Buckwalter J A, Bowman G N, Albright J P, Wolf B R, Bollier M
Iowa Orthop J. 2014;34:44-9.
Juvenile particulated cartilage allograft (DeNovo NT®, Zimmer, Warsaw, IN) transplantation is a relatively new technology for the treatment of high-grade cartilage lesions. To date there is limited literature demonstrating its effectiveness and safety. The present study specifically looks at the short-term efficacy of DeNovo NT® allograft for symptomatic high-grade cartilage lesions of the patella. Clinical outcomes and complications are reported.
Seventeen cases of DeNovo NT® allograft transplantation at our institution were retrospectively reviewed from 2010 to 2013. Thirteen patients had the procedure performed for patellar lesions and are included in the present study. A chart review was performed to record demographic data, surgical technique, and complications. In addition, we analyzed preoperative and postoperative KOOS outcome scores.
The mean age was 22.5 years (range, 14-34), with 3 males and 10 females. Mean follow-up was 8.2 months (range, 0.67-32.7). Six of the patients had concomitant anteromedialization of the tibial tubercle. DeNovo NT® allograft transplantation resulted in improvement for each outcome measure used. Overall KOOS score significantly improved from a mean of 58.4±15.7 to 69.2±18.6 (P = 0.04). Improvement in KOOS subscales of pain, ADL, and symptoms all approached but did not reach statistical significance (P values between 0.05 and 0.10). There were no infections or hardware complications.
This series demonstrates that DeNovo NT® allograft transplantation for symptomatic high-grade cartilage lesions of the patella results in pain relief and improved outcomes in the short term. Further studies are needed to better evaluate this new technology.
Level IV, therapeutic case series.
青少年颗粒状软骨同种异体移植（DeNovo NT®，捷迈邦美公司，华沙，印第安纳州）是一种用于治疗高级别软骨损伤的相对较新的技术。迄今为止，仅有有限的文献证明其有效性和安全性。本研究专门观察了DeNovo NT®同种异体移植治疗有症状的髌骨高级别软骨损伤的短期疗效。报告了临床结果和并发症情况。
回顾性分析了2010年至2013年在我院进行的17例DeNovo NT®同种异体移植病例。其中13例患者因髌骨损伤接受了该手术，并纳入本研究。通过查阅病历记录人口统计学数据、手术技术和并发症情况。此外，我们分析了术前和术后的膝关节损伤与骨关节炎疗效评分（KOOS）结果。
平均年龄为22.5岁（范围14 - 34岁），男性3例，女性10例。平均随访时间为8.2个月（范围0.67 - 32.7个月）。6例患者同时进行了胫骨结节内移术。DeNovo NT®同种异体移植使所使用的各项结果指标均有所改善。总体KOOS评分从平均58.4±15.7显著提高至69.2±18.6（P = 0.04）。KOOS疼痛、日常生活活动能力（ADL）和症状亚量表的改善均接近但未达到统计学显著性（P值在0.05至0.10之间）。未发生感染或硬件相关并发症。
本系列研究表明，DeNovo NT®同种异体移植治疗有症状的髌骨高级别软骨损伤在短期内可缓解疼痛并改善结果。需要进一步研究以更好地评估这项新技术。
IV级，治疗性病例系列。
