Abstract
Full thickness cartilage defects of the femoral condyles are frequent, can be highly symptomatic, and pose treatment challenges when encountered in middle-aged patients. A history of biological repair procedures is frequent and patient management is complex in order to delay joint replacement procedures in active patients. Focal metallic resurfacing provides a joint preserving bridging procedure with a clinical exit into primary arthroplasty.
Methods.
This study presents a review of several multicenter investigations exploring the clinical benefits and validity of focal resurfacing in 78 patients, ages 35–67, with a follow-up ranging from 2 to 6 years.
All patients were treated with a 15 or 20 mm contoured resurfacing implant on the medial or lateral femoral condyle.
Results.
At 2 years follow up, average scores for WOMAC domains improved by over 100% (40 preop to 86 postop where 100 = best). At 3 year follow-up KOOS scores were within 88 to 102% of a normal aged matched population (domain range 72–91 where 100 = best). At a minimum of 5 years, the KOOS domains were close to normative reference levels on pain relief, symptoms, and activities of daily living (range 83–89% of normal). Radiographic results demonstrated solid fixation, preservation of joint space, and no change in the osteoarthritic stage.
Conclusion.
The procedure adds a new layer to reconstructive treatment options in the long-term management of knee arthrosis and arthritis and allows for a clinical alternative to lifestyle changes required by many patients who failed cartilage procedures and continue to have an isolated symptomatic defect precluding them from joint arthroplasty.
