2017 ISAKOS Biennial Congress ePoster #229

 

Hyaluronic Acid-Based Scaffold Versus Bilayer Collagen Scaffold in Patellofemoral Chondral Defect Repair Using Dry Arthroscopy

Mariusz A. Puszkarz, MD, Rybnik POLAND
Boguslaw Sadlik, MD, PhD, Bielsko-Biala POLAND
Alberto Gobbi, MD, Milan ITALY
Martin Wiewiorski, MD, Basel SWITZERLAND
Bartosz Gaj, MD, Wroclaw POLAND
Wojciech Klon, MD, Rybnik, Slaskie POLAND
Graeme P. Whyte, MD, MSc, FRCSC, New York, NY UNITED STATES

Biological Reconstruction Department / Orthopaedic Department, Bielsko-Biala, slaskie, POLAND

The FDA has not cleared the following pharmaceuticals and/or medical device for the use described in this presentation. The following pharmaceuticals and/or medical device are being discussed for an off-label use: Anika Therapeutics, HyaloFast; Geistlich Pharma AG, Chondro-Gide

Summary

The comparison of chondral reconstruction in patellofemoral joint with two types of scaffolds (ChondroGide vs HyaloFast) using dry arthroscopy technique revealed that each group of patient had statistically significant improvement, but it was no statistically significant differences between two groups.

Abstract

Purpose

To compare the short-term clinical and radiological outcomes of cartilage repair using two different types of scaffolds, composed of either hyaluronic-acid or type I/III collagen, in arthroscopic treatment of patients with patellofemoral chondral lesions.

Methods

and Materials

Nineteen physically active patients with cartilage lesions of the patellofemoral joint were treated with 1 of 2 scaffold types. Eleven patients underwent dry arthroscopic implantation of a bilayer type I/III collagen scaffold (Chondro-Gide), and 8 with a hyaluronic acid-based scaffold (HyaloFast). Patients were prospectively followed for a minimum of 2 years postoperatively. Patient-reported instruments to assess clinical outcome at 2-year follow-up consisted of the Visual Analog Scale (VAS), International Knee Documentation Committee (IKDC) subjective score, Tegner Activity Scale, and Lysholm Knee Questionnaire. All patients had MRI evaluation preoperatively and 1 year postoperatively. Cartilage repair tissue was evaluated using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score.

Results

Patient age and size of cartilage lesion were similar between the treatment groups, with a cohort mean age of 33.9 years (range 20 to 53 years), and a mean lesion size of 2.5 cm2 (range 0.84 to 4.6 cm2). Patient-reported outcome scores were significantly improved at 2-year follow-up compared to preoperative scores in both treatment groups (p<0.001), while no difference in final follow-up scores was identified between treatment groups. At final follow-up, comparative mean VAS, IKDC subjective, Tegner, and Lysholm scores in the Hyalofast vs Chondro-Gide treatment groups were 1.3 vs 2.5 (p=0.192), 80.3 vs 79.6 (p=0.869), 5.8 vs 5.5 (p=0.524), and 80.6 vs 89.1 (p=0.340). The mean MOCART score in the HyaloFast treatment group was 72.5, compared to 60.0 in the Chondro-Gide group (p=0.106).

Conclusion

Good to excellent short-term clinical and radiological outcomes of cartilage repair of patellofemoral defects may be achieved using arthroscopic implantation of scaffolding composed of either hyaluronic acid or type I/III collagen.