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Volume 13 Journal of Orthopaedics Trauma Surgery & Related Research Arthroplasty 2018
September 24-25, 2018
ArthroplastySeptember 24-25, 2018 London, UK
11th International Conference on
Treatment of articular cartilage lesion of the knee: Biopolymer hydrogel and microfracture versus
microfracture only technique
Raffaele Borghi, Gennaro Pipino and Davide Vaccarisi
Rizzoli Orthopedic Institute-Villa Regina Hospital, Italy
Introduction&Aim: Articular cartilage injuries of the knee are a common finding in patients with knee pain. In recent years, thermo-
gelling biopolymer systems have elicited interest for biomedical applications, such as filler matrix for treatment of osteoarthritis
and post-traumatic cartilage lesion. The purpose of this study was to evaluate and compare outcomes in two groups of patients,
one treated with Microfractures (MF) and one treated with microfracture and a thermo-sensitive bio-adhesive hydrogel made of
polyglucosamine/glucosamine carbonate (JR).
Methods: Sixty-nine (69) patients with symptomatic articular cartilage lesions in the knee, grade III-IV (outerbridge), treated from
January 2015 to April 2015 were prospectively divided into two groups. All patients were treated with standard knee arthroscopy
procedure, also associated with other treatment such as meniscal repair. The 46 patients included in JR group were treated with
microfractures, plus a thermo-sensitive bio-adhesive hydrogel made of polyglucosamine/glucosamine carbonate that was applied
directly on the site after marrow stimulation. In MF group, 23 patients were treated with arthroscopic microfractures as traditionally
described by Steadman. All patients were allowed to full weight bearing 3 hours after surgery. The patients were evaluated clinically
using WOMAC scores preoperatively, at 6 month, 1 year and 2 years follow up and VAS scores, preoperatively at 48 hours, 1 month
and 6 months, 1 year and 2 years follow up. MRI and T2 mapping were performed before surgery and after 6 months to control the
quality of the regenerated cartilage.
Results: The demographics and comorbid conditions known to affect outcome of cartilage repair techniques were similar between
the two groups. No adverse event or complications related to surgery were observed or reported by patients. At 48 hours from surgery
VAS score decreased of 41% (JR group) and of 32% (MF group), at 1 month, the decrease were 72% (JR) and 53% (MF), at 6 months
there was no pain in the JR group and a decrease of 89% in the MF group, no pain was registered in both group afterwards. Before
surgery WOMAC score was 56.5 in the JR group and 58.9 in the MR group, at 6 months follow up was 7.4 in JR and 28.4 in MR and
at the last follow up 4.4 in JR group and 41.9 in MR group. Results from T2 mapping in JR group were compared with results from
native cartilage. Biopsy was performed in 2 patients of the JR group who needed new surgical procedure due to trauma; both biopsies
contained hyaline-like cartilage.
Conclusion: Patients treated with biopolymer hydrogel and microfracture technique obtained better clinical results than patients
treated with only microfracture. This new technique resulted to be safe and allowed significant improvements in function and pain.
Biography
Raffaele Borghi is working as an Orthopedic Consultant in Rizzoli Orthopaedic Institute, Bologna, Italy and he is also working as Surgeon in Villa Regina Hospital
located in Bologna at Italy.
Raffaele Borghi et al., J Arthroplasty 2018, Volume 13