Chitosan‐based scaffold augmentation to microfractures: Stable results at mid‐term follow‐up in patients with patellar cartilage lesions

Abstract

AbstractPurposePatellar cartilage lesions are a frequent and challenging finding in orthopaedic clinical practice. This study aimed to evaluate a chitosan‐based scaffold's mid‐term clinical and imaging results patients with patellar cartilage lesions.MethodsThirteen patients (nine men, four women, 31.3 ± 12.7 years old) were clinically evaluated prospectively at baseline, 12, 24 and at a final minimum follow‐up of 60 months (80.2 ± 14.7) with International Knee Documentation Committee (IKDC) subjective, Knee Injury and Osteoarthritis Outcome Score and Tegner scores. A magnetic resonance analysis was performed at the last follow‐up using the Magnetic resonance Observation of CArtilage Repair Tissue (MOCART) 2.0 score.ResultsAn overall significant clinical improvement in the scores was observed from baseline to all follow‐ups, with stable clinical results from 24 months to the mid‐term evaluation. The IKDC subjective score passed from 46.3 ± 20.0 at baseline to 70.1 ± 21.5 at the last follow‐up (p = 0.029). Symptoms' duration before surgery negatively correlated with the clinical improvement from baseline to the final follow‐up (p = 0.013) and sex influenced the improvement of activity level from the preoperative evaluation to the final follow‐up, with better results in men (p = 0.049). In line with the clinical findings, positive results were documented in terms of cartilage repair quality with a mean MOCART 2.0 score of 72.4 ± 12.5.ConclusionsOverall, the use of this chitosan‐based scaffold provided satisfactory results with a stable clinical improvement up to mid‐term follow‐up, which should be confirmed by further high‐level studies to be considered a suitable surgical option to treat patients affected by patellar cartilage lesions.Level of EvidenceLevel IV, prospective case series.