Case Presentation ALBERTO GOBBI M.D. Graeme P. Whyte M.D. - PowerPoint PPT Presentation

Case Presentation ALBERTO GOBBI M.D. Graeme P. Whyte M.D. Francesca Fabro Fontana Pharm.D. info@oasiortopedia.it www. kneecartilagedoctor.com

Case Discussion Age/sex: 42 Y, Male o Activity: professional athlete(Ice Hockey) o Lesion anatomical location/description: Grade 4 – Throclea & Medial femoral condyle o Method of application: Open Surgery o BMAC + Hyalofast, fixzation: fibrin glue

MRI Pre op Grade 4 Chondral lesion involving Grade 4 Chondral lesion involving Articular surface of trochlea Articular surface of medial femoral condyle

Intra op pictures Debridement BMAC & scaffold and preparation of lesion BMAC with scaffold and fibrin glue

MRI 1 year post op Good homogenous integration of the graft with isointense signal

MRI 5 years post op Good homogenous integration of the graft with isointense signal Return to high level sport

Clinical score at 5 years follow up SCORES PRE OP 5 YEAR POST OP VAS 3 0 TEGNER 4 8 IKDC Subjective 63.2 91.4 Objective C B

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 )

MICROFRACTURE AFTER 1 YEAR: ARTHROSCOPIC IMAGES Femoral condyle defect NOT HEALED Preparation of the lesion

Intra op pictures: HA-BMAC

Intra op pictures: HA-BMAC Shouldering the lesion Hyalofastand BMAC The membrane perfectly preparation covers the lesion

Patient at 5 year follow up

Patient at 10 year follow up SCORES PRE OP 10 YEAR POST OP VAS 3 0 TEGNER 4 8 IKDC Subjective 63.2 80.11 Objective C B

Patient at 10 year follow up