Minimal invasive total ankle implant arthoplasty
Customized total ankle implant arthoplasty
Biological resurfacing in severe ankle or as alternative to traditional implant arthroplasty
An innovative personal clinical experience has provided evidence that widest areas of cartilage reconstruction in severe defects due to osteoarthritis of the inferior limb, Kellgren stage I to III, in particular knee and ankle, can be successfully restored through the combinatorial transplant of human bone marrow derived stem cells and adipose tissue derived stem cells: both are embedded within nanofabricated scaffolds with tailored oriented architecture and fiber diameter (Chondrotissue by Biotissue, Freiburg,D http.//www.biotissue.de). This scaffold is a 100% syntetic and resorbable membrane that is cut in an appropriate size following the area of the lesion and loaded by a perfusion device with a different share of bone marrow concentrate and adipose stromal tissue Regenerative Fraction source. The loaded scaffold/s is/are placed in situ and sealed with fibrin glue and stay sutures or resorbable T pins to resurface a single/multiple wide loss/es of cartilage tissue. In severe osteoarthritis where the surface is completely bald and there are no health cartilage shoulders, the reconstruction is made by a personal indentation technique in which patches are stabilized at each corner by resorbable micro anchors after encasement of the last. The mean size of the lesions in our cases serie is 9.5cm2 (range 4.5–34 cm2).Patients are then directed to a specific rehabilitation program.
On these bases, the combinatorial use of autologous non-expanded tissue products made of whole bone marrow and human WAT derivatives, such as the adipose stromal tissue Regenerative Fraction source product (My STEM), can be considered as an autologous/homologous strategy for improving the natural capacity for self-healing in damaged osteo-articular tissues. These results suggest that MSCs resurfacing procedure even in severe unicompartmental OA demonstrates as an effective treatment for a biological coating that provides at least at medium-term data, remission of pain and swelling, with good functional recovery and an overlapping outcome vs ACT procedure with the advantage of a single operative step, and consequent and important cost reductions.