RESEARCH ARTICLE


A 5-Year Follow-Up After Cartilage Repair in the Knee Using a Platelet-Rich Plasma-Immersed Polymer-Based Implant



Alberto Siclari*, 1, Gennaro Mascaro 2, Christian Kaps 3, 4, Eugenio Boux 1
1 Struttura Complessa di Ortopedia e Traumatologia, Ospedale degli Infermi di Biella ASLBI, Biella, Italy
2 Servizio di Immunoematologia e Medicina Trasfusionale, Ospedale degli Infermi di Biella ASLBI, Biella, Italy
3 TransTissue Technologies GmbH, Berlin, Germany
4 Tissue Engineering Laboratory, Charité Campus Mitte, Charité-University Medicine Berlin, Berlin, Germany


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© Siclari et al.; Licensee Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the Struttura Complessa di Ortopedia e Traumatologia, Ospedale degli Infermi di Biella ASLBI, Str. Cantone Rondolina 50, 13900 Biella, Piemonte, Italy; Tel: 00390153503431; Fax: 00390153503765; E-mail: alsicl@libero.it


Abstract

The aim of our study was to analyze the clinical outcome after repair of cartilage defects of the knee with subchondral drilling and resorbable polymer-based implants immersed with autologous platelet-rich plasma (PRP). Fifty-two patients with focal chondral defects were treated with subchondral drilling, followed by covering with a polyglycolic acid - hyaluronan (PGA-HA) implant (chondrotissue®) immersed with autologous PRP. At 5-year follow-up, patients’ situation was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and compared to the pre-operative situation. The KOOS showed clinically meaningful and significant (p < 0.05) improvement in all subcategories compared to baseline. Subgroup analysis showed that there were no differences in the clinical outcome regarding defect size and localization as well as degenerative condition of the knee. Cartilage repair was complete in 20 out of 21 patients at 4-year follow-up as shown by magnetic resonance observation of cartilage repair tissue (MOCART) scoring. Covering of focal cartilage defects with the PGA-HA implant and PRP after bone marrow stimulation leads to a lasting improvement of the patients’ situation.

Keywords: Bone marrow stimulation, cartilage repair, drilling, microfracture, platelet-rich plasma, polyglycolic acid-hyaluronan scaffold, polymer-based implant..