Treatment of multiple and single articular cartilage defects using multi-layer collagen-hydroxyapatite scaffolds with bone marrow stimulation
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2020-11-19 |
Surgery
The Conference is organized by the Student’s Scientific Society of Lithuanian University of Health Sciences The content of the abstract book is redacted. The Student’s Scientific Society of Lithuanian University of Health Sciences did not have control over the abstracts. The authors remain responsible for the content of their respective abstracts. All abstracts presented in the conference were reviewed.
Introduction Articular cartilage (AC) defects can often be difficult to diagnose and treat. Damaged AC usually does not regenerate on its own, and without treatment it is likely to progress to osteoarthrosis (OA), which is expensive to manage and leads to total joint arthroplasty. In most cases AC defects are treated using microfracture procedure; it is known that after microfractures only 1-3% of cells are capable of regeneration. Recently, multi-layer collagen scaffolds with bone marrow stimulation (BMS+S) is gaining popularity however, there is little evidence of this treatment effectiveness. Advanced cellular therapy is expensive and not covered by the National health insurance fund (NHIF) therefore, analysis of treatment effectiveness is important in determining correct indications for this type of treatment. Aim To compare BMS+S with Bone marrow stimulation (BMS) alone for treating multiple and single AC defects. Methods In a retrospective study, comparisons between clinical approaches for BMS+S (35 patients) and only BMS (40 patients) were performed for treatment of single and multiple AC lesions. The study included 75 patients who underwent surgery at LSMUL KK OT Clinic in the period between 2010 and 2018. In combination with these techniques patients who underwent High Tibial Osteotomy (HTO) and Anterior Cruciate Ligament reconstruction (ACLr) were also included in the study. Patients in BMS+S group were treated with bone marrow stimulation (S) and MaioRegen Chondro+ multi-layer collagenhydroxyapatite scaffold. Based on the complexity of reconstructions, 7 groups were distinguished for final evaluation: 1- BMS+S; 2- BMS+S+HTO; 3- BMS+S+ACLr, 4- BMS+S+MPFLr; 5- BMS; 6- BMS+HTO; 7- BMS+ACLr. Results were evaluated based on the ICRS questionnaire and in some cases, a control MRI. Mean period of assessment in the BMR+S group was 9.5 months (8-24 m.), and 6.8 years (2-8 y.) in the BMS group. Pre-operati... [...].