Introduction: Always more orthopaedic surgeons are nowadays putting all their efforts in improving knee osteochondral defects treatment.

Material and Methods: In order to relieve patient symptoms we have retained of value, among other treatment options in use at our institution, to rely, in older patients, on a new, non biological, method of treating chondral and osteochondral defects and since November 2002 we started using artificial synthetic cartilage implants made of polyvinylalcohol-hydrogel (SaluCartilage™ – Salumedica).

Results: Serial clinical and MRI follow-ups have been conducted. The 65 treated patients have shown significant improvement over preoperative values of 2000 International Knee Documentation Committee Knee Examination Forms. In fact at one year follow-up patients showed an average increase of 24 points over preoperative values of IKDC score, this improvement further raised up at the two year follow-up to a 33 points improvement (range of improvement 14,94 – 68,67) and has been confirmed at the three years evaluation.

Follow-up MRI images revealed normal healing process, without signs of osteolysis or wear. No synovial joint reaction has been observed, but one case of implant’s dislocation occurred.

Conclusions: Based on our mid term results, that have confirmed the short term ones, this study demonstrates that, in middle aged patients, between the fourth and the seventh decade, the use of a non biologic device, the implantation of a polyvinyl alcohol prosthesis in the chondral defect, represents an innovative treatment choice that knee surgeons need to be aware of and prompt to use it in the correct cases. In fact, in our opinion, the “chondral surgeon” must be ready to use different treatments in the different patients. To facilitate the use of Salucartilage ™ implant we suggest the rationale of it’s use with the auspice that surgeon’s experience and round tables will be able to better define the correct indications of each surgical possible solution of chondral defects. The immediate postoperative weight bearing and full regaining of recreational and sport activities are an added advantage of this technique that can be therefore when needed associated to other surgical procedures, such as osteotomies or ACL reconstructions.