title: Treatment of osteochondritis dissecans of the knee with a biomimetic scaffold. A prospective multicenter study.
abstract: OBJECTIVE
  the aim of the present study was to evaluate the clinical outcome of the treatment of osteochondritis dissecans (OCD) of the knee with a type-I collagen-hydroxyapatite nanostructural biomimetic osteochondral scaffold.
  
  
  METHODS
  twenty-three patients affected by symptomatic knee OCD of the femoral condyles, grade 3 or 4 of the International Cartilage Repair Society (ICRS) scale, underwent biomimetic scaffold implantation. The site of the defect was the medial femoral condyle in 14 patients, whereas in 9 patients the lateral femoral condyle was involved. The average size of the defects was 3.5±1.43 cm(2). All patients were clinically evaluated using the ICRS subjective score, the IKDC objective score, the EQ-VAS and the Tegner Activity Score. Minimum follow-up was two years. MRI was performed at 12 and 24 months after surgery and then every 12 months thereafter.
  
  
  RESULTS
  the ICRS subjective score improved from the baseline value of 50.93±20.6 to 76.44±18.03 at the 12 months (p<0.0005) and 82.23± 17.36 at the two-year follow-up (p<0.0005). The IKDC objective score confirmed the results. The EQ-VAS showed a significant improvement from 3.15±1.09 to 8.15±1.04 (p<0.0005) at two years of follow-up. The Tegner Activity Score improvement was statistically significant (p<0.0005).
  
  
  CONCLUSIONS
  biomimetic scaffold implantation was a good procedure for treating grade 3 and 4 OCD, in which other classic techniques are burdened by different limitations. This open one-step surgery gave promising stable results at short-term follow-up.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Catholic University, Department of Orthopaedics, "A. Gemelli" University Hospital, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Delcogliano
authors.affiliation: Catholic University, Department of Orthopaedics, "A. Gemelli" University Hospital, Rome, Italy.
authors.forename: Amerigo
authors.initials: A
authors.lastname: Menghi
authors.affiliation: Catholic University, Department of Orthopaedics, "A. Gemelli" University Hospital, Rome, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Placella
authors.affiliation: Catholic University, Department of Orthopaedics, "A. Gemelli" University Hospital, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Speziali
authors.affiliation: Catholic University, Department of Orthopaedics, "A. Gemelli" University Hospital, Rome, Italy.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Cerulli
authors.affiliation: Gaetano Pini Orthopedic Institute, Milan, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Carimati
authors.affiliation: Gaetano Pini Orthopedic Institute, Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Pasqualotto
authors.affiliation: Gaetano Pini Orthopedic Institute, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Berruto
keywords: cartilage; knee; ostechondritis dissecans; osteochondral lesions; scaffold