Patellofemoral Full-Thickness Chondral Defects Treated with Hyalograft-C: A Clinical, Arthroscopic, and Histologic Review

• Published in: American journal of sports medicine 2006-11, Vol.34 (11), p.1763-1773
• Main Authors: Gobbi, Alberto, Kon, Elisaveta, Berruto, Massimo, Francisco, Ramces, Filardo, Giuseppe, Marcacci, Maurilio
• Format: Article
• Language: English
• Subjects: Adjuvants, Immunologic - therapeutic use; Adolescent; Adult; Arthroscopy; Biological and medical sciences; Biomedical materials; Biopsy; Care and treatment; Cartilage; Cartilage cells; Cartilage, Articular - injuries; Cartilage, Articular - pathology; Cartilage, Articular - physiology; Chondrocytes - transplantation; Clinical outcomes; Diseases of the osteoarticular system; Documentation; Endoscopy; Female; Health aspects; Humans; Hyaluronic Acid - therapeutic use; Injuries; Injuries of the limb. Injuries of the spine; Investigative techniques, diagnostic techniques (general aspects); Joint surgery; Joints; Knee; Knee injuries; Knee Injuries - therapy; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; NMR; Nuclear magnetic resonance; Osteoarthritis, Knee - therapy; Osteochondritis Dissecans - therapy; Pain Measurement; Prospective Studies; Recovery of Function; Regeneration; Second-Look Surgery; Skin & tissue grafts; Sports injuries; Sports medicine; Tissue engineering; Tissue Engineering - methods; Transplantation, Autologous; Traumas. Diseases due to physical agents; Vascular bone diseases
• ISSN: 0363-5465; 1552-3365
• DOI: 10.1177/0363546506288853

Background Tissue engineering has emerged as a potential therapeutic option for cartilage regeneration. Hypothesis Hyaluronan-based scaffolds seeded with autologous chondrocytes are a viable treatment for damaged articular surface of the patellofemoral joint. Study Design Case series; Level of evidence, 4. Methods Thirty-two chondral lesions with a mean size of 4.7 cm2 were treated with Hyalograft-C. Twenty-two lesions were located in the patella and 10 in the trochlea. Sixteen patients had previous trauma, 3 had osteochondritis dissecans, and 13 had degenerative changes. Transplantations were carried out arthroscopically or through a miniarthrotomy incision. Eight patients had concomitant procedures, including patellar realignment (2), lateral release (3), and meniscectomy (3). Results were evaluated using the International Cartilage Repair Society–International Knee Documentation Committee scale, EuroQol EQ-5D form, and magnetic resonance imaging scans at 12 and 24 months. Six patients had second-look arthroscopy and biopsies. Statistical analysis was performed using the paired ttest and Wilcoxon signed rank test. Results The International Cartilage Repair Society–International Knee Documentation Committee and EuroQol EQ-5D scores demonstrated a statistically significant improvement (P