The Experts below are selected from a list of 141 Experts worldwide ranked by ideXlab platform
Giuseppe Filardo - One of the best experts on this subject based on the ideXlab platform.
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cell free Osteochondral Scaffold for the treatment of focal articular cartilage defects in early knee oa 5 years follow up results
Journal of Clinical Medicine, 2019Co-Authors: Andrea Sessa, Alessandro Di Martino, Stefano Zaffagnini, Luca Andriolo, Iacopo Romandini, Roberto De Filippis, Giuseppe FilardoAbstract:The purpose of this study was to investigate the clinical results at five years’ follow-up of a tri-layered nanostructured biomimetic Osteochondral Scaffold used for focal articular cartilage defects in patients meeting the criteria of early osteoarthritis (EOA). The study population comprised 22 patients (mean age: 39 years), prospectively assessed before surgery, at 24 and 60 months’ follow-up. Inclusion criteria were: at least two episodes of knee pain for more than 10 days in the last year, Kellgren-Lawrence OA grade 0, I or II and arthroscopic or MRI findings according to the European Society of Sports Traumatology, Knee Surgery & Arthroscopy (ESSKA) criteria. Clinical results demonstrated significant improvement in International Knee Documentation Committee (IKDC) subjective and objective scores and in Tegner score, although activity level never reached the pre-injury level. The complication rate of this study was 8.3%. Two patients underwent re-operation (8.3%), while a comprehensive definition of failure (including both surgical and clinical criteria) identified four failed patients (16.6%) at this mid-term follow-up evaluation. The use of a free-cell Osteochondral Scaffold represented a safe and valid alternative for the treatment of focal articular cartilage defects in the setting of an EOA, and was able to permit a significant clinical improvement and stable outcome with low complication and failure rates.
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Treatment of unstable knee osteochondritis dissecans in the young adult: results and limitations of surgical strategies-The advantages of allografts to address an Osteochondral challenge
Knee Surgery Sports Traumatology Arthroscopy, 2019Co-Authors: Giuseppe Filardo, Luca Andriolo, Peter Verdonk, Massimo Berruto, Paolo Ferrua, Francesc Soler, Frédéric Rongieras, Dennis C. CrawfordAbstract:Joint surface incongruence resulting from osteochondritis dissecans (OCD) alters the articular physiologic congruence, increasing the contact stress on adjacent joint surfaces and accelerating wear and the cascade of joint degeneration. Accordingly, the restoration of articular surface integrity is of major importance, especially in young adults where, in lesions left untreated or following simple fragment excision, early osteoarthritis can be anticipated. Therefore, the treatment algorithm in unstable knee OCD of the young adult foresees surgical options to restore the articular surface. Several procedures have been proposed, including refixation of the detached fragment bone marrow stimulation, Osteochondral autograft implantation, fresh Osteochondral allograft transplantation, and cell-based or cell-free regenerative techniques. The aim of this review was to summarize the evidence for these surgical strategies, reporting their results and limitations. The overall evidence documents positive results for each of the assorted surgical procedures applied to treat unstable OCD, thus indicating support for their selected use to treat Osteochondral defects paying particular attention to their specific indications for the lesion characteristics. The fixation of a good quality fragment should be pursued as a first option, while unfixable small lesions may benefit from autografts. For large lesions, available cell-based or cell-free Osteochondral Scaffold are a feasible solution but with limitation in terms of regenerated tissue quality. In this light, fresh allografts may offer articular surface restoration with viable physiologic Osteochondral tissue providing a predictably successful outcome, and therefore they may currently represent the most suitable option to treat unstable irreparable OCD lesion in young adults. LEVEL OF EVIDENCE: V.
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cartilage and bone serum biomarkers as novel tools for monitoring knee osteochondritis dissecans treated with Osteochondral Scaffold
BioMed Research International, 2018Co-Authors: Elena Gabusi, Giuseppe Filardo, Elizaveta Kon, Francesca Paolella, Cristina Manferdini, Laura Gambari, Erminia Mariani, Gina LisignoliAbstract:Knee osteochondritis dissecans (OCD) is a focal disease of the joint characterized by modifications of bone and cartilage tissues. Biomimetic Osteochondral Scaffolds are used to restore these tissues. The aim of this prognostic prospective cohort study was to evaluate serum biomarkers of cartilage (fragments or propeptide of type II collagen: CTXII, C2C, and CPII) and bone (tartrate-resistant acid phosphatase (TRAP) 5b and osteocalcin (OC)) turnover during follow-up of patients treated with an Osteochondral Scaffold, to identify which were related to healing outcome and clinical score. We found that cartilage (CPII) and bone (OC) synthetic biomarkers were significantly increased during the first-year follow-up, while the respective degradative markers (CTXII, C2C, and TRAP5b) were not modulated. Only CTXII/CPII and C2C/CPII cartilage ratios were significantly modulated, evidencing a higher remodeling of cartilage compared to bone tissue. Cartilage and bone single biomarkers or ratios at one-year follow-up showed values close to or similar to those of healthy subjects. International Knee Documentation Committee (IKDC) score significantly increased from T0 to T2, while the Tegner score did not. Taking into consideration an IKDC score > 70 as clinical success, we found that all OCD cases with both CPII (> 300 pg/ml) and C2C/CPII (<0.35) presented IKDC scores of clinical success. OCD patients treated with an Osteochondral Scaffold showed an improvement at one-year follow-up, evidenced by both clinical and serum cartilage biomarkers. These data confirmed that cartilage and bone remodeling took place and showed that systemic biomarkers represent a sensitive tool for monitoring OCD patients during the follow-up.
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treatment of knee osteochondritis dissecans with a cell free biomimetic Osteochondral Scaffold clinical and imaging findings at midterm follow up
American Journal of Sports Medicine, 2018Co-Authors: Francesco Perdisa, Maurilio Marcacci, Elizaveta Kon, Andrea Sessa, Luca Andriolo, Maurizio Busacca, Giuseppe FilardoAbstract:Background:Osteochondritis dissecans (OCD) is a developmental condition of subchondral bone that may result in secondary separation and instability of the overlying articular cartilage, which in tu...
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Cartilage and Bone Serum Biomarkers as Novel Tools for Monitoring Knee Osteochondritis Dissecans Treated with Osteochondral Scaffold
Hindawi Limited, 2018Co-Authors: Elena Gabusi, Giuseppe Filardo, Elizaveta Kon, Francesca Paolella, Cristina Manferdini, Laura Gambari, Erminia Mariani, Gina LisignoliAbstract:Knee osteochondritis dissecans (OCD) is a focal disease of the joint characterized by modifications of bone and cartilage tissues. Biomimetic Osteochondral Scaffolds are used to restore these tissues. The aim of this prognostic prospective cohort study was to evaluate serum biomarkers of cartilage (fragments or propeptide of type II collagen: CTXII, C2C, and CPII) and bone (tartrate-resistant acid phosphatase (TRAP) 5b and osteocalcin (OC)) turnover during follow-up of patients treated with an Osteochondral Scaffold, to identify which were related to healing outcome and clinical score. We found that cartilage (CPII) and bone (OC) synthetic biomarkers were significantly increased during the first-year follow-up, while the respective degradative markers (CTXII, C2C, and TRAP5b) were not modulated. Only CTXII/CPII and C2C/CPII cartilage ratios were significantly modulated, evidencing a higher remodeling of cartilage compared to bone tissue. Cartilage and bone single biomarkers or ratios at one-year follow-up showed values close to or similar to those of healthy subjects. International Knee Documentation Committee (IKDC) score significantly increased from T0 to T2, while the Tegner score did not. Taking into consideration an IKDC score > 70 as clinical success, we found that all OCD cases with both CPII (> 300 pg/ml) and C2C/CPII (
Maurilio Marcacci - One of the best experts on this subject based on the ideXlab platform.
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treatment of knee osteochondritis dissecans with a cell free biomimetic Osteochondral Scaffold clinical and imaging findings at midterm follow up
American Journal of Sports Medicine, 2018Co-Authors: Francesco Perdisa, Maurilio Marcacci, Elizaveta Kon, Andrea Sessa, Luca Andriolo, Maurizio Busacca, Giuseppe FilardoAbstract:Background:Osteochondritis dissecans (OCD) is a developmental condition of subchondral bone that may result in secondary separation and instability of the overlying articular cartilage, which in tu...
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one step treatment for patellar cartilage defects with a cell free Osteochondral Scaffold a prospective clinical and mri evaluation
American Journal of Sports Medicine, 2017Co-Authors: Francesco Perdisa, Giuseppe Filardo, Maurilio Marcacci, Stefano Zaffagnini, Andrea Sessa, Maurizio Busacca, Elizaveta KonAbstract:Background:The treatment of symptomatic cartilage defects of the patella is particularly challenging, and no gold standard is currently available.Purpose:To evaluate the clinical results of a biphasic cell-free collagen-hydroxyapatite Scaffold and to evaluate Osteochondral tissue regeneration with magnetic resonance imaging (MRI).Study Design:Case series; Level of evidence, 4.Methods:Thirty-four patients (18 men and 16 women; mean ± SD: age, 30.0 ± 10 years) were treated by Scaffold implantation for knee chondral or Osteochondral lesions of the patella (area, 2.1 ± 1 cm2). The clinical evaluation was performed prospectively at 12 and 24 months via the IKDC (International Knee Documentation Committee; objective and subjective) and Tegner scores. MRI evaluation was performed at both follow-ups in 18 lesions through the MOCART score (magnetic resonance observation of cartilage repair tissue) and specific subchondral bone parameters.Results:A statistically significant improvement in all the scores was observe...
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surgical treatment of early knee osteoarthritis with a cell free Osteochondral Scaffold results at 24 months of follow up
Injury-international Journal of The Care of The Injured, 2015Co-Authors: Alessandro Di Martino, Giuseppe Filardo, Elizaveta Kon, Francesco Perdisa, Andrea Sessa, M P Neri, Laura Bragonzoni, Maurilio MarcacciAbstract:Abstract Purpose “Early Osteoarthritis (EOA)” has been defined combining clinical, imaging and surgical parameters, with the aim to identify patients in early degenerative phases, who might benefit from the use of available regenerative procedures. Aim of this first clinical trial is to prospectively evaluate the results obtained in a group of patients meeting the inclusion criteria of “EOA” as proposed by the ESSKA Cartilage Committee, and surgically treated with the implantation of a multi-phasic Osteochondral Scaffold. Methods 23 patients were prospectively evaluated at 12 and 24 months of follow-up. Etiology of the chondral or Osteochondral defect was rated as microtraumatic or degenerative in 18 cases, and traumatic in 5 cases. Patients included were complaining of clinical symptoms like knee pain and affected by chondral and Osteochondral lesions located at the femoral condyles or trochlea and MRI findings demonstrating articular cartilage degeneration and/or meniscal degeneration and/or subchondral bone marrow lesions. Results All patients increased significantly in any clinical score adopted. The IKDC subjective score increased from 42.8 ± 13.8 at basal evaluation to 74.3 ± 17.4 at 12 months' (p Conclusions The implantation of a multi-phasic Osteochondral Scaffold represents a good option after failure of conservative management for Early OA patients, where younger age represent an important factor for a better outcome. Longer follow-up is needed to evaluate the benefit over time. Level of evidence IV, case series.
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tibial plateau lesions surface reconstruction with a biomimetic Osteochondral Scaffold results at 2 years of follow up
Injury-international Journal of The Care of The Injured, 2014Co-Authors: Elizaveta Kon, Giuseppe Filardo, Francesco Perdisa, Giulia Venieri, Maurilio MarcacciAbstract:Abstract Introduction 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. Materials and 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 p Conclusion 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.
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fibrin glue improves Osteochondral Scaffold fixation study on the human cadaveric knee exposed to continuous passive motion
Osteoarthritis and Cartilage, 2014Co-Authors: Giuseppe Filardo, Elizaveta Kon, Francesco Perdisa, Matej Drobnic, M Hribernik, Maurilio MarcacciAbstract:Summary Objective To evaluate stability and integrity of bi-layer and three-layer collagen-hydroxyapatite (C-HA) Osteochondral Scaffolds in a human cadaveric knee exposed to continuous passive motion (CPM) with and without loading and the role of added fibrin glue to improve the press-fit fixation of C-HA Scaffolds. Design Osteochondral lesions (2.0 × 1.5 cm) were chiseled out on both condyles and trochlea in eight human cadaveric knees. A total of 24 bi-layer (5 mm, four in each condyle) or three-layer C-HA Scaffolds (8 mm, eight in the trochlea, four in each condyle) were first press-fit implanted and underwent testing with CPM, 90 cycles, 0°–90°. The second set of 24 Scaffolds was implanted in cleaned lesions with the addition of fibrin glue. Two knees with fibrin glue fixation were additionally exposed to 15 kg loading, with 30 cycles of CPM, 0°–30°. Then, the knees were reopened and the Scaffolds were evaluated using semi-quantitative Drobnic and modified Bekkers scores. Results All but two Scaffolds remained in the lesions site throughout CPM. Two implants failed: both were bi-layer Osteochondral Scaffolds, press-fit implanted at the lateral femoral condyle (LFC). A statistically significant difference was obtained between press-fit and fibrin glue implants with both Drobnic (2.9 ± 0.7 vs 4.3 ± 0.1, P P Conclusion This cadaveric study showed fibrin glue notably improved bi-layer or three-layer C-HA Scaffold press-fit fixation regardless of lesion location. It is therefore recommended that fibrin glue be used during surgery to improve early post-operative C-HA Scaffold stability and integrity.
Elizaveta Kon - One of the best experts on this subject based on the ideXlab platform.
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cartilage and bone serum biomarkers as novel tools for monitoring knee osteochondritis dissecans treated with Osteochondral Scaffold
BioMed Research International, 2018Co-Authors: Elena Gabusi, Giuseppe Filardo, Elizaveta Kon, Francesca Paolella, Cristina Manferdini, Laura Gambari, Erminia Mariani, Gina LisignoliAbstract:Knee osteochondritis dissecans (OCD) is a focal disease of the joint characterized by modifications of bone and cartilage tissues. Biomimetic Osteochondral Scaffolds are used to restore these tissues. The aim of this prognostic prospective cohort study was to evaluate serum biomarkers of cartilage (fragments or propeptide of type II collagen: CTXII, C2C, and CPII) and bone (tartrate-resistant acid phosphatase (TRAP) 5b and osteocalcin (OC)) turnover during follow-up of patients treated with an Osteochondral Scaffold, to identify which were related to healing outcome and clinical score. We found that cartilage (CPII) and bone (OC) synthetic biomarkers were significantly increased during the first-year follow-up, while the respective degradative markers (CTXII, C2C, and TRAP5b) were not modulated. Only CTXII/CPII and C2C/CPII cartilage ratios were significantly modulated, evidencing a higher remodeling of cartilage compared to bone tissue. Cartilage and bone single biomarkers or ratios at one-year follow-up showed values close to or similar to those of healthy subjects. International Knee Documentation Committee (IKDC) score significantly increased from T0 to T2, while the Tegner score did not. Taking into consideration an IKDC score > 70 as clinical success, we found that all OCD cases with both CPII (> 300 pg/ml) and C2C/CPII (<0.35) presented IKDC scores of clinical success. OCD patients treated with an Osteochondral Scaffold showed an improvement at one-year follow-up, evidenced by both clinical and serum cartilage biomarkers. These data confirmed that cartilage and bone remodeling took place and showed that systemic biomarkers represent a sensitive tool for monitoring OCD patients during the follow-up.
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treatment of knee osteochondritis dissecans with a cell free biomimetic Osteochondral Scaffold clinical and imaging findings at midterm follow up
American Journal of Sports Medicine, 2018Co-Authors: Francesco Perdisa, Maurilio Marcacci, Elizaveta Kon, Andrea Sessa, Luca Andriolo, Maurizio Busacca, Giuseppe FilardoAbstract:Background:Osteochondritis dissecans (OCD) is a developmental condition of subchondral bone that may result in secondary separation and instability of the overlying articular cartilage, which in tu...
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Cartilage and Bone Serum Biomarkers as Novel Tools for Monitoring Knee Osteochondritis Dissecans Treated with Osteochondral Scaffold
Hindawi Limited, 2018Co-Authors: Elena Gabusi, Giuseppe Filardo, Elizaveta Kon, Francesca Paolella, Cristina Manferdini, Laura Gambari, Erminia Mariani, Gina LisignoliAbstract:Knee osteochondritis dissecans (OCD) is a focal disease of the joint characterized by modifications of bone and cartilage tissues. Biomimetic Osteochondral Scaffolds are used to restore these tissues. The aim of this prognostic prospective cohort study was to evaluate serum biomarkers of cartilage (fragments or propeptide of type II collagen: CTXII, C2C, and CPII) and bone (tartrate-resistant acid phosphatase (TRAP) 5b and osteocalcin (OC)) turnover during follow-up of patients treated with an Osteochondral Scaffold, to identify which were related to healing outcome and clinical score. We found that cartilage (CPII) and bone (OC) synthetic biomarkers were significantly increased during the first-year follow-up, while the respective degradative markers (CTXII, C2C, and TRAP5b) were not modulated. Only CTXII/CPII and C2C/CPII cartilage ratios were significantly modulated, evidencing a higher remodeling of cartilage compared to bone tissue. Cartilage and bone single biomarkers or ratios at one-year follow-up showed values close to or similar to those of healthy subjects. International Knee Documentation Committee (IKDC) score significantly increased from T0 to T2, while the Tegner score did not. Taking into consideration an IKDC score > 70 as clinical success, we found that all OCD cases with both CPII (> 300 pg/ml) and C2C/CPII (
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one step treatment for patellar cartilage defects with a cell free Osteochondral Scaffold a prospective clinical and mri evaluation
American Journal of Sports Medicine, 2017Co-Authors: Francesco Perdisa, Giuseppe Filardo, Maurilio Marcacci, Stefano Zaffagnini, Andrea Sessa, Maurizio Busacca, Elizaveta KonAbstract:Background:The treatment of symptomatic cartilage defects of the patella is particularly challenging, and no gold standard is currently available.Purpose:To evaluate the clinical results of a biphasic cell-free collagen-hydroxyapatite Scaffold and to evaluate Osteochondral tissue regeneration with magnetic resonance imaging (MRI).Study Design:Case series; Level of evidence, 4.Methods:Thirty-four patients (18 men and 16 women; mean ± SD: age, 30.0 ± 10 years) were treated by Scaffold implantation for knee chondral or Osteochondral lesions of the patella (area, 2.1 ± 1 cm2). The clinical evaluation was performed prospectively at 12 and 24 months via the IKDC (International Knee Documentation Committee; objective and subjective) and Tegner scores. MRI evaluation was performed at both follow-ups in 18 lesions through the MOCART score (magnetic resonance observation of cartilage repair tissue) and specific subchondral bone parameters.Results:A statistically significant improvement in all the scores was observe...
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surgical treatment of early knee osteoarthritis with a cell free Osteochondral Scaffold results at 24 months of follow up
Injury-international Journal of The Care of The Injured, 2015Co-Authors: Alessandro Di Martino, Giuseppe Filardo, Elizaveta Kon, Francesco Perdisa, Andrea Sessa, M P Neri, Laura Bragonzoni, Maurilio MarcacciAbstract:Abstract Purpose “Early Osteoarthritis (EOA)” has been defined combining clinical, imaging and surgical parameters, with the aim to identify patients in early degenerative phases, who might benefit from the use of available regenerative procedures. Aim of this first clinical trial is to prospectively evaluate the results obtained in a group of patients meeting the inclusion criteria of “EOA” as proposed by the ESSKA Cartilage Committee, and surgically treated with the implantation of a multi-phasic Osteochondral Scaffold. Methods 23 patients were prospectively evaluated at 12 and 24 months of follow-up. Etiology of the chondral or Osteochondral defect was rated as microtraumatic or degenerative in 18 cases, and traumatic in 5 cases. Patients included were complaining of clinical symptoms like knee pain and affected by chondral and Osteochondral lesions located at the femoral condyles or trochlea and MRI findings demonstrating articular cartilage degeneration and/or meniscal degeneration and/or subchondral bone marrow lesions. Results All patients increased significantly in any clinical score adopted. The IKDC subjective score increased from 42.8 ± 13.8 at basal evaluation to 74.3 ± 17.4 at 12 months' (p Conclusions The implantation of a multi-phasic Osteochondral Scaffold represents a good option after failure of conservative management for Early OA patients, where younger age represent an important factor for a better outcome. Longer follow-up is needed to evaluate the benefit over time. Level of evidence IV, case series.
Alessandro Di Martino - One of the best experts on this subject based on the ideXlab platform.
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cell free Osteochondral Scaffold for the treatment of focal articular cartilage defects in early knee oa 5 years follow up results
Journal of Clinical Medicine, 2019Co-Authors: Andrea Sessa, Alessandro Di Martino, Stefano Zaffagnini, Luca Andriolo, Iacopo Romandini, Roberto De Filippis, Giuseppe FilardoAbstract:The purpose of this study was to investigate the clinical results at five years’ follow-up of a tri-layered nanostructured biomimetic Osteochondral Scaffold used for focal articular cartilage defects in patients meeting the criteria of early osteoarthritis (EOA). The study population comprised 22 patients (mean age: 39 years), prospectively assessed before surgery, at 24 and 60 months’ follow-up. Inclusion criteria were: at least two episodes of knee pain for more than 10 days in the last year, Kellgren-Lawrence OA grade 0, I or II and arthroscopic or MRI findings according to the European Society of Sports Traumatology, Knee Surgery & Arthroscopy (ESSKA) criteria. Clinical results demonstrated significant improvement in International Knee Documentation Committee (IKDC) subjective and objective scores and in Tegner score, although activity level never reached the pre-injury level. The complication rate of this study was 8.3%. Two patients underwent re-operation (8.3%), while a comprehensive definition of failure (including both surgical and clinical criteria) identified four failed patients (16.6%) at this mid-term follow-up evaluation. The use of a free-cell Osteochondral Scaffold represented a safe and valid alternative for the treatment of focal articular cartilage defects in the setting of an EOA, and was able to permit a significant clinical improvement and stable outcome with low complication and failure rates.
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surgical treatment of early knee osteoarthritis with a cell free Osteochondral Scaffold results at 24 months of follow up
Injury-international Journal of The Care of The Injured, 2015Co-Authors: Alessandro Di Martino, Giuseppe Filardo, Elizaveta Kon, Francesco Perdisa, Andrea Sessa, M P Neri, Laura Bragonzoni, Maurilio MarcacciAbstract:Abstract Purpose “Early Osteoarthritis (EOA)” has been defined combining clinical, imaging and surgical parameters, with the aim to identify patients in early degenerative phases, who might benefit from the use of available regenerative procedures. Aim of this first clinical trial is to prospectively evaluate the results obtained in a group of patients meeting the inclusion criteria of “EOA” as proposed by the ESSKA Cartilage Committee, and surgically treated with the implantation of a multi-phasic Osteochondral Scaffold. Methods 23 patients were prospectively evaluated at 12 and 24 months of follow-up. Etiology of the chondral or Osteochondral defect was rated as microtraumatic or degenerative in 18 cases, and traumatic in 5 cases. Patients included were complaining of clinical symptoms like knee pain and affected by chondral and Osteochondral lesions located at the femoral condyles or trochlea and MRI findings demonstrating articular cartilage degeneration and/or meniscal degeneration and/or subchondral bone marrow lesions. Results All patients increased significantly in any clinical score adopted. The IKDC subjective score increased from 42.8 ± 13.8 at basal evaluation to 74.3 ± 17.4 at 12 months' (p Conclusions The implantation of a multi-phasic Osteochondral Scaffold represents a good option after failure of conservative management for Early OA patients, where younger age represent an important factor for a better outcome. Longer follow-up is needed to evaluate the benefit over time. Level of evidence IV, case series.
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treatment of knee osteochondritis dissecans with a cell free biomimetic Osteochondral Scaffold clinical and imaging evaluation at 2 year follow up
American Journal of Sports Medicine, 2013Co-Authors: Giuseppe Filardo, Alessandro Di Martino, Maurizio Busacca, Giulio Altadonna, Maurilio MarcacciAbstract:Background:Osteochondritis dissecans (OCD) is an acquired lesion of the subchondral bone that may result in separation and instability of the overlying articular cartilage. Unstable lesions must be treated surgically to reestablish the joint surface as anatomically as possible.Hypothesis/Purpose:The aim of this study was to evaluate the potential of a biomimetic Osteochondral Scaffold to treat OCD by analyzing the results obtained at 2-year follow-up. The hypothesis was that this Scaffold, which was developed to treat the entire Osteochondral unit, might restore the articular surface and improve symptoms and function in patients affected by knee OCD.Study Design:Case series; Level of evidence, 4.Methods:Twenty-seven consecutive patients (19 men, 8 women; age [mean ± SD], 25.5 ± 7.7 years) who were affected by symptomatic knee OCD of the femoral condyles (average defect size 3.4 ± 2.2 cm2), grade 3 or 4 on the International Cartilage Repair Society (ICRS) scale, were enrolled and treated with the implantat...
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how to treat osteochondritis dissecans of the knee surgical techniques and new trends aaos exhibit selection
Journal of Bone and Joint Surgery American Volume, 2012Co-Authors: Francesca Vannini, Matteo Nanni, Alessandro Di Martino, Alberto Ruffilli, Roberto Buda, Marco Cavallo, Giuseppe Filardo, Maurilio Marcacci, Sandro GianniniAbstract:Background: Osteochondritis dissecans is a relatively common cause of knee pain. The aim of this study was to describe the outcomes of five different surgical techniques in a series of sixty patients with osteochondritis dissecans. Methods: Sixty patients (age 22.4 ± 7.4 years, sixty-two knees) with osteochondritis dissecans of a femoral condyle (forty-five medial and seventeen lateral) were treated with Osteochondral autologous transplantation, autologous chondrocyte implantation with bone graft, biomimetic nanostructured Osteochondral Scaffold (MaioRegen) implantation, bone-cartilage paste graft, or a “one-step” bone-marrow-derived cell transplantation technique. Preoperative and follow-up evaluation included the International Knee Documentation Committee (IKDC) score, the EuroQol visual analog scale (EQ-VAS) score, radiographs, and magnetic resonance imaging. Results: The global mean IKDC score improved from 40.1 ± 14.3 preoperatively to 77.2 ± 21.3 (p < 0.0005) at 5.3 ± 4.7 years of follow-up, and the EQ-VAS improved from 51.7 ± 17.0 to 83.5 ± 18.3 (p < 0.0005). No influence of age, lesion size, duration of follow-up, or previous surgical procedures on the result was found. The only difference among the results of the surgical procedures was a trend toward better results following autologous chondrocyte implantation (p = 0.06). Conclusions: All of the techniques were effective in achieving good clinical and radiographic results in patients with osteochondritis dissecans, and the effectiveness of autologous chondrocyte implantation was confirmed at a mean follow-up of five years. Newer techniques such as MaioRegen implantation and the “one-step” transplantation technique are based on different rationales; the first relies on the characteristics of the Scaffold and the second on the regenerative potential of mesenchymal cells. Both of these newer procedures have the advantage of being minimally invasive and requiring a single operation.
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how to treat osteochondritis dissecans of the knee surgical techniques and new trends aaos exhibit selection
Journal of Bone and Joint Surgery American Volume, 2012Co-Authors: Francesca Vannini, Matteo Nanni, Alessandro Di Martino, Alberto Ruffilli, Roberto Buda, Marco Cavallo, Giuseppe Filardo, Maurilio Marcacci, Sandro GianniniAbstract:Background: Osteochondritis dissecans is a relatively common cause of knee pain. The aim of this study was to describe the outcomes of five different surgical techniques in a series of sixty patients with osteochondritis dissecans. Methods: Sixty patients (age 22.4 ± 7.4 years, sixty-two knees) with osteochondritis dissecans of a femoral condyle (forty-five medial and seventeen lateral) were treated with Osteochondral autologous transplantation, autologous chondrocyte implantation with bone graft, biomimetic nanostructured Osteochondral Scaffold (MaioRegen) implantation, bone-cartilage paste graft, or a “one-step” bone-marrow-derived cell transplantation technique. Preoperative and follow-up evaluation included the International Knee Documentation Committee (IKDC) score, the EuroQol visual analog scale (EQ-VAS) score, radiographs, and magnetic resonance imaging. Results: The global mean IKDC score improved from 40.1 ± 14.3 preoperatively to 77.2 ± 21.3 (p < 0.0005) at 5.3 ± 4.7 years of follow-up, and the EQ-VAS improved from 51.7 ± 17.0 to 83.5 ± 18.3 (p < 0.0005). No influence of age, lesion size, duration of follow-up, or previous surgical procedures on the result was found. The only difference among the results of the surgical procedures was a trend toward better results following autologous chondrocyte implantation (p = 0.06). Conclusions: All of the techniques were effective in achieving good clinical and radiographic results in patients with osteochondritis dissecans, and the effectiveness of autologous chondrocyte implantation was confirmed at a mean follow-up of five years. Newer techniques such as MaioRegen implantation and the “one-step” transplantation technique are based on different rationales; the first relies on the characteristics of the Scaffold and the second on the regenerative potential of mesenchymal cells. Both of these newer procedures have the advantage of being minimally invasive and requiring a single operation.
Sandro Giannini - One of the best experts on this subject based on the ideXlab platform.
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how to treat osteochondritis dissecans of the knee surgical techniques and new trends aaos exhibit selection
Journal of Bone and Joint Surgery American Volume, 2012Co-Authors: Francesca Vannini, Matteo Nanni, Alessandro Di Martino, Alberto Ruffilli, Roberto Buda, Marco Cavallo, Giuseppe Filardo, Maurilio Marcacci, Sandro GianniniAbstract:Background: Osteochondritis dissecans is a relatively common cause of knee pain. The aim of this study was to describe the outcomes of five different surgical techniques in a series of sixty patients with osteochondritis dissecans. Methods: Sixty patients (age 22.4 ± 7.4 years, sixty-two knees) with osteochondritis dissecans of a femoral condyle (forty-five medial and seventeen lateral) were treated with Osteochondral autologous transplantation, autologous chondrocyte implantation with bone graft, biomimetic nanostructured Osteochondral Scaffold (MaioRegen) implantation, bone-cartilage paste graft, or a “one-step” bone-marrow-derived cell transplantation technique. Preoperative and follow-up evaluation included the International Knee Documentation Committee (IKDC) score, the EuroQol visual analog scale (EQ-VAS) score, radiographs, and magnetic resonance imaging. Results: The global mean IKDC score improved from 40.1 ± 14.3 preoperatively to 77.2 ± 21.3 (p < 0.0005) at 5.3 ± 4.7 years of follow-up, and the EQ-VAS improved from 51.7 ± 17.0 to 83.5 ± 18.3 (p < 0.0005). No influence of age, lesion size, duration of follow-up, or previous surgical procedures on the result was found. The only difference among the results of the surgical procedures was a trend toward better results following autologous chondrocyte implantation (p = 0.06). Conclusions: All of the techniques were effective in achieving good clinical and radiographic results in patients with osteochondritis dissecans, and the effectiveness of autologous chondrocyte implantation was confirmed at a mean follow-up of five years. Newer techniques such as MaioRegen implantation and the “one-step” transplantation technique are based on different rationales; the first relies on the characteristics of the Scaffold and the second on the regenerative potential of mesenchymal cells. Both of these newer procedures have the advantage of being minimally invasive and requiring a single operation.
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how to treat osteochondritis dissecans of the knee surgical techniques and new trends aaos exhibit selection
Journal of Bone and Joint Surgery American Volume, 2012Co-Authors: Francesca Vannini, Matteo Nanni, Alessandro Di Martino, Alberto Ruffilli, Roberto Buda, Marco Cavallo, Giuseppe Filardo, Maurilio Marcacci, Sandro GianniniAbstract:Background: Osteochondritis dissecans is a relatively common cause of knee pain. The aim of this study was to describe the outcomes of five different surgical techniques in a series of sixty patients with osteochondritis dissecans. Methods: Sixty patients (age 22.4 ± 7.4 years, sixty-two knees) with osteochondritis dissecans of a femoral condyle (forty-five medial and seventeen lateral) were treated with Osteochondral autologous transplantation, autologous chondrocyte implantation with bone graft, biomimetic nanostructured Osteochondral Scaffold (MaioRegen) implantation, bone-cartilage paste graft, or a “one-step” bone-marrow-derived cell transplantation technique. Preoperative and follow-up evaluation included the International Knee Documentation Committee (IKDC) score, the EuroQol visual analog scale (EQ-VAS) score, radiographs, and magnetic resonance imaging. Results: The global mean IKDC score improved from 40.1 ± 14.3 preoperatively to 77.2 ± 21.3 (p < 0.0005) at 5.3 ± 4.7 years of follow-up, and the EQ-VAS improved from 51.7 ± 17.0 to 83.5 ± 18.3 (p < 0.0005). No influence of age, lesion size, duration of follow-up, or previous surgical procedures on the result was found. The only difference among the results of the surgical procedures was a trend toward better results following autologous chondrocyte implantation (p = 0.06). Conclusions: All of the techniques were effective in achieving good clinical and radiographic results in patients with osteochondritis dissecans, and the effectiveness of autologous chondrocyte implantation was confirmed at a mean follow-up of five years. Newer techniques such as MaioRegen implantation and the “one-step” transplantation technique are based on different rationales; the first relies on the characteristics of the Scaffold and the second on the regenerative potential of mesenchymal cells. Both of these newer procedures have the advantage of being minimally invasive and requiring a single operation.
