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Two-stage bone and meniscus allograft and autologous chondrocytes implant for unicompartmental osteoarthritis: midterm results

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Abstract

Background

We analyzed the clinical and radiographic evolution of patients with knee unicompartmental osteoarthritis and axis alteration and osteochondral lesions in the femoral condyle, treated with tibial plateau and meniscus allograft and cultured autologous chondrocyte implantation in the femur in two steps.

Purpose

To analyze the clinical results with the first patients treated with this two-stage technique to avoid knee prosthesis in patients with unicompartmental osteoarthritis.

Material and methodology

Sixteen patients, average age 56 years, were included in a cohort study. We performed an osteotomy with tibia plateau allograft, including the meniscus. In a second surgery, the chondrocyte fibrin scaffold was placed in the femur. Clinical symptoms and function were measured using KSSR and KOOS scores. Wilcoxon's test was performed to compare the results over the 2-year follow-up period.

Results

Mean KSSR before surgery was 35.69 (SD: 3.75) points, rising to 67 (SD: 15.42) at 3 months, 95.88 at 12 months (SD: 2.68) and 96.31 at 24 months (SD: 2.24). The KOOS before surgery was 65.14 (SD: 16.34), rising to 72.68 after 3 months (SD: 19.15), 76.68 at 12 months (SD: 18.92) and 64.28 at 24 months (SD: 11.79). Four of 5 patients returned to engaging in the activity that they had stopped practicing. Three patients experienced collapse of the tibia allograft, and they needed later a prosthesis.

Conclusions

Simultaneous tibia plateau allograft and autologous chondrocyte implantation in the femur, after correction of the angular deformity, were performed, restoring the anatomy of the medial compartment and knee function in 82% of the patients 2 years after the operation.

Level of evidence

IV.

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Author information

Authors and Affiliations

  1. Department of Traumatology and Orthopedics, Hospital Universitario Dr. Jose E. González, Universidad Autónoma de Nuevo León (UANL), Monterrey, NL, Mexico

    E. Álvarez-Lozano, D. Luna-Pizarro, G. Meraz-Lares, R. Quintanilla-Loredo & M. V. Cerdá-García

  2. Department of Traumatology and Orthopedics, Medica Sur Private Hospital, Ciudad de México (CDMX), México

    G. Meraz-Lares & M. V. Cerdá-García

  3. Department of Research Division, Mexican Institute of Social Security (IMSS), Hospital of Traumatology and Orthopedics “Lomas Verdes”, Médica Sur Private Hospital, Ciudad de México (CDMX), Mexico

    D. Luna-Pizarro

  4. Department of Clinical Sciences, School of Medicine, University CEU – San Pablo, Campus Monteprincipe, Madrid, Spain

    F. Forriol

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  1. E. Álvarez-Lozano
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Corresponding author

Correspondence to F. Forriol.

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Conflict of interest

The authors have no conflict of interest for this study.

Ethical approval

The study was approved by the Ethical Committee of Hospital Universitario Dr. Jose E. González, Universidad Autónoma de Nuevo León (UANL), Monterrey, N.L., Mexico (approval included). All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Research Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

The patients clinical study was performed in the Hospital Universitario Dr. Jose E. González, Universidad Autónoma de Nuevo León (UANL), Monterrey, N.L., Mexico. Prof. Forriol was in this university for a long time to prepare the chondrocyte culture and surgical technique details.

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Álvarez-Lozano, E., Luna-Pizarro, D., Meraz-Lares, G. et al. Two-stage bone and meniscus allograft and autologous chondrocytes implant for unicompartmental osteoarthritis: midterm results . Musculoskelet Surg 106, 133–143 (2022). https://doi.org/10.1007/s12306-020-00680-w

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