Cartilage repair in the knee with subchondral drilling augmented with a platelet-rich plasma-immersed polymer-based implant.
Knee Surg Sports Traumatol Arthrosc
; 22(6): 1225-34, 2014 Jun.
Article
em En
| MEDLINE
| ID: mdl-23563814
ABSTRACT
PURPOSE:
The aim of our study was to analyse the clinical and histological outcome after the treatment of focal cartilage defects in non-degenerative and degenerative knees with bone marrow stimulation and subsequent covering with a cell-free resorbable polyglycolic acid-hyaluronan (PGA-HA) implant immersed with autologous platelet-rich plasma (PRP).METHODS:
Fifty-two patients (mean age 44 years) with focal chondral defects in radiologically confirmed non-degenerative or degenerative knees were subjected to subchondral drilling arthroscopically. Subsequently, defects were covered with the PGA-HA implant immersed with autologous PRP. At 2-year follow-up, the patients' situation was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and compared to the pre-operative situation and 3-12-month follow-up. Biopsies (n = 4) were harvested at 18-24 months after implantation and were analysed by histology and collagen type II immune staining.RESULTS:
At 1- and 2-year follow-up, the KOOS showed clinically meaningful and significant (p < 0.05) improvement in all subcategories compared to baseline and to 3-month follow-up. There were no differences in KOOS data obtained after 2 years compared to 1 year after the treatment. Histological analysis of the biopsy tissue showed hyaline-like to hyaline cartilage repair tissue that was rich in cells with a chondrocyte morphology, proteoglycans and type II collagen.CONCLUSIONS:
Covering of focal cartilage defects with the PGA-HA implant and PRP after bone marrow stimulation improves the patients' situation and has the potential to regenerate hyaline-like cartilage. LEVEL OF EVIDENCE Case series, Level IV.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Osteoartrite do Joelho
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Plasma Rico em Plaquetas
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Artroplastia Subcondral
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Traumatismos do Joelho
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Articulação do Joelho
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Prótese do Joelho
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article