Abstract
Introduction
We describe a single stage arthroscopic procedure for the treatment of articular cartilage defects in the knee. The novel procedure involves microdrilling and application of atellocollagen and fibrin gel. The aim of the study was to evaluate the clinical outcomes at 4 years.
Materials and Methods
A prospective study of 30 patients with symptomatic ICRS grade III/IV chondral defects which were assessed clinically and radiologically. The lesions were located on the MFC, LFC, trochlea or patella, ranging from 2–8cm2. The surgical procedure involved debridement of the lesion, microdrilling and application of atellocollagen and fibrin gel under CO2 insufflation. Patients were clinically assessed using the Lysholm, IKDC and KOOS scores. Radiological assessment used the MOCART score.
Results
At 4 year follow-up:
-
Lysholm score was 80.46 ± 24.7, up from 51.7 ± 27.1 pre-operatively (p < 0.05).
-
KOOS (symptomatic) was 89, up from 66.2 pre-operatively.
-
IKDC (subjective) was 78.6, up from 41 preoperatively.
-
MOCART score for all lesions was 71.3
-
The mean T2* relaxation-times for the repair tissue and native cartilage were 28.8 and 29.7 respectively. dGEMRIC scan suggests hyaline like repair tissue.
Conclusion
Our technique shows encouraging results at 4 year follow-up as assessed by reliable validated scores and qualitative MRI scans.
