SLIDE 1 info@oasiortopedia.it
- www. kneecartilagedoctor.com
ALBERTO GOBBI M.D.
Graeme P. Whyte M.D. Francesca Fabro Fontana Pharm.D.
Case Presentation
SLIDE 2 Case Discussion
Age/sex: 42 Y, Male
- Activity: professional athlete(Ice Hockey)
- Lesion anatomical location/description:
Grade 4 – Throclea & Medial femoral condyle
- Method of application: Open Surgery
- BMAC + Hyalofast, fixzation: fibrin glue
SLIDE 3
MRI Pre op
Grade 4 Chondral lesion involving Articular surface of trochlea
Grade 4 Chondral lesion involving Articular surface of medial femoral condyle
SLIDE 4
Intra op pictures
BMAC & scaffold Debridement and preparation of lesion BMAC with scaffold and fibrin glue
SLIDE 5
MRI 1 year post op
Good homogenous integration of the graft with isointense signal
SLIDE 6
MRI 5 years post op
Good homogenous integration of the graft with isointense signal Return to high level sport
SLIDE 7
Clinical score at 5 years follow up SCORES PRE OP 5 YEAR POST OP VAS 3 TEGNER 4 8 IKDC Subjective 63.2 91.4 Objective C B
SLIDE 8
The patient after 6 years….
Complaning for pain in the opposite knee, medial femoral condyle chondral defect was diagnosed not possible to repeat the same surgery within the USA so microfracture were done. After rehabilitation program due to continous pain the patient came back to our clinic in Italy: arthroscopy revealed a large full thickness lesion (12 cm2 )
SLIDE 9
MICROFRACTURE AFTER 1 YEAR: ARTHROSCOPIC IMAGES
Femoral condyle defect NOT HEALED Preparation of the lesion
SLIDE 10
Intra op pictures: HA-BMAC
SLIDE 11
Intra op pictures: HA-BMAC
Shouldering the lesion Hyalofastand BMAC preparation The membrane perfectly covers the lesion
SLIDE 12
Patient at 5 year follow up
SLIDE 13
Patient at 10 year follow up
SCORES PRE OP 10 YEAR POST OP VAS 3 TEGNER 4 8 IKDC Subjective 63.2 80.11 Objective C B
SLIDE 14
Patient at 10 year follow up
