title: Tibial plateau lesions. Surface reconstruction with a biomimetic osteochondral scaffold: Results at 2 years of follow-up.
abstract: BACKGROUND
  Tibial plateau articular pathology caused by post-traumatic or degenerative lesions is a challenge for the orthopaedic surgeon and can lead to early osteoarthritis. The aim of the present study was to evaluate the results of treatment of these complex defects with implantation of an osteochondral scaffold, which is designed to target the cartilage surface and to reconstruct joint anatomy by addressing the entire osteochondral unit.
  
  
  METHODS
  Eleven patients (5 female and 6 male) with a mean age of 37.3 ± 11.0 years and osteochondral lesions of the tibial plateau (mean 5.1 ± 2.7 cm(2); range 3.0-12.5 cm(2)) were treated with the implantation of an osteochondral biomimetic collagen-hydroxyapatite scaffold (Maioregen(®), Fin-Ceramica, Faenza, Italy). Comorbidities were addressed taking care to restore the correct limb alignment. Patients were evaluated pre-operatively and prospectively followed-up for 2 years using the International Knee Documentation Committee (IKDC) subjective and objective scores; activity level was documented using the Tegner score.
  
  
  RESULTS
  Three patients experienced minor adverse events. No patients required further surgery for treatment failure during the study follow-up period, and 8 patients (72.7%) reported a marked improvement. The IKDC subjective score improved from 42.5 ± 10.2 before treatment to 69.8 ± 19.0 at 12 months (p<0.05), with stable results at 24 months. The IKDC objective score increased from 27.3% normal and nearly normal knees before treatment to 85.7% normal and nearly normal knees at 24 months of follow-up. The Tegner score increased from 2.3 ± 2.1 before treatment to 4.8 ± 2.4 at 12 months (p<0.05), and was stable at the final follow-up.
  
  
  CONCLUSIONS
  The present study on the implantation of an osteochondral scaffold for the treatment of tibial plateau lesions showed a promising clinical outcome at short-term follow-up, which indicates that this procedure can be considered as a possible treatment option, even in these complex defects, when comorbidities are concomitantly addressed.
authors.affiliation: Nano-Biotechnology Laboratory, II Orthopaedic Clinic, Rizzoli Orthopaedic Institute, Via di Barbiano 1/10, 40136 Bologna, Italy. Electronic address: e.kon@biomec.ior.it.
authors.forename: Elizaveta
authors.initials: E
authors.lastname: Kon
authors.affiliation: Nano-Biotechnology Laboratory, II Orthopaedic Clinic, Rizzoli Orthopaedic Institute, Via di Barbiano 1/10, 40136 Bologna, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Filardo
authors.affiliation: Biomechanics Laboratory, II Orthopaedic Clinic, Rizzoli Orthopaedic Institute, Via di Barbiano 1/10, 40136 Bologna, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Venieri
authors.affiliation: Biomechanics Laboratory, II Orthopaedic Clinic, Rizzoli Orthopaedic Institute, Via di Barbiano 1/10, 40136 Bologna, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Perdisa
authors.affiliation: Biomechanics Laboratory, II Orthopaedic Clinic, Rizzoli Orthopaedic Institute, Via di Barbiano 1/10, 40136 Bologna, Italy.
authors.forename: Maurilio
authors.initials: M
authors.lastname: Marcacci
mesh_terms: D000328:Adult; D040761:Biomimetic Materials; D024042:Collagen Type I; D005260:Female; D005500:Follow-Up Studies; D048091:Guided Tissue Regeneration / Q000379:methods*; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000473:pathology*; D008297:Male; D049329:Nanostructures; D011446:Prospective Studies; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D054457:Tissue Scaffolds; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D024042:Collagen Type I
keywords: Biomimetic scaffold; Cartilage; Joint reconstruction; Osteochondral lesion; Tibial plateau