Clinical outcomes of a novel single-stage cartilage repair technique using calcified cartilage zone debridement with hyalofast

by Badrul Akmal Hisham Md Yusoff, Muhammad Ikmal Hazli, Norlelawati Mohamad, Muhamad Karbela Reza Ramlan, Nik Kamarul Arif Bin Nik Kamrulzaman, Mohamed Razzan Rameez, Mohamad Azwan Aziz

This study aims to determine the clinical outcomes of a new technique of cartilage repair surgery, using calcified cartilage zone debridement coupled with Hyalofast and bone marrow aspirate concentrate, in terms of pain and functional outcomes.

This was a retrospective case series in 19 patients with cartilage injuries, ICRS 3 and 4. Using arthroscopic examination, cartilage defects were identified and debrided. Then, the calcified cartilage zone was identified and scrapped, until punctate bleeding occurred. Hyalofast was fixed into the defect and bone marrow aspirate concentrate was injected into the Hyalofast. Patients were followed up at baseline, 1, 6, and 18 months post-operative, using visual analog scale, KOOS, IKDC, and Lysholm Score.

The mean age was 45.33 ± 9.68 years, with the mean cartilage defects of 10.21 ± 11.10 X 9.43 ± 10.85 mm². Among the cohort, seven patients (36.8%) underwent three chondral repair procedures, five (26.4%) received two procedures, and the remaining seven (36.8%) were treated with a single procedure. In the KOOS subscale, there was a steady improvement; symptoms (mean difference: −23.87, CI: −43.97 – −3.77, p-value = 0.015), pain (mean difference: −28.39, CI: −43.94 – −12.83, p-value = 0.001), activity of daily living (mean difference: −26.23, CI: −40.95 – −10.14, p-value = 0.001), and sports subscale (mean difference: −57.36, CI: −80.76 – −33.97, p-value  Conclusion

The calcified cartilage zone debridement technique served as a novel technique to preserve subchondral plate allowing better outcomes for cartilage repair.