Cell-free biomimetic scaffold for osteochondral defects: a prospective clinical study at 72 months of follow-up

Objectives: This prospective clinical study tested the mid-term follow-
up of a one-step procedure using a cell-free biomimetic
multilayered scaffold for the treatment of osteochondral lesions of the
knee.
Methods: 27 patients (9F, 18 M, mean age 34.9 yy) affected by
symptomatic ICRS grade III-IV chondral lesions of the knee were
treated. Patients were analyzed prospectively up to 72 months using
the ICRS Cartilage Standard Evaluation Form, and high resolution
MRI. Sites of the defects were: 7 MFC, 5 LFC, 11 patellae, 7
trochleae, and 2 lateral tibial plateaus. Five patients had multiple
lesions. Defect area was 2.9 ± 1.3 cm2. Etiology was traumatic in 5
cases, microtraumatic/degenerative in 16 and OCD in 6 cases.
Results: Function recovery and a significant clinical improvement
were detected. Mean IKDC subjective increased from 40.0 ± 14.7 to
77.4 ± 19.6 at final evaluation, showing the significant improvement
stable over time. Mean pre-injury Tegner score increased from
1.6 ± 1.1 pre-operative to 4.0 ± 1.8 at 12 months and 3.9 ± 1.8
(n.s.) at final follow-up. Despite the significant improvement
(p\0.05) at 1 year, the final sport activity was lower than the preinjury
level. MRI evaluation revealed a good integration of the
scaffold and a satisfactory filling of the defect.
Conclusions: This one-step surgery seems to be an easy and effective
procedure for chondral and osteochondral lesions of the knee. Results
show satisfactory outcomes even in large osteochondral lesions or
complex cases. MRI improves over time but abnormal findings are
still present at mid-term follow-up.