Repair of Articular Osteochondral Defect

Background: Matrix-associated autologous chondrocyte implantation (MACI) has been recently used to treat cartilage defects. The investigators had previously developed a biphasic osteochondral composite as the construct for chondrocyte implantation. The investigators further conducted this feasibility study of such device to treat patients with osteochondral lesion of the knee joints.

Methods: Ten patients with symptomatic isolated osteochondritis at the femoral condyle were treated by replacing the pathological tissue with autologous chondrocyte-laden biphasic cylindrical plug of DL-poly-lactide-co-glycolide, with its lower body impregnated with -tricalcium phosphate as the osseous phase. The osteochondral lesion was drilled to fashion a pit of identical size and shape as the plug. The chondrocyte-laden plug was press-fit to fill the pit. Outcome of repair was examined by KOOS scale at 3, 6 and 12 months postoperatively, and tissue sample was collected with second-look arthroscopic needle-biopsy at 12 months. The primary outcome parameter was the postoperative change of KOOS; and the secondary outcome parameter was the regeneration of cancellous bone and hyaline cartilage at the repair site.

We had previously developed a biphasic osteochondral composite as the construct for chondrocyte implantation. We further conducted this feasibility study of such device to treat patients with osteochondral lesion of the knee joints.

Inclusion Criteria: Age: 18 ~ 60 years Articular cartilage defect of the knee Diagnosis by X-ray and/or MRI, Arthroscopy Confined area: diameter < 3 cm Full layer cartilage damage Exclusion Criteria: Pregnancy Nonunion of fracture around the knee Diffuse degenerative arthropathy of the knee Diffuse cartilage pathology due to Rheumatism: rheumatoid, psoriatic, … Metabolic disorder: gouty, hemorrhagic, … Stiff knee from any reason Flexion < 130˚ Extension loss > 20˚