Biomimetic osteochondral scaffold for the treatment of complex tibial plateau defects: results at 2 years of follow up

Objectives: The management of post-traumatic and degenerative
osteochondral defects of the proximal tibia represents a challenge for the
orthopedic surgeon. In fact, some studies reported how this kind of
injuries often imply in the long term an early secondary post-traumatic
osteoarthritis,which requires a total knee replacement. In this context and
given the young age of patients affected by these lesions, treatments
should have as main objective to restore the articular surface thus permitting
a complete restoration of the joint functionality.With this aimwe
treated patients affected by complex defects of the tibial plateau with an
osteochondral three-layer biomimetic scaffold.
Methods: 11 patients (13 lesions) enrolled between 2007 and 2010
affected by post-traumatic osteochondral lesion of the tibial plateau
and treated with the implantation of an osteochondral three-layer
biomimetic scaffold. Patients were evaluated clinically up to
24 months of follow-up by the International Documentation Committee
(IKDC) scores and Tegner score Results: A statistically significant improvement of all clinical scores
was obtained from basal evaluation to the final evaluation at
24 months. The subjective IKDC improved from 42.5 ± 10.2 at basal
evaluation to 68.4 ± 17.0 at 24 months of follow-up. Tegner score
improves from 2.3 ± 2.1 pre-operative to 4.4 ± 1.9 at 24 months of
follow-up. Three patients referred postoperative fever and swelling,
that resolved within 1 month after surgery.
Conclusions: Encouraging results have been registered in the present
study, with a significant improvement of symptoms and functionality
at short term follow-up, thus delaying the need of joint replacement
for these complex patients.