title: Use of innovative biomimetic scaffold in the treatment for large osteochondral lesions of the knee.
abstract: OBJECTIVE
  Large osteochondral defects involve two different tissues characterized by different intrinsic healing capacity. Different techniques have been proposed to treat these lesions with results still under discussion. The aim of the study is to evaluate the clinical outcome of 19 patients treated with a type I collagen-hydroxyapatite nanostructural biomimetic osteochondral scaffold at minimum follow-up of 2 years.
  
  
  METHODS
  Twenty lesions, 19 patients were treated with this scaffold implantation. The lesions size went from 4 to 8 cm(2) (mean size 5.2 ± 1.6 cm(2)). All patients were clinically evaluated using the International Repair Cartilage Society score, the Tegner Score and EQ-VAS. MRI was performed at 12 and 24 months after surgery and then every 12 months and evaluated with magnetic resonance observation of cartilage repair tissue scoring scale.
  
  
  RESULTS
  The IKDC subjective score improved from a mean score of 35.7 ± 6.3 at the baseline evaluation to 67.7 ± 13.4 at 12-month follow-up (p < 0.0005). A further improvement was documented from 12 to 24 months (mean score of 72.9 ± 12.4 at 24 months) (p < 0.0005). The IKDC objective score confirmed the results. The Tegner activity score improvement was statistically significant (p < 0.0005). The EQ-VAS showed a significant improvement from 3.15 ± 1.09 to 7.35 ± 1.14 (p < 0.0005) at 2-year follow-up. The lesion' site seems to influence the results showing a better outcome in the patients affected in the medial femoral condyle.
  
  
  CONCLUSIONS
  The use of the MaioRegen scaffold is a good procedure for the treatment for large osteochondral defects where other classic techniques are difficult to apply. It is an open one-step surgery with promising stable results at medium follow-up.
  
  
  METHODS
  IV.
authors.affiliation: University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Delcogliano
authors.forename: Francesca
authors.initials: F
authors.lastname: de Caro
authors.forename: Edoardo
authors.initials: E
authors.lastname: Scaravella
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ziveri
authors.forename: Carlo Felice
authors.initials: CF
authors.lastname: De Biase
authors.forename: Domenico
authors.initials: D
authors.lastname: Marotta
authors.forename: Pietro
authors.initials: P
authors.lastname: Marenghi
authors.forename: Antonio
authors.initials: A
authors.lastname: Delcogliano
mesh_terms: D000293:Adolescent; D000328:Adult; D040761:Biomimetic Materials; D001847:Bone Diseases / Q000601:surgery*; D002357:Cartilage Diseases / Q000601:surgery*; D002358:Cartilage, Articular / Q000601:surgery*; D024042:Collagen Type I / Q000008:administration & dosage; D017886:Durapatite / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D049329:Nanostructures; D011446:Prospective Studies; D054457:Tissue Scaffolds; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult
chemical_list: D024042:Collagen Type I; D017886:Durapatite