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Treatment of osteochondral lesions in the knee using a cell-free scaffold

Peter Verdonk (UGent) , Aad Dhollander, Karl Almqvist (UGent) , René Verdonk (UGent) and Jan Victor (UGent)
(2015) BONE & JOINT JOURNAL. 97B(3). p.318-323
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Abstract
The treatment of osteochondral lesions is of great interest to orthopaedic surgeons because most lesions do not heal spontaneously. We present the short-term clinical outcome and MRI findings of a cell-free scaffold used for the treatment of these lesions in the knee. A total of 38 patients were prospectively evaluated clinically for two years following treatment with an osteochondral nanostructured biomimetic scaffold. There were 23 men and 15 women; the mean age of the patients was 30.5 years (15 to 64). Clinical outcome was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Tegner activity scale and a Visual Analgue scale for pain. MRI data were analysed based on the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) scoring system at three, 12 and 24 months post-operatively. There was a continuous significant clinical improvement after surgery. In two patients, the scaffold treatment failed (5.3%) There was a statistically significant improvement in the MOCART precentage scores. The repair tissue filled most of the defect sufficiently. We found subchondral laminar changes in all patients. Intralesional osteophytes were found in two patients (5.3%). We conclude that this one-step scaffold-based technique can be used for osteochondral repair. The surgical technique is straightforward, and the clinical results are promising. The MRI aspects of the repair tissue continue to evolve during the first two years after surgery. However, the subchondral laminar and bone changes are a concern.
Keywords
ARTICULAR-CARTILAGE DEFECTS, COMPOSITE MULTILAYERED BIOMATERIAL, AUTOLOGOUS CHONDROCYTE TRANSPLANTATION, REPAIR TISSUE, REGENERATION, MICROFRACTURE, MOSAICPLASTY, MANAGEMENT

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MLA
Verdonk, Peter et al. “Treatment of Osteochondral Lesions in the Knee Using a Cell-free Scaffold.” BONE & JOINT JOURNAL 97B.3 (2015): 318–323. Print.
APA
Verdonk, P., Dhollander, A., Almqvist, K., Verdonk, R., & Victor, J. (2015). Treatment of osteochondral lesions in the knee using a cell-free scaffold. BONE & JOINT JOURNAL, 97B(3), 318–323.
Chicago author-date
Verdonk, Peter, Aad Dhollander, Karl Almqvist, René Verdonk, and Jan Victor. 2015. “Treatment of Osteochondral Lesions in the Knee Using a Cell-free Scaffold.” Bone & Joint Journal 97B (3): 318–323.
Chicago author-date (all authors)
Verdonk, Peter, Aad Dhollander, Karl Almqvist, René Verdonk, and Jan Victor. 2015. “Treatment of Osteochondral Lesions in the Knee Using a Cell-free Scaffold.” Bone & Joint Journal 97B (3): 318–323.
Vancouver
1.
Verdonk P, Dhollander A, Almqvist K, Verdonk R, Victor J. Treatment of osteochondral lesions in the knee using a cell-free scaffold. BONE & JOINT JOURNAL. 2015;97B(3):318–23.
IEEE
[1]
P. Verdonk, A. Dhollander, K. Almqvist, R. Verdonk, and J. Victor, “Treatment of osteochondral lesions in the knee using a cell-free scaffold,” BONE & JOINT JOURNAL, vol. 97B, no. 3, pp. 318–323, 2015.
@article{5949320,
  abstract     = {The treatment of osteochondral lesions is of great interest to orthopaedic surgeons because most lesions do not heal spontaneously. We present the short-term clinical outcome and MRI findings of a cell-free scaffold used for the treatment of these lesions in the knee. A total of 38 patients were prospectively evaluated clinically for two years following treatment with an osteochondral nanostructured biomimetic scaffold. There were 23 men and 15 women; the mean age of the patients was 30.5 years (15 to 64). Clinical outcome was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Tegner activity scale and a Visual Analgue scale for pain. MRI data were analysed based on the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) scoring system at three, 12 and 24 months post-operatively. There was a continuous significant clinical improvement after surgery. In two patients, the scaffold treatment failed (5.3%) There was a statistically significant improvement in the MOCART precentage scores. The repair tissue filled most of the defect sufficiently. We found subchondral laminar changes in all patients. Intralesional osteophytes were found in two patients (5.3%). We conclude that this one-step scaffold-based technique can be used for osteochondral repair. The surgical technique is straightforward, and the clinical results are promising. The MRI aspects of the repair tissue continue to evolve during the first two years after surgery. However, the subchondral laminar and bone changes are a concern.},
  author       = {Verdonk, Peter and Dhollander, Aad and Almqvist, Karl and Verdonk, René and Victor, Jan},
  issn         = {2049-4394},
  journal      = {BONE & JOINT JOURNAL},
  keywords     = {ARTICULAR-CARTILAGE DEFECTS,COMPOSITE MULTILAYERED BIOMATERIAL,AUTOLOGOUS CHONDROCYTE TRANSPLANTATION,REPAIR TISSUE,REGENERATION,MICROFRACTURE,MOSAICPLASTY,MANAGEMENT},
  language     = {eng},
  number       = {3},
  pages        = {318--323},
  title        = {Treatment of osteochondral lesions in the knee using a cell-free scaffold},
  url          = {http://dx.doi.org/10.1302/0301-620X.97B3.34555},
  volume       = {97B},
  year         = {2015},
}

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