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Matrix-assisted Autologous Chondrocyte Transplantation for Remodeling and Repair of Chondral Defects in a Rabbit Model
Published on: May 21, 2013
Cartilage reconstruction using Chondrofiller in intra-articular distal radius fractures
Wolfram Demmer1, Antonia Zörnpfenning2, Kevin Brugetti2
1Department of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University Munich, 80336, Munich, Germany. wolfram.demmer@med.uni-muenchen.de.
Introduction:
Intra-articular distal radius fractures (DRF) frequently result in post-traumatic cartilage defects, which can lead to early osteoarthritis, particularly when residual step-offs or gaps ≥ 2 mm remain after fracture reduction. While cartilage repair techniques are well established in large joints, options for small joints like the wrist remain limited. Chondrofiller liquid, a cell-free collagen type I hydrogel, has demonstrated regenerative potential in larger joints; however, its application in the wrist has not yet been studied.
Methods:
In this prospective clinical study, 59 patients with intra-articular DRFs treated by arthroscopy-assisted open reduction and internal fixation (ORIF) were included. In 25 cases, residual chondral defects between 0.5 and ≤ 2 mm were filled with Chondrofiller. Technical feasibility, defect characteristics, and application parameters were recorded. A subgroup of 8 Chondrofiller-treated patients underwent follow-up arthroscopy and was compared to a matched control group (n = 7) that had received ORIF without Chondrofiller. Cartilage quality was assessed using Outerbridge and the International Cartilage Repair Society (ICRS) classifications.
Results:
Chondrofiller was applied arthroscopically under dry conditions using G20-21 cannulas. Only 0.2-0.3 mL of the 1 mL preparation was required in most cases. At follow-up arthroscopy, patients treated with Chondrofiller showed significantly better cartilage quality (median Outerbridge 1.5 vs. 3, P = 0.006; ICRS 1 vs. 3, P = 0.002). Fibrous tissue formation (FTF) occurred only in overfilled defects, while flush applications were free of FTF. No significant differences were found in consolidation, complications, or associated injuries between groups.
Conclusion:
Chondrofiller is technically feasible and safe for use in the wrist. When applied precisely and flush with the cartilage surface, it may improve cartilage quality after intra-articular DRF. Further long-term clinical and radiological studies are needed to assess its effectiveness in preventing post-traumatic osteoarthritis and to evaluate cost-effectiveness compared to standard treatment.
