The study "Therapy of osteochondral defects: chondrointegration of metal implants improves after hydroxyapatite coating" by H. Schell et al. (Julius Wolff Institut, Charité University Hospital, Berlin, Germany), shows the effect of hydroxyapatite coating on cartilage. 

"This exciting article about the concept "chondrointegration", which is a unique feature of the Episealer implant, implies that chondrointegration becomes accepted in the field of cartilage surgery. In this comparative sheep study, it has been shown that cartilage adheres to the hydroxyapatite which is used for coating of the Episealer implant. This encourages sealing of the cartilage lesion, resulting in protection of the deeper parts of the joint from aggressive joint fluid, which, in turn, should give better longevity of the implant" says Prof. Leif Ryd, Senior Medical Advisor, Episurf Medical.

 

Episealer, a Patient-Specific Implant for Focal Cartilage Lesions - a 24-month follow-up
 

 

- Dr Anders, your department performed its first Episealer surgery 22 months ago, what convinced you to start using Episealer?
Due to a lack of treatment options for middle-aged patients with isolated extensive osteochondral defects on the femoral condyles, we were looking for alternative treatment methods. In this particular case, we did not find the indication was right for hemiarthroplasty or total knee replacement. Nonetheless, ongoing pain and insufficiency suggested an operative treatment.

- Did you consider any other treatment alternatives for this patient?
Unfortunately, until today there is no advancement in biological procedures for this kind of indication. Osteochondral graft transfer and autologous cartilage repair are still considered problematic, so we did not find any other alternative.

- What made you decide to use Episealer?
Episealer is a well-balanced treatment process. Starting with a special diagnostic MRI, we first discussed the indications with the Episurf Medical team. After a positive decision, the patient was informed and the production process of the individualised implant initiated. The surgery itself is well supported by a properly designed 'Final Design' document and an Episurf representative present. All in all, it is a very safe surgical procedure.

- With soon two years’ experience of using Episealer, how do you find Episealer suits your clinic today?
We are now following up 7 patients; all have excellent clinical outcomes. No infections were seen and there was no need for additional procedures. Episealer is a modern and innovative treatment option for patients with isolated extensive osteochondral defects on the femoral condyles. The pre-operative planning process with visualisation of the size and depth of the defect guarantees a perfect and individualised implant fit. With a minimally invasive approach, excellent postoperative clinical results are achieved. We are therefore able to close the therapeutical treatment gap to hemi- or total arthroplasty in these particular cases.

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Some highlights:

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