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Focal articular prosthetic resurfacing for the treatment of full-thickness articular cartilage defects in the knee: 12-year follow-up of two cases and review of the literature

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The rationale of focal articular prosthetic resurfacing used as a primary arthroplasty procedure in the treatment of articular cartilage defects is still under debate. Conflicting reports raise concern about high rates of re-operations and continued development of osteoarthritis, while others have reported good outcomes. The goal of this paper is to present the long-term results of two patients with a 12-year follow-up and to report the results of a literature review.

Materials and methods

Two patients (male, 70 years; female 63 years) with a follow-up of 12 years were reviewed. Patients were evaluated with standard radiographs to assess the progression of osteoarthritis (OA), a clinical examination including the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Tegner activity scale. The literature review was performed using the search terms HemiCAP, focal, femoral, condyle, inlay, and resurfacing to identify articles published in the English language up until September 25, 2016.

Results

The clinical and radiographic follow-ups of the patients were 11.9 and 11.8 years, respectively. Both patients were satisfied with their outcome and would have the operation again. Comparing the first postoperative to 12-year follow-up X-rays, the radiographic results demonstrated no signs of periprosthetic loosening, preservation of joint space, and no change in the osteoarthritic stage. KOOS Scores were 86 and 83 for pain, 89 and 93 for symptoms, 88 and 100 for activities of daily living (ADL), 75 and 65 for sports and recreation, and 75 and 81 for quality of life (QOL). The Tegner activity level was 5 and 4. The literature review comprised 6 studies with 169 focal articular prosthetic resurfacing procedures in 169 patients (84 male, 85 female) with a mean age at implantation ranging from 44.7 to 53.7 years and a follow-up range of 20 months to 7 years. Five studies were classified as level 4 and one as level 3. Clinical and radiographic results showed mainly good to excellent outcomes but were different among the studies depending on the indication. Re-operation rates ranged from 0 to 23% depending on the length of follow-up.

Conclusions

The results suggest that focal articular prosthetic resurfacing is an effective and safe treatment option in selected cases.

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Authors and Affiliations

  1. HKF, International Center for Hip-, Knee and Foot Surgery/Sports Trauma, ATOS Clinic, Bismarckstr. 9-15, 69115, Heidelberg, Germany

    C. Becher & E. B. Cantiller

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  1. C. Becher
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  2. E. B. Cantiller
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Correspondence to C. Becher.

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Conflict of interest

A fee for speaking and reimbursement for attending a symposium was received by the corresponding author from 2med GmbH, Hamburg, Germany (Distributor of Arthrosurface in Germany) in 2015. The authors declare no other conflict of interest.

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There is no funding source.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors. The follow-up examinations were performed on a regular base of follow-up and not for study reasons.

Informed consent

Informed consent was obtained from both participants included in the report of the two cases.

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Becher, C., Cantiller, E.B. Focal articular prosthetic resurfacing for the treatment of full-thickness articular cartilage defects in the knee: 12-year follow-up of two cases and review of the literature. Arch Orthop Trauma Surg 137, 1307–1317 (2017). https://doi.org/10.1007/s00402-017-2717-8

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