PMID- 30195954
OWN - NLM
STAT- MEDLINE
DCOM- 20191008
LR  - 20200627
IS  - 1526-3231 (Electronic)
IS  - 0749-8063 (Linking)
VI  - 34
IP  - 10
DP  - 2018 Oct
TI  - Arthroscopic Repair of Acetabular Cartilage Lesions by Chitosan-Based Scaffold: 
      Clinical Evaluation at Minimum 2 Years Follow-up.
PG  - 2821-2828
LID - S0749-8063(18)30525-5 [pii]
LID - 10.1016/j.arthro.2018.06.037 [doi]
AB  - PURPOSE: To evaluate the functional outcome of using chitosan-based material in 
      our patients after 2 years of follow-up. METHODS: Nonarthritic nondysplastic 
      femoroacetabular impingement patients with an acetabular chondral lesion, 18 to 
      55 years of age, were included for arthroscopic repair between May 2013 and July 
      2015. Full-thickness chondral defects >/=2 cm(2) were filled with chitosan-based 
      implant after microfractures. Follow-up consisted of alpha angle assessment and 
      clinical outcome in the form of the Non Arthritic Hip Score (NAHS), International 
      Hip Outcome Tool 33 (iHOT33), Hip Outcome Score of Activities of Daily Living 
      (HOS-ADL), and Hip Outcome Score of Sports Specific Scale (HOS-SSS). RESULTS: 
      Twenty-three patients were included. The mean follow-up was 38.4 +/- 7.0 months 
      (range, 24-50 months). The mean defect size was 3.5 +/- 1.0 cm(2), principally 
      involving zone 2 and to a lesser extent in zones 1 and 3. Using femoroplasty, the 
      alpha angle was corrected from a mean 70.5 +/- 6.3 degrees  to 44.3 +/- 4.9 degrees  (P = .00001). 
      Significant improvement occurred comparing the preoperative to the first-year 
      postoperative patient-reported outcomes: P = .00001 for the NAHS, P = .00004 for 
      the iHOT33, P = .00005 for the HOS-ADL, and P = .0002 for the HOS-SSS. No 
      statistically significant change has been observed in the patient-reported 
      outcomes obtained at the endpoint when compared with the first-year values (P = 
      .13 for the NAHS, P = .21 for the HOS-ADL, and P = .29 for the HOS-SSS), except 
      for the iHOT33, which showed further significant improvement (P = .02). Up to 91% 
      of the patients met or exceeded the minimal clinically important difference. One 
      patient needed total hip arthroplasty. Perineal hypoesthesia occurred in 3 
      patients, who recovered within 2 to 6 weeks, and 1 patient needed a prolonged 
      physiotherapy program for postoperative muscular stiffness. CONCLUSIONS: The 
      arthroscopic combined treatment of microfractures and chitosan-based scaffold has 
      maintained satisfactory clinical outcomes in 91% of the patients with s large 
      (>/=2 cm(2)) full-thickness acetabular chondral defect associated with 
      femoroacetabular impingement at a mean follow-up of 38.4 months. The study could 
      not definitely draw any conclusion regarding the safety of chitosan-based 
      material for use in the hip joint. LEVEL OF EVIDENCE: Level IV, case series.
CI  - Copyright (c) 2018 Arthroscopy Association of North America. Published by Elsevier 
      Inc. All rights reserved.
FAU - Tahoun, Mahmoud Fathy
AU  - Tahoun MF
AD  - Department of Orthopedics, Menoufia University, Egypt; Department of Orthopedics, 
      Parc de Salut Mar, Universitat Autonoma de Barcelona, Barcelona, Spain. 
      Electronic address: mftahoon@hotmail.com.
FAU - Tey, Marc
AU  - Tey M
AD  - Department of Orthopedics, Parc de Salut Mar, Universitat Autonoma de Barcelona, 
      Barcelona, Spain; Hip Unit, iMove Traumatologia, Clinica Mitrestorres, Barcelona, 
      Spain.
FAU - Mas, Jesus
AU  - Mas J
AD  - Department of Orthopedics, Hospital Vistahermosa, Alicante, Spain.
FAU - Abd-Elsattar Eid, Taher
AU  - Abd-Elsattar Eid T
AD  - Department of Orthopedics, Menoufia University, Egypt.
FAU - Monllau, Joan Carles
AU  - Monllau JC
AD  - Department of Orthopedics, Parc de Salut Mar, Universitat Autonoma de Barcelona, 
      Barcelona, Spain.
LA  - eng
PT  - Journal Article
DEP - 20180906
PL  - United States
TA  - Arthroscopy
JT  - Arthroscopy : the journal of arthroscopic & related surgery : official 
      publication of the Arthroscopy Association of North America and the International 
      Arthroscopy Association
JID - 8506498
RN  - 9012-76-4 (Chitosan)
SB  - IM
CIN - Arthroscopy. 2018 Oct;34(10):2829-2831. PMID: 30286882
MH  - Acetabulum/*surgery
MH  - Activities of Daily Living
MH  - Adult
MH  - Arthroscopy/*methods
MH  - Cartilage/*surgery
MH  - Chitosan/*therapeutic use
MH  - Female
MH  - Femoracetabular Impingement/*surgery
MH  - Follow-Up Studies
MH  - Hip Joint/surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Minimal Clinically Important Difference
MH  - *Tissue Scaffolds/chemistry
EDAT- 2018/09/10 06:00
MHDA- 2019/10/09 06:00
CRDT- 2018/09/10 06:00
PHST- 2018/01/07 00:00 [received]
PHST- 2018/06/06 00:00 [revised]
PHST- 2018/06/10 00:00 [accepted]
PHST- 2018/09/10 06:00 [pubmed]
PHST- 2019/10/09 06:00 [medline]
PHST- 2018/09/10 06:00 [entrez]
AID - S0749-8063(18)30525-5 [pii]
AID - 10.1016/j.arthro.2018.06.037 [doi]
PST - ppublish
SO  - Arthroscopy. 2018 Oct;34(10):2821-2828. doi: 10.1016/j.arthro.2018.06.037. Epub 
      2018 Sep 6.