Chitosan based scaffold applied in patellar cartilage lesions showed positive clinical and MRI results at minimum 2 years of follow up.

Abstract

New scaffold-based cartilage regeneration techniques have been developed to improve the results of microfractures also in complex locations like the patello-femoral joint. The aim of this study was to analyse the results obtained in patellar lesions treated with a bioscaffold, a mixture composed by a chitosan solution, a buffer, and the patient's whole blood which forms a stable clot into the lesion. Fifteen patients with ICRS grade 3-4 cartilage lesions of the patellar surface were treated with a chitosan bioscaffold. Fourteen patients were clinically and radiologically evaluated prospectively for a minimum follow-up of 2years with IKDC, KOOS, Tegner score, and MRI.The mean age of patients at the time of surgery was31.8 ± 11.9and nine patients presented degenerative aetiology, four patients with previous trauma, and 1 patient with osteochondritis dissecans. RESULTS: The IKDC subjective score improved from 46.2 ± 19.3 preoperatively to 69.5 ± 20.3 (p < 0.05) and74.1 ± 23.2(p < 0.05) at 12 and 24months, respectively. Also KOOS Pain, KOOS Sport/Rec and KOOS QOLshowed a significant improvement from baseline to 12months and to the final follow-up.MRI evaluation showed a complete filling of the cartilage defect at the final follow-up in 70% of the lesions, obtaining a total MOCART 2.0 score of 71.5 ± 13.6 at 24months after surgery. Chondral patellar lesions represent a complex pathology, with lower results compared to other sites. This bioscaffold representsa safe surgical treatment providing a significant clinical improvement at 24months in the treatment of patellar cartilage lesions. IV.