by the International Documentation Committee (IKDC) scores and Tegner score Results: A statistically significant improvement of all clinical scores was obtained from basal evaluation to the final evaluation at 24 months. The subjective IKDC improved from 42.5 ± 10.2 at basal evaluation to 68.4 ± 17.0 at 24 months of follow-up. Tegner score improves from 2.3 ± 2.1 pre-operative to 4.4 ± 1.9 at 24 months of follow-up. Three patients referred postoperative fever and swelling, that resolved within 1 month after surgery. Conclusions: Encouraging results have been registered in the present study, with a significant improvement of symptoms and functionality at short term follow-up, thus delaying the need of joint replacement for these complex patients.