title: Successful osteoconduction but limited cartilage tissue quality following osteochondral repair by a cell-free multilayered nano-composite scaffold at the knee.
abstract: BACKGROUND
  The treatment of larger osteochondral lesions in the knee is still a clinical challenge. One promising strategy to overcome this problem could be surgical repair by using a cell-free multilayered nano-composite scaffold.
  
  
  METHODS
  In this prospective cohort study eight consecutive patients which suffered from a single osteochondral lesion (≥1.5 cm(2)) on the femoral condyle were enrolled. The repair potential of the implant was assessed by using MRI based biochemical MR sequences (T2 mapping) as well as semi-quantitative morphological analyses (MOCART score) at 18 months after the surgery. The clinical outcome was determined at six, 12, 18, and 24 month follow ups by using IKDC, Tegner-Lysholm, and Cincinnati knee scores.
  
  
  RESULTS
  Seven out of eight patients showed a complete integration of the scaffold into the border zone and five out of eight patients excellent or good subchondral ossification of the implant at 18 months following implantation. The surface of the repair tissue was found to be intact in all eight patients. T2 mapping data and the zonal T2 index significantly differed in the repair tissue compared to the healthy control cartilage (P < 0.001) which indicates a limited quality of the repair cartilage. The clinical outcome scores consistently improved during the follow up period without reaching statistical significance.
  
  
  CONCLUSIONS
  Osteochondral repair by implanting the MaioRegen® scaffold provides a successful osteoconduction and filling of the cartilage defect. However there is evidence for a limited repair cartilage tissue quality at 18 months after the surgery.
authors.affiliation: Centre of Excellence "High-field Magnetic Resonance (MR)", Medical University Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Brix
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Barmherzige Brüder Hospital, Johannes von Gott-Platz 1, A-7000, Eisenstadt, Austria. martin.kaipel@ortho-sued.at.
authors.forename: Martin
authors.initials: M
authors.lastname: Kaipel
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Barmherzige Brüder Hospital, Johannes von Gott-Platz 1, A-7000, Eisenstadt, Austria.
authors.forename: Richard
authors.initials: R
authors.lastname: Kellner
authors.affiliation: Centre of Excellence "High-field Magnetic Resonance (MR)", Medical University Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria.
authors.forename: Markus
authors.initials: M
authors.lastname: Schreiner
authors.affiliation: Department of Orthopaedics, Medical University Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Apprich
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Barmherzige Brüder Hospital, Johannes von Gott-Platz 1, A-7000, Eisenstadt, Austria.
authors.forename: Harald
authors.initials: H
authors.lastname: Boszotta
authors.affiliation: Department of Orthopaedics, Medical University Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Windhager
authors.affiliation: Centre of Excellence "High-field Magnetic Resonance (MR)", Medical University Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria.
authors.forename: Stephan
authors.initials: S
authors.lastname: Domayer
authors.affiliation: Centre of Excellence "High-field Magnetic Resonance (MR)", Medical University Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Trattnig
mesh_terms: D000293:Adolescent; D000328:Adult; D001861:Bone Regeneration; D002357:Cartilage Diseases / Q000473:pathology / Q000601:surgery*; D002358:Cartilage, Articular / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D005269:Femur / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D053761:Nanocomposites / Q000627:therapeutic use*; D011446:Prospective Studies; D054457:Tissue Scaffolds; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult
keywords: Knee; Osteochondral lesions; Osteochondral repair; Scaffold