Purpose New scaffold-based cartilage regeneration techniques have been developed to improve the results of microfractures also in complex locations like the patello-femoral joint. The aim of this study was to analyse the results obtained in patellar lesions treated with a bioscaffold, a mixture composed by a chitosan solution, a buffer, and the patient's whole blood which forms a stable clot into the lesion. Methods Fifteen patients with ICRS grade 3-4 cartilage lesions of the patellar surface were treated with a chitosan bioscaffold. Fourteen patients were clinically and radiologically evaluated prospectively for a minimum follow-up of 2 years with IKDC, KOOS, Tegner score, and MRI. The mean age of patients at the time of surgery was 31.8 +/- 11.9 and nine patients presented degenerative aetiology, four patients with previous trauma, and 1 patient with osteochondritis dissecans. Results The IKDC subjective score improved from 46.2 +/- 19.3 preoperatively to 69.5 +/- 20.3 (p < 0.05) and 74.1 +/- 23.2 (p < 0.05) at 12 and 24 months, respectively. Also KOOS Pain, KOOS Sport/Rec and KOOS QOL showed a significant improvement from baseline to 12 months and to the final follow-up. MRI evaluation showed a complete filling of the cartilage defect at the final follow-up in 70% of the lesions, obtaining a total MOCART 2.0 score of 71.5 +/- 13.6 at 24 months after surgery. Conclusion Chondral patellar lesions represent a complex pathology, with lower results compared to other sites. This bioscaffold represents a safe surgical treatment providing a significant clinical improvement at 24 months in the treatment of patellar cartilage lesions.

Chitosan based scaffold applied in patellar cartilage lesions showed positive clinical and MRI results at minimum 2 years of follow up / Poggi, Alberto; Di Martino, Alessandro; Andriolo, Luca; Reale, Davide; Filardo, Giuseppe; Kon, Elizaveta; Zaffagnini, Stefano. - In: KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY. - ISSN 0942-2056. - STAMPA. - 1:(2022), pp. 1-10. [10.1007/s00167-022-07023-1]

Chitosan based scaffold applied in patellar cartilage lesions showed positive clinical and MRI results at minimum 2 years of follow up

Poggi, Alberto;Di Martino, Alessandro;Andriolo, Luca;Reale, Davide;Filardo, Giuseppe;Kon, Elizaveta;Zaffagnini, Stefano
2022

Abstract

Purpose New scaffold-based cartilage regeneration techniques have been developed to improve the results of microfractures also in complex locations like the patello-femoral joint. The aim of this study was to analyse the results obtained in patellar lesions treated with a bioscaffold, a mixture composed by a chitosan solution, a buffer, and the patient's whole blood which forms a stable clot into the lesion. Methods Fifteen patients with ICRS grade 3-4 cartilage lesions of the patellar surface were treated with a chitosan bioscaffold. Fourteen patients were clinically and radiologically evaluated prospectively for a minimum follow-up of 2 years with IKDC, KOOS, Tegner score, and MRI. The mean age of patients at the time of surgery was 31.8 +/- 11.9 and nine patients presented degenerative aetiology, four patients with previous trauma, and 1 patient with osteochondritis dissecans. Results The IKDC subjective score improved from 46.2 +/- 19.3 preoperatively to 69.5 +/- 20.3 (p < 0.05) and 74.1 +/- 23.2 (p < 0.05) at 12 and 24 months, respectively. Also KOOS Pain, KOOS Sport/Rec and KOOS QOL showed a significant improvement from baseline to 12 months and to the final follow-up. MRI evaluation showed a complete filling of the cartilage defect at the final follow-up in 70% of the lesions, obtaining a total MOCART 2.0 score of 71.5 +/- 13.6 at 24 months after surgery. Conclusion Chondral patellar lesions represent a complex pathology, with lower results compared to other sites. This bioscaffold represents a safe surgical treatment providing a significant clinical improvement at 24 months in the treatment of patellar cartilage lesions.
2022
Chitosan based scaffold applied in patellar cartilage lesions showed positive clinical and MRI results at minimum 2 years of follow up / Poggi, Alberto; Di Martino, Alessandro; Andriolo, Luca; Reale, Davide; Filardo, Giuseppe; Kon, Elizaveta; Zaffagnini, Stefano. - In: KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY. - ISSN 0942-2056. - STAMPA. - 1:(2022), pp. 1-10. [10.1007/s00167-022-07023-1]
Poggi, Alberto; Di Martino, Alessandro; Andriolo, Luca; Reale, Davide; Filardo, Giuseppe; Kon, Elizaveta; Zaffagnini, Stefano
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/899414
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