TruFit CB bone plug: chondral repair, scaffold design, surgical technique and early experiences

The TruFit CB osteochondral scaffold plug is a commercially available and licensed scaffold implant for the treatment of chondral and osteochondral defects of the knee. A number of surgical techniques have been described that are designed to achieve neocartilaginous tissue cover of a chondral defect, but many result in fibrocartilage tissue, not type II collagen hyaline cartilage. This fibrocartilage layer can fail with high shear forces in the knee joint, and lead to ongoing articular surface irregularity and subsequent secondary arthritic change. Recent research and clinical interest has focused on employing tissue-engineering techniques utilizing scaffolds in an attempt to obtain cartilage repair tissue that is histologically and biomechanically superior. The TruFit CB implant is one such device. This article describes the techniques of attempted chondral repair and the problems that can be experienced. Current concepts in chondral scaffold design are discussed, and the surgical technique and early experiences with the TruFit CB implant are presented.