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Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 22, Issue 6, pp 1225–1234 | Cite as

Cartilage repair in the knee with subchondral drilling augmented with a platelet-rich plasma-immersed polymer-based implant

  • Alberto SiclariEmail author
  • Gennaro Mascaro
  • Chiara Gentili
  • Christian Kaps
  • Ranieri Cancedda
  • Eugenio Boux
Knee

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.

Keywords

Cartilage repair Knee Arthroscopy Regenerative medicine PGA-HA scaffold Platelet-rich plasma Microfracture Bone marrow stimulation Polymer-based implant Polyglycolic acid 

Notes

Acknowledgments

CK is employee of TransTissue Technologies GmbH and consultant of BioTissue AG

Conflict of interest

All other authors declare that there is no financial or other conflict of interest.

Supplementary material

167_2013_2484_MOESM1_ESM.tif (2.8 mb)
Supplementary material 1 (TIFF 2898 kb)

Supplementary material 2 (MPG 10505 kb)

Supplementary material 3 (MPG 9779 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Alberto Siclari
    • 1
    Email author
  • Gennaro Mascaro
    • 2
  • Chiara Gentili
    • 3
  • Christian Kaps
    • 4
  • Ranieri Cancedda
    • 3
    • 5
  • Eugenio Boux
    • 1
  1. 1.Struttura Complessa di Ortopedia e TraumatologiaOspedale degli Infermi di Biella ASLBIPiemonteItaly
  2. 2.Servizio di Immunoematologia e Medicina TrasfusionaleOspedale degli Infermi di Biella ASLBIPiemonteItaly
  3. 3.Dipartimento di Medicina SperimentaleUniversità di GenovaGenoaItaly
  4. 4.Tissue Engineering Laboratory, Charité Campus MitteCharité-University Medicine BerlinBerlinGermany
  5. 5.IRCCS AOU San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, DIMESUniversità di GenovaGenoaItaly

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