E-ISSN 2367-699X | ISSN 2367-7414
 

Case Report 


A MODERN TREATMENT OF BILATERAL OSTEOCHONDRITIS DISSECANS IN KNEES: FROM A CASE REPORT TO LITERATURE'S REVIEW

Marco Corzani, Luigi Meccariello, Michele Bisaccia, Pellegrino Ferrrara, Giuseppe Rinonapoli, Luigi Piscitelli, Maria Liberata Meccariello, Auro Caraffa.

Cited by (1)

Abstract
Background
Osteocondrithis dissecans (OCD) is an acquired disease due to a subcondral bone ischaemia that affects generally the medial femoral condyle as well as above lying cartilage.
Though the incidence of OCD is only 6/10,000 in the general population, in the later stages of disease, OCD fragment can break off inside the articular cavity it is the most Frequently reported cause of free endoarticular body.
The etiology has been hypothesized as being multi-factored due to traumas or
microtraumas along with metabolic, endocrine and genetic disorders leading to subchondral ischemia .
Description of case
A 15-year old male amateur soccer player presented to our department complaining of recurrent episodes of pain at rest in both knees, swelling and articular blockage occurring over the past 3 years. RX and MRIrevealed bilateral lesions on both medial condyles.
A ONE-STEP surgical technique was performed that incorporated the drawing of
mesenchymal staminal cells (MSCs) and their implantation.

Conclusion

This case report deals with a rare case of bilateral OCD of the knee treated with the latest technique in regenerative medicine. At 6-month follow up there was a complete return of muscular tonality in both knees andthe patient was allowed to return to light physical activity. These results are noteworthyfor the fact they were obtained from a combined surgical approach that when compared toalternative approaches lead to a shorter hospital stay and a reduced hospital burden. Each of the osteochondral lesions was evaluated from imaging results and arthroscopic findings.

Key words: Mesenchymal Stem Cells; Osteocondrithis dissecans; ICRS Classification; Bone Marrow Concentration, Knee, Arthroscopic; Scaffold


 
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REFERENCES
1. Shea KG, Jacobs JC Jr, Carey JL, Andreson AF, Oxford JT: Osteochondritis dissecans knee histology studies have variable findings and theories of 75 etiology. Clin OrthopRelat Res 2013; 471(4):1127-36. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
2. Kessler JI, Nikizad H, Shea KG, Jacobs JC Jr, Bebchuk JD, Weiss JM: The demographics and the epidemiology of the Osteochondritis dissecans of the knee in children and adolescents. Am J Sports Med. 2014 Feb;42(2):320-6. [DOI via Crossref]    [Pubmed]   
3. Brandon J. Erickson, Peter N. Chalmers, Adam B. Yanke, and Brian J. Cole.Surgical management of Osteochondritis dissecans of the knee. CurrRevMusculoskeletMed. 2013 Jun; 6(2): 102-114. Published online 2013 Feb 3. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
4. Jacobs JC Jr, Archibald-Seiffer N, Grimm NL, Carey JL, Shea KG: A Review ofArthroscopic Classification Systems for Osteochondritisdissecans of the Knee.Clin Sports Med 2014; 2:189-197. [DOI via Crossref]    [Pubmed]   
5. Brittberg M: Clinical evaluation of cartilage defects and repair.Proceedings of the3rd Symposium of International Cartilage Repair Society in the New Millennium (2000). [Pubmed]   
6. Buda R, Vannini F, Cavallo M, Baldassarri M, Luciani D, Mazzotti A, Pungetti C, Olivieri A, Giannini S: One-step arthroscopic technique for the treatment of osteochondral lesions of the knee with bone-marrow-derived cells: three years results. MusculoskeletSurg 2013; 97(2):145-51. [DOI via Crossref]    [Pubmed]   
7. Veronesi F, Giavaresi G, Tschon M, Borsari V, NicoliAldini N, Fini M: Clinical use of bone marrow, bone marrow concentrate, and expanded bone marrow mesenchymal stem cells in cartilage disease. Stem Cells Dev 2013; 15;22(2):181- 92.
8. Buda R, Vannini F, Cavallo M, Baldassarri M, Luciani D, Mazzotti A, Pungetti C, Olivieri A, Giannini S. One-step arthroscopic technique for the treatment of osteochondral lesions of the knee with bone-marrow-derived cells: three years results. Musculoskelet Surg. 2013 Aug;97(2):145-51. [DOI via Crossref]    [DOI via Crossref]   
9. Vaananen HK. Mesenchymal stem cells. Ann Med. 2005;37(7):469-79. [DOI via Crossref]    [Pubmed]   
10. Barry FP, Murphy JM. Mesenchymal stem cells: clinical applications and biological characterization. Int J Biochem Cell Biol. 2004;36(4):568-84. [DOI via Crossref]    [Pubmed]   
11. Djouad F, Bouffi C, Ghannam S, et al. Mesenchymal stem cell: innovative therapeutic tools for rheumatic diseases. Nat Rev Rheumatol. 2009;5:392-9. [DOI via Crossref]    [Pubmed]   
12. Vega A, Martín-Ferrero MA, Del Canto F, Alberca M, García V, Munar A, Orozco L, Soler R, Fuertes JJ, Huguet M, Sánchez A, García-Sancho J.Treatment of Knee Osteoarthritis with Allogenic Bone Marrow Mesenchymal Stem Cells; A Randomized Controlled Trial.
13. Irrgang JJ, Andreson AF,Boland AL, et al.: Development and validation of the International Knee Committee subjective knee form. Am J Sports Med 2001;29(5):600-613. [Pubmed]   
14. Peterson L, Minas T, Brittberg M, Lindahl A: Treatment of osteochondritis dissecans of the knee with autologous chondrocyte transplantation: results at two to ten years. J Bone Joint Surg Am, 2003)+;85-A Suppl 2:17-24.
15. Saris DB, Vanlauwe J, Victor KF, Almqvist KF, Verdonk R, Bellemans J, Luyten FP, TIG/ACT/01/2000&EXT Study Group: Treatment of symptomatic cartilage defects of the knee: characterized chondrocyte implantation results in better clinical outcome at 36 months in a randomized trial compared to microfracture. Am J Sports Med 2009;37 Suppl 1:10S-19S. [DOI via Crossref]    [Pubmed]   
16. Papaioannou G, Demetropulos CK, King YH: Predicting the effects of knee focal articular surface injury with a patientspecific finite element model. Knee 2010; 17(1):61-8. [DOI via Crossref]    [Pubmed]   
17. Moradi B, Schonit E, Nierhoff C, Hagmann S, Oberle D, GotterbarmT, Schmitt H, Zeifang F: First-generation autologous chondrocyte implantation in patients with cartilage defects of the knee: 7 to 14 years clinical and magnetic resonance imaging follow-up evaluation Arthroscopy,(2012);28(12):1851-61. [DOI via Crossref]    [Pubmed]   
18. Beris AE, Lykissas MG, Kostas-Agnantis I, Manoudis GN: Treatment of full-thickness condrale defects of the knee with autologous chondrocyte implantation: a functional evaluation with long-term follow-up. Am J Sports Med,(2012); 40(3):562-7. [DOI via Crossref]    [Pubmed]   
19. Ossendorf C, Steinwachs MR, Kreuz PC, Osterhoff G, Lahm A, DucommunPP,Erggelet C: Autologous chondrocyte implantation (ACI) for the treatment of large and complex cartilage lesions of the knee.Sports Med ArthroscRehabilTherTechnol,(2011);21;3-11. [DOI via Crossref]   
20. Grigolo B, Lisignoli G, Desando G, Cavallo C, Marconi E, Tschon M, Giavaresi G, Fini M, Giardino R. Osteoarthritis treated with mesenchymal stem cells on a hyaluronanbased scaffold in the rabbit. Tissue Eng Part C Methods. 2009;15:647-58. [DOI via Crossref]    [Pubmed]   
21. Nejadnik H, Hui JH, Feng Choong EP, et al. Autologous bone marrow-derived mesenchymal stem cells versus autologous chondrocyte implantation: an observational cohort study. Am J Sports Med. 2010;38:1110-6. [DOI via Crossref]    [Pubmed]   
22. Wakitani S, Imoto K, Yamamoto T, et al. Human autologous culture expanded bone marrow mesenchymal cell transplantation for repair of cartilage defects in osteoarthritic knees. Osteoarthritis Cartilage. 2002;10:199-206 [DOI via Crossref]    [Pubmed]   
23. Saw KY, Hussin P, Loke SC, et al. Articular cartilage regeneration with autologous marrow aspirate and hyaluronic acid: an experimental study in a goat model. Arthroscopy. 2009;25(12):1391-400. [DOI via Crossref]    [Pubmed]   
24. Kuroda R, Ishida K, et al. Treatment of a full-thickness articular cartilage defect in the femoral condyle of an athlete with autologous bone-marrow stromal cells. Osteoarthritis Cartilage. 2007;15:226-31. [DOI via Crossref]    [Pubmed]   
25. Saw KY et al. Articular cartilage regeneration with autologous peripheral blood stem cells versus hyaluronic acid: a randomized controlled trial. Arthroscopy. 2013;29(4):684-94. [DOI via Crossref]    [Pubmed]   
26. Bosniakovski D, Mizuno M, Kim G, Ishiguro T, Okumura M, Iwanaga T, Kadosawa T, Fujinaga T: Chondrogenic differentiation of bovine bone marrow mesenchymal stemcells in cultural pellet system.ExpHematol 2004;32(5):502-9. [DOI via Crossref]    [Pubmed]   
27. Di Martino A, Liverani L, Rainer A, Salvatore G, Trombetta M, Denaro V. Electrospun scaffolds for bone tissue engineering.MusculoskeletSurg 2011;95(2):69-80. [DOI via Crossref]   
28. Kon E, Gobbi A, Filardo G, Delcogliano M, Zaffagnni S, Marcacci M: Arthroscopic second-generation autologous chondrocyte implantation compared with microfracture for chondral lesions of the knee: prospective nonrandomized study at five years. Am J Sports Med 2009;37(1):33-41. [DOI via Crossref]    [Pubmed]   
29. Nejadnik H, Hui JH, Feng Choong EP, Tai BC, Lee EH: Autologous bonemarrow-derived mesenchymal stem cells versus autologous chondrocyte implantation: an observational cohort study. Am J Sports Med 2010; 38(6):1110-6. [DOI via Crossref]    [Pubmed]   
30. Giannini S,Buda R,Vannini F,Cavallo M,Grigolo B: One-step bone marrow derived cell transplantation in talar osteochondral lesions.Clin Orthop Relat Res 2009;467(12):3307- 3320. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
31. Necas A, Planka L, Srnec R, Crha M, et al.: Quality of newly formed cartilaginous tissue in defects of the articular surface after transplantation of mesenchymal stem cells in a composite scaffold based on collagen I with chitosan microand nanofibres.Physiol Res 2010; 59(4):605-14. [Pubmed]   
32. Gobbi A, Karnatzikos G, Sankineani SR: One step surgery with multipotent stem cells for the treatment of large fullthickness condrale defects of the knee.Am J Sports Med. 2014 Mar;42(3):648-57. [DOI via Crossref]    [Pubmed]   
33. Lodi D, Iannitti T, Palmieri B: Stem cells in clinical practice: applications and warnings. J ExpClin Cancer Res. 2011 Jan 17;30:9. [DOI via Crossref]    [DOI via Crossref]   
34. Chen FH: Mesenchymal stem cells in arthritic diseases.Arthr Res Ther 2008;8710(5):223. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
35. Frisbie DD, Lu Y, Kawcak CE, DiCarlo EF, Binette F, McIlwraith CW: In Vivo evaluation of autologous cartilage fragment-loaded scaffolds implanted into equine articular defects and compared with autologous chondrocyte implantation. Am J Sports Med 2009; 37 Suppl 1:71S-80S. [DOI via Crossref]    [Pubmed]   
36. Koga H, Engebretsen L, Brinchmann JE, Muneta T, Sekiya I: Mesenchymal stem cell-based therapy for cartilage repair: a review.KneeSurg Sports TraumatolArthrosc 2009; 17(11):1289-97. [DOI via Crossref]    [Pubmed]   
37. Wakitani S, Yamamoto T: Response of the donor and recipient cells in mesenchymal cell transplantation to cartilage defect.Microsc Res Terap 2002;58(1):14-8. [DOI via Crossref]    [Pubmed]   
38. Xie X, Wang Y, Zhao C, Guo S, Liu S, Jia W, Tuan RS, Zhang C: Comparative evaluation of MSCs from bone marrow and adipose tissue seeded in PRP-derived scaffold for cartilage regeneration. Biomaterials 2012; 33(29):7008-18. [DOI via Crossref]    [Pubmed]   
39. Zhang Y, Wang F, Chen J, Ning Z, Yang L: Bone marrowderived mesenchymal stem cells versus bone marrow nucleated cells in the treatment of chondral defects. IntOrthop 2012; 36(5):1079-86. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
40. Lee JM, Kim BS, Lee H, Im GI: In vivo tracking of mesenchymal stem cells using fluorescent nanoparticles in an osteochondral repair model.MolTher 2012;20(7):1434-42. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
41. Mimura T, Imai S, Okumura N, LI L, Nishizawa K, Araki S, Ueba H, KuboM, Mori K, Matsusue Y: Spatiotemporal control of proliferation and differentiation of bone marrowderived mesenchymal stem cells recruited using collagen hydrogel for repair of articular cartilage defects. J Biomed Mater Res B ApplBiomater 2011; 98(2):360-8. [DOI via Crossref]    [Pubmed]   
42. Re’em T, Witte F, Willbold E, Ruvinov E, Cohen S: Simultaneous regeneration of articular cartilage and subchondral bone induced by spatially presented TGFbetaand BMP-4 in a bilayer affinity binding system. ActaBiomater 2012;8(9):3283-93. [DOI via Crossref]    [Pubmed]   
43. Sukarto A, Yu C, Flynn LE, Amsden BG: Co-delivery of adipose-derived stem cells and growth factor-loaded microspheres in RGD-grafted N-methacrylate glycol chitosan gels for focal chondral repair. Biomacromolecules 2012;13(8):2490-502. [DOI via Crossref]    [Pubmed]   

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How to Cite this Article
Pubmed Style

Marco Corzani, Luigi Meccariello, Michele Bisaccia, Pellegrino Ferrrara, Giuseppe Rinonapoli, Luigi Piscitelli, Maria Liberata Meccariello, Auro Caraffa. A MODERN TREATMENT OF BILATERAL OSTEOCHONDRITIS DISSECANS IN KNEES: FROM A CASE REPORT TO LITERATURE'S REVIEW. Int J Surg Med. 2016; 2(4): 223-229. doi:10.5455/ijsm-treatment-osteocondrithisdissecans-bilateral-knee


Web Style

Marco Corzani, Luigi Meccariello, Michele Bisaccia, Pellegrino Ferrrara, Giuseppe Rinonapoli, Luigi Piscitelli, Maria Liberata Meccariello, Auro Caraffa. A MODERN TREATMENT OF BILATERAL OSTEOCHONDRITIS DISSECANS IN KNEES: FROM A CASE REPORT TO LITERATURE'S REVIEW. http://www.ejos.org/?mno=231720 [Access: November 03, 2020]. doi:10.5455/ijsm-treatment-osteocondrithisdissecans-bilateral-knee


AMA (American Medical Association) Style

Marco Corzani, Luigi Meccariello, Michele Bisaccia, Pellegrino Ferrrara, Giuseppe Rinonapoli, Luigi Piscitelli, Maria Liberata Meccariello, Auro Caraffa. A MODERN TREATMENT OF BILATERAL OSTEOCHONDRITIS DISSECANS IN KNEES: FROM A CASE REPORT TO LITERATURE'S REVIEW. Int J Surg Med. 2016; 2(4): 223-229. doi:10.5455/ijsm-treatment-osteocondrithisdissecans-bilateral-knee



Vancouver/ICMJE Style

Marco Corzani, Luigi Meccariello, Michele Bisaccia, Pellegrino Ferrrara, Giuseppe Rinonapoli, Luigi Piscitelli, Maria Liberata Meccariello, Auro Caraffa. A MODERN TREATMENT OF BILATERAL OSTEOCHONDRITIS DISSECANS IN KNEES: FROM A CASE REPORT TO LITERATURE'S REVIEW. Int J Surg Med. (2016), [cited November 03, 2020]; 2(4): 223-229. doi:10.5455/ijsm-treatment-osteocondrithisdissecans-bilateral-knee



Harvard Style

Marco Corzani, Luigi Meccariello, Michele Bisaccia, Pellegrino Ferrrara, Giuseppe Rinonapoli, Luigi Piscitelli, Maria Liberata Meccariello, Auro Caraffa (2016) A MODERN TREATMENT OF BILATERAL OSTEOCHONDRITIS DISSECANS IN KNEES: FROM A CASE REPORT TO LITERATURE'S REVIEW. Int J Surg Med, 2 (4), 223-229. doi:10.5455/ijsm-treatment-osteocondrithisdissecans-bilateral-knee



Turabian Style

Marco Corzani, Luigi Meccariello, Michele Bisaccia, Pellegrino Ferrrara, Giuseppe Rinonapoli, Luigi Piscitelli, Maria Liberata Meccariello, Auro Caraffa. 2016. A MODERN TREATMENT OF BILATERAL OSTEOCHONDRITIS DISSECANS IN KNEES: FROM A CASE REPORT TO LITERATURE'S REVIEW. International Journal of Surgery and Medicine, 2 (4), 223-229. doi:10.5455/ijsm-treatment-osteocondrithisdissecans-bilateral-knee



Chicago Style

Marco Corzani, Luigi Meccariello, Michele Bisaccia, Pellegrino Ferrrara, Giuseppe Rinonapoli, Luigi Piscitelli, Maria Liberata Meccariello, Auro Caraffa. "A MODERN TREATMENT OF BILATERAL OSTEOCHONDRITIS DISSECANS IN KNEES: FROM A CASE REPORT TO LITERATURE'S REVIEW." International Journal of Surgery and Medicine 2 (2016), 223-229. doi:10.5455/ijsm-treatment-osteocondrithisdissecans-bilateral-knee



MLA (The Modern Language Association) Style

Marco Corzani, Luigi Meccariello, Michele Bisaccia, Pellegrino Ferrrara, Giuseppe Rinonapoli, Luigi Piscitelli, Maria Liberata Meccariello, Auro Caraffa. "A MODERN TREATMENT OF BILATERAL OSTEOCHONDRITIS DISSECANS IN KNEES: FROM A CASE REPORT TO LITERATURE'S REVIEW." International Journal of Surgery and Medicine 2.4 (2016), 223-229. Print. doi:10.5455/ijsm-treatment-osteocondrithisdissecans-bilateral-knee



APA (American Psychological Association) Style

Marco Corzani, Luigi Meccariello, Michele Bisaccia, Pellegrino Ferrrara, Giuseppe Rinonapoli, Luigi Piscitelli, Maria Liberata Meccariello, Auro Caraffa (2016) A MODERN TREATMENT OF BILATERAL OSTEOCHONDRITIS DISSECANS IN KNEES: FROM A CASE REPORT TO LITERATURE'S REVIEW. International Journal of Surgery and Medicine, 2 (4), 223-229. doi:10.5455/ijsm-treatment-osteocondrithisdissecans-bilateral-knee