Cartilage reconstruction using Chondrofiller in intra-articular distal radius fractures.

INTRODUCTION

Intra-articular distal radius fractures (DRF) frequently result in post-traumatic cartilage defects, which can lead to early osteoarthritis, particularly when residual step-offs or gaps ≥ 2 mm remain after fracture reduction. While cartilage repair techniques are well established in large joints, options for small joints like the wrist remain limited. Chondrofiller liquid, a cell-free collagen type I hydrogel, has demonstrated regenerative potential in larger joints; however, its application in the wrist has not yet been studied.

METHODS

In this prospective clinical study, 59 patients with intra-articular DRFs treated by arthroscopy-assisted open reduction and internal fixation (ORIF) were included. In 25 cases, residual chondral defects between 0.5 and ≤ 2 mm were filled with Chondrofiller. Technical feasibility, defect characteristics, and application parameters were recorded. A subgroup of 8 Chondrofiller-treated patients underwent follow-up arthroscopy and was compared to a matched control group (n = 7) that had received ORIF without Chondrofiller. Cartilage quality was assessed using Outerbridge and the International Cartilage Repair Society (ICRS) classifications.

RESULTS

Chondrofiller was applied arthroscopically under dry conditions using G20-21 cannulas. Only 0.2-0.3 mL of the 1 mL preparation was required in most cases. At follow-up arthroscopy, patients treated with Chondrofiller showed significantly better cartilage quality (median Outerbridge 1.5 vs. 3, P = 0.006; ICRS 1 vs. 3, P = 0.002). Fibrous tissue formation (FTF) occurred only in overfilled defects, while flush applications were free of FTF. No significant differences were found in consolidation, complications, or associated injuries between groups.

CONCLUSION

Chondrofiller is technically feasible and safe for use in the wrist. When applied precisely and flush with the cartilage surface, it may improve cartilage quality after intra-articular DRF. Further long-term clinical and radiological studies are needed to assess its effectiveness in preventing post-traumatic osteoarthritis and to evaluate cost-effectiveness compared to standard treatment.