Summary

A single stage arthroscopic procedure for the treatment of articular cartilage defects in the knee which uses atellocollagen and fibrin gel is used with the aim to evaluate the clinical outcomes at 4 years.

Abstract

Background

The joint cartilage has a limited capacity for healing. Over time the natural history of the disease may progress to develop osteoarthritis there is need for improvement of the techniques to repair cartilage with the goal to restore the morphology and function of normal joint cartilage.
We describe a single stage arthroscopic procedure for the treatment of articular cartilage defects in the knee. The novel procedure involves microdrilling and application of atellocollagen and fibrin gel. The aim of the study was to evaluate the clinical outcomes at 4 years.

Materials & Methods: A prospective study of 30 patients with symptomatic ICRS grade III/IV chondral defects which were assessed clinically and radiologically. The lesions were located on the MFC, LFC, trochlea or patella, ranging from 2-8cm2. The surgical procedure involved debridement of the lesion, microdrilling and application of atellocollagen and fibrin gel under CO2 insufflation. Patients were clinically assessed using the Lysholm, IKDC and KOOS scores. Radiological assessment used the MOCART score.

Result: At 4 year follow-up, the mean scores were as follows:
• Lysholm score was 80.46 ± 24.7, as compared to 51.7 ± 27.1 pre-operatively (p < 0.05).
• KOOS (symptomatic) was 89 , as compared to 66.2 pre-operatively.
• IKDC (subjective) was 78.6, up from 41 preoperatively.
• MOCART score for all lesions was 71.3

Conclusion

Our technique shows encouraging clinical and radiological results at 4 year follow-up as assessed by reliable validated scores.

Keywords: ACIC, cartilage, knee