alexa 10 years clinical follow-up of the first Hemicap® resurfacing mini prosthesis in the knee of a former active 55 year old man with a full thickness osteochondrale lesion | Open Access Journals
Journal of Medical Implants & Surgery
Like us on:
Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on
Medical, Pharma, Engineering, Science, Technology and Business

10 years clinical follow-up of the first Hemicap® resurfacing mini prosthesis in the knee of a former active 55 year old man with a full thickness osteochondrale lesion

Jens Ole Laursen*

Othopedic and Emergency Department, Hospital of South Jutland, Vimmelskaftet, Sydals, Denmark

*Corresponding Author:
Jens Ole Laursen
Othopedic and Emergency Department
Hospital of South Jutland
Vimmelskaftet 16, 6470 Sydals, Denmark
Tel: +45 29173433
E-mail: [email protected]; [email protected]

Received Date: January 04, 2017; Accepted Date: February 03, 2017; Published Date: February 10, 2017

Citation: Laursen JO (2017) 10 Years Clinical Follow-Up of the First Hemicap® Resurfacing Mini Prosthesis in the Knee of a Former Active 55 Year Old Man with a Full Thickness Osteochondrale Lesion. J Med Imp Surg 2: 112.

Copyright: © 2017 Laursen JO. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Visit for more related articles at Journal of Medical Implants & Surgery


The treatment of osteochondral lesions remains a clinical challenge. A “treatment-gap” has been identified, where middle-aged patients with focal knee-lesions are considered too old for biological treatment, and yet too young for uni- or total arthroplasty (UKA/ TKA). In order to try to fill this gap, a novel metal mini-prosthesis – Hemicap® - was invented and clinically tested, and was introduced in Denmark ( DK ) in 2006. The aim of this case report is to present this first “Danish patient” at his 10-year clinical follow-up.


Osteochondral; Arthroplasty; Hemicap procedure


The HemiCAP® resurfacing implant consists of two components: a fixation component and a modular articular component, connected with a Morse Taper (HemiCAP® Focal Femoral Condyle Resurfacing Prosthesis, Arthrosurface Inc, Franklin, MA, USA). The fixation component is a titanium cancellous screw with full-length cannulation. The cobalt chrome articular component is available in 15 or 20 mm diameter and comes in 16 different offset configurations which 15 correspond to the superior/inferior and medial/lateral radius of curvatures at the implant site. The trochlear implant is 15 or 20 mm in diameter with a single concave shape fitting the trochleal 17 sulcus (Figure 1). A polyethylene inlay is available for the patella and is recommended to be used 18 in combination with the trochlear implant. [1-11].


Figure 1: Hemicap for femoral condyle and trochlea.

Surgical procedure The procedure was initiated with a standard arthroscopy to identify cartilage status and treat any concomitant intra articular pathology. The defect was exposed using a small para-patellar incision. The cartilage lesion was sized and a special centralized drill guide was used to place a k-wire perpendicular and central to the articular cartilage surface. Over the k-wire, the reaming for the fixation screw was performed and the screw was implanted into the bone. Mapping instruments were used to measure the surface curvature, and a matching surface reamer prepared the inlay implant bed. Sizing trials were used to confirm an accurate fit to the surrounding cartilage. The resurfacing implant was press- fit onto the fixation screw and was seated slightly recessed – (0.5 mm) - to the surrounding articular cartilage surface (Figure 2). A standardized rehabilitation protocol with free range of motion was allowed immediately postoperatively.


Figure 2: Steps in the operation.

Case Presentation

55 year-old man a construction worker with his own small subcontracting company having problems working due to increasing knee pain. He had been using strong painkillers (Paracetamol, NSAIDs and periodically morphine) to be able to continue to work, and had two arthroscopies and micro- fractures done without clinical effect on his large osteochondritis dissecans in the medial condyle (Figure 3). Radiographs and MR and arthroscopy showed nice, healthy cartilage in the other compartments. He had been unable to work for the last 6 months prior to operation because of pain and impaired function, and was now at risk of long-term unemployment.


Figure 3: Osteochondral lesion (osteochondritis dissecans) in the medial femur-condyle. Radiographs: a) preoperation, b) postoperation and at c) 10 year clinical control.

He was chosen to be the first person in Denmark to undergo the Hemicap procedure. He followed our postoperative protocol, and was pain free at his 6 week appointment, not on any medications and had returned to fulltime work. The Patient continued to work his construction job for another 9 years and to this day remains active and pain free.

He was followed up in clinic and with radiographs at 3 months, 1, 2, 5 and 10 years. VAS preoperative at 7 fell to 1 – 2 at the present and AKSS rising from 45 postoperative and at 10 years 90 – 95. KLgrade was preoperative 0 – 1 in all compartments, and now at 10-years, 2 in medial compartment and 1 in the others. There are no signs of any loosening of the Hemicap® (Table 1).

  Prep 3 months 1 year 2 years 5 years 10 years
Pain score - VAS 8 4 2 1 1 2
AKSSfunc. 45 80 95 95 90 90
AKSSobj. 50 85 90 90 90 90
KL grade            
Medil 1 1 1 1 1 2
Lateal 0 0 0 1 1 1

Table 1: Clinical and radiographic outcomes.


The 10-year follow-up result after treatment with this new metal inlay mini-prosthesis -Hemicap® - in a challenging “older” patient with focal full-thickness (osteo) chondral lesion ( osteochondritis dissecans ) and a history of failed previous cartilage surgery demonstrated excellent long-term pain and subjective/objective outcome improvements. The patient went from being on the verge of losing his livelihood with all the financial and emotional risks that come with the unemployment to returning to full time work with minimal to no limitations [1,2,12,13]. In the US alone, 3.6 million people fall into this “treatment gap” and may significant benefit from having this procedure done [14].

Conflict of Interest

There is no conflict of interests.


Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Relevant Topics

Recommended Conferences

Article Usage

  • Total views: 345
  • [From(publication date):
    June-2017 - Oct 18, 2017]
  • Breakdown by view type
  • HTML page views : 291
  • PDF downloads :54

Post your comment

captcha   Reload  Can't read the image? click here to refresh

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

[email protected]

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals


[email protected]

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

[email protected]

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001 Extn: 9042

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version