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Knee resurfacing implants may be reliable bridging treatment for OA cartilage lesions
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Despite symptom relief among patients who underwent focal resurfacing for the treatment of early osteoarthritis cartilage lesions, results presented at the European Society of Sports Traumatology, Knee Surgery and Arthroscopy showed patients also had a high revision rate to arthroplasty.
“[Resurfacing implants are] not a long-term treatment but can be a bridging treatment for patients who have improved life quality and knee function until they need a total joint replacement of some kind,” Martin Lind, MD, PhD, said in his presentation.
Current resurfacing implants available include the HemiCAP (Arthrosurface Inc.) and Episealer (Episurf Medical), according to Lind, but limited clinical data are available on each implant.
“For the HemiCAP, there are two case series presented with around 20 patients,” Lind said. “Then, there is a bigger case series from Denmark from a single center with more than 70 patients and we have some revision rate data from registries both from Denmark and Australia. For the Episealer implant, there are still no published data, but there is an ongoing European post-market surveillance study.”
Lind noted the two case series revealed the HemiCAP had excellent outcomes with KOOS scores, excellent improvement from preoperative measures to postoperative measures and one reoperation in each series. In a Danish case series of 74 patients with focal lesions grade 3 and 4, Lind said patients had excellent improvements with high Knee Society pain and function scores up to 2 years and reduced pain for up to 2 years.
“Regarding failure rates, a 25% rate was seen over 5 years in this series and looking at the registries ... for all of these implants in the Danish registry ... a failure rate at 6 years of 47%, so high revision rate,” Lind said.
He added an Australian registry for the HemiCAP also had a revision rate of 26% at 5 years.
In the ongoing surveillance study for Episealer, Lind noted a revision rate of 4.5% among 86 patients with International Cartilage Repair Society grade 3 and 4 lesions, as well as limited complications.
“There is a good increase in the various KOOS subscales, and these increases stayed constant up to 24 months for the patients we have. It is not all patients, yet,” Lind said. “Similar for pain, there is good pain relief with the use of this implant.” – by Casey Tingle
Reference:
Lind M. Outcomes after small knee implants – What do we know? Presented at: European Society of Sports Traumatology, Knee Surgery and Arthroscopy Congress; May 9-12, 2018; Glasgow, United Kingdom.
Disclosure: Lind reports no relevant financial disclosures.