Magnetic resonance evaluation of TruFit® plugs for the treatment of osteochondral lesions of the knee shows the poor characteristics of the repair tissue

Background: Treatment of osteochondral lesions of the knee with synthetic scaffolds seems to offer a good surgical option preventing donor site morbidity. The TruFit (R) plug has frequently been shown to not properly incorporate into. Objective: To evaluate the relationship between MRI findings and functional scores of patients with osteochondral lesions of the knee treated with TruFit (R). Methods: Patients were evaluated with MOCART score for magnetic resonance imaging assessment of the repair tissue. KOOS, SF-36 and VAS were used for clinical evaluation. Correlation between size of the treated chondral defect and functional scores was also analyzed. Results: Fifty-seven patients with median follow-up of 44.8 months (range 24-73) were included. KOOS, SF-36 and VAS improved from a mean 58.5, 53.9 and 8.5 points to a mean 87.4, 86.6 and 1.2 at last follow-up (p < 0.001). Larger lesions showed less improvement in KOOS (p = 0.04) and SF-36 (p = 0.029). Median Tegner values were restored to preinjury situation (5, range 2-10). Mean MOCART score was 43.2 +/- 16.1. Although the cartilage layer had good integration, it showed high heterogeneity and no filling of the subchondral bone layer. Conclusions: TruFit (R) failed to restore the normal MRI aspect of the subchondral bone and lamina in most cases. The appearance of the chondral layer in MRI was partially re-established. This unfavourable MRI appearance did not adversely influence the patient's outcome in the short time and they restored their previous level of activity. There was an inverse linear relationship between the size of the lesion and the functional scores. (C) 2014 Elsevier B.V. All rights reserved.