Vol.XXXVII, Suppl. 1 - Giornale Italiano di Ortopedia e Traumatologia

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Certe affezioni della superfi cie articolare, come ad esempio
quelle risultanti da OCD, osteonecrosi e traumi, possono
coinvolgere primariamente l’osso subcondrale 1 3 4 .
Lo stato anatomo-funzionale della cartilagine articolare
e dell’osso che la sostiene sono strettamente collegati ed
infortuni di vario genere possono infl uire sia sulla biomeccanica
che sull’ambiente intra-articolare, interferendo direttamente
sulle modalità con cui la superfi cie cartilaginea
viene sollecitata 3 , col rischio di contribuire ad avviare lo
sviluppo di osteoartrosi.
Obiettivi del chirurgo dovrebbero essere ristabilire la superfi
cie articolare in maniera più anatomica possibile,
ripristinando le proprietà fi siologiche dell’unità osteocon-
Bibliografi a
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drale in maniera stabile nel tempo. L’innesto di scaffolds
bioingegnerizzati direttamente a livello del sito di lesione
permette inoltre di effettuare la procedura chirurgica in
una sola soluzione (tecniche “one step”) ed è in questo
senso che si sta orientando la ricerca in questi anni.
In tempi recenti sono stati sviluppati molti scaffolds dotati
di potenziale rigenerativo in senso osteocondrale, di cui
solo due attualmente impiegati in clinica. Sebbene i risultati
preliminari, pur non sempre concordi, si siano rivelati
promettenti, vi è ancora la necessità di studi comparativi
di elevato valore scientifi co e a più lunghi tempi di followup
per testimoniare l’effi cacia e l’affi dabilità di queste
procedure nel tempo.
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A novel nano-composite multi-layered biomaterial
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Orderly ostechondral regeneration in a
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