Focal metallic inlay resurfacing prosthesis in articular cartilage defects: short-term results of 118 patients and 2 different implants
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The goal of this study was to share our experience with two different inlay metallic implants in the treatment of knee cartilage defects and to analyze their effects on functional scores.
This retrospective study included 118 patients operated on for focal full-thickness knee cartilage lesions, who were treated with a focal metallic inlay resurfacing prosthesis. A cobalt–chromium (Co–Cr) resurfacing implant was applied to 73 patients with a knee chondral lesion, and a biosynthetic implant was applied to 45. All patients were evaluated preoperatively and postoperatively using the KOOS, VAS, and Tegner activity scores.
The group with the Co–Cr-resurfacing implant showed a significantly greater improvement (p < 0.001) in the Tegner and VAS scores at the 2-year follow-up examination. The KOOS scores were similar in both groups. Median patient age was similar in both groups. All patients had a follow-up of at least 2 years. The preoperative and postoperative scores were compared and significant improvements (p < 0.001) were observed. The biosynthetic implant had a higher revision rate. In the univariate analysis, age and type of implant were significantly associated with revision surgery. In the multivariate Cox-regression analysis model, the type of implant was significantly associated with revision surgery.
All the patients operated with the above-mentioned implants showed significant improvements in pain and activity scores. Despite the overall good clinical results, 17% of patients with a biosynthetic implant and > 6% of patients with Co–Cr-resurfacing implant required revision surgery. Age and implant type were the main risk factors associated with revision.
KeywordsCartilage Inlay-resurfacing prosthesis Focal osteochondral defects Osteoarthritis
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interests and no funding was received from any source.
This article does not contain any studies with human participants or animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
- 6.Heir S, Nerhus TK, Røtterud JH, Løken S, Ekeland A, Engebretsen L, Arøen A (2010) Focal cartilage defects in the knee impair quality of life as much as severe osteoarthritis: a comparison of knee injury and osteoarthritis outcome score in 4 patient categories scheduled for knee surgery. Am J Sports Med 38(2):231–237CrossRefGoogle Scholar
- 12.Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthrop Relat Res 198:43–49Google Scholar
- 21.Kirker-Head CA, Van Sickle DC, Ek SW, McCool JC (2006) Safety of, and biological and functional response to, a novel metallic implant for the management of focal full-thickness cartilage defects: preliminary assessment in an animal model out to 1 year. J Orthop Res 24:1095–1108CrossRefGoogle Scholar
- 23.Beyzadeoglu T, Pehlivanoglu T (2018) Cartilage. 9(2):156–160Google Scholar
- 25.Bollars P, Bousquet M, Vandekerckhove B, Hardeman F, Bellemans J (2012) Prosthetic inlay resurfacing for the treatment of focal, full thickness cartilage defects of the femoral condyle: a bridge between biologics and conventional arthroplasty. Knee Surg Sports Traumatol Arthrosc 20(9):1753–1759CrossRefGoogle Scholar
- 26.Becher C, Kalbe C, Thermann H, Paessler HH, Laprell H, Kaiser T, Fechner A, Bartsch S, Windhagen H, Ostermeier S (2011) Minimum 5-year results of focal articular prosthetic resurfacing for the treatment of full-thickness articular cartilage defects in the knee. Arch Orthop Trauma Surg 131(8):1135–1143CrossRefGoogle Scholar
- 29.Hobbs H, Ketse-Matiwane N, van der Merwe W, Posthumus M (2013) Focal full thickness articular cartilage lesions treated with an articular resurfacing prosthesis in the middle-aged. SA Orthop J 12(4): 41–46. http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1681-150X2013000500008&lng=en. Accessed 28 Oct 2019