March 11, 2025
2 min learn
Key takeaways:
- An aragonite-based scaffold confirmed superior outcomes for osteochondral defects of the knee vs. the usual of care.
- The outcomes replicate 4-year follow-up information.
SAN DIEGO — Use of an aragonite-based scaffold for the therapy of chondral or osteochondral defects of the knee had superior outcomes in contrast with debridement or microfracture at 4-year follow-up, in keeping with outcomes.
“It has been the relative ‘holy grail’ to search out significant therapy for osteoarthritis. The difficult inhabitants of early osteoarthritis is much more troublesome. A few of our typical remedies, notably when nonsurgical measures fail, resembling cell-based repairs or bone and cartilage transplants, don’t switch after we begin having joint area narrowing or a number of lesions,” Seth L. Sherman, MD, affiliate professor of orthopedic surgical procedure at Stanford College, advised Healio about outcomes introduced on the American Academy of Orthopaedic Surgeons Annual Assembly, right here. “The intrigue of a scaffold like this that’s off-the-shelf, acellular, comparatively price efficient and pretty easy to do, if it may ship outcomes for this troublesome inhabitants with out burning main bridges for attainable future interventions, resembling osteotomy or partial or whole alternative, then I believe it could be an actual bonus for the group of us who take care of these troublesome conditions daily in our practices.”
Sherman and colleagues randomly assigned 251 sufferers with chondral or osteochondral defects within the knee to obtain both a cell-free aragonite-based scaffold (Agili-C, Smith & Nephew) or the usual of care of debridement or microfracture.
The researchers collected patient-reported outcomes preoperatively and postoperatively at 6 months and yearly as much as 48 months after therapy. The change from baseline to 48 months in KOOS-General Ranking was thought-about the first endpoint and secondary endpoints included change from baseline within the Tegner Exercise Scale; KOOS subscales; responder price, outlined as the proportion of sufferers attaining a rise in KOOS general rating of 30 factors or extra; and therapy failure price.
In his presentation, Sherman stated sufferers who had acquired the aragonite-based scaffold had superior KOOSoverall score scores at 2 years, which was sustained all through the 4-year timeframe. He stated sufferers within the therapy group had superior Tegner scores that leveled off at 24 months and had been sustained all through the 4-year time interval.
“[For] these sufferers who began out lively vs. inactive, there was the identical superiority and the identical sustained outcomes,” Sherman stated in his presentation.
When stratified by age and BMI, sufferers within the therapy group had superior outcomes in contrast with the usual of care group, in keeping with Sherman. He stated the sufferers within the aragonite-based scaffold group had low charges of therapy failure in contrast with sufferers in the usual of care group.
“The 4-year information is kind of reassuring that the outcomes that we noticed within the FDA examine are prolonged out,” Sherman advised Healio.
He added, “Persevering with to fastidiously comply with these outcomes extra time, who may want injection remedy or different nonoperative therapy [and] who may go on to require different surgical interventions will assist us to refine our indications for Agili-C for joint preservation.”
Sources/Disclosures
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Sherman SL, et al. Paper 2. Introduced at: American Academy of Orthopaedic Surgeons Annual Assembly; March 10-14, 2025; San Diego.
Disclosures:
Sherman studies being an academic marketing consultant for Smith & Nephew.
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