Maurilio Marcacci

Istituto Ortopedico Rizzoli, Bolonia, Emilia-Romagna, Italy

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Publications (332)654.01 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: While midterm results of matrix-assisted autologous chondrocyte transplantation (MACT) are now available, less attention has been paid to the evaluation of failures of this surgical approach. Aim of this study was to analyse how "failures" are generally defined in cartilage surgery, in order to understand how the survival rate may change according to different definitions of failure.
    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 09/2014;
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    ABSTRACT: Background aims Platelet-rich plasma (PRP), a blood derivative rich in platelets, is a relatively new technique used in tissue regeneration and engineering. The increased quantity of platelets makes this formulation of considerable value for their role in tissue healing and microbicidal activity. This activity was investigated against five of the most important strains involved in nosocomial infections (Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae and Streptococcus faecalis) to understand the prophylactic role of pure (P)-PRP. Microbicidal proteins released from activated P-PRP platelets were also determined. Methods The microbicidal activity of P-PRP and platelet-poor plasma (PPP) was evaluated on different concentrations of the five bacterial strains incubated for 1, 2, 4 and 18 h and plated on agar for 18–24 h. P-PRP and PPP-released microbicidal proteins were evaluated by means of multiplex bead–based immunoassays. Results P-PRP and PPP inhibited bacterial growth for up to 2 h of incubation. The effect of P-PRP was significantly higher than that of PPP, mainly at the low seeding concentrations and/or shorter incubation times, depending on the bacterial strain. Chemokine (C-C motif) ligand-3, chemokine (C-C motif) ligand-5 and chemokine (C-X-C motif) ligand-1 were the molecules mostly related to Pseudomonas aeruginosa, Staphylococcus aureus and Streptococcus faecalis inhibition. Escherichia coli and Klebsiella pneumoniae were less influenced. Conclusions The present results show that P-PRP might supply an early protection against bacterial contaminations during surgical interventions because the inhibitory activity is already evident from the first hour of treatment, which suggests that physiological molecules supplied in loco might be important in the time frame needed for the activation of the innate immune response.
    Cytotherapy 09/2014; 16(9):1294–1304. · 3.06 Impact Factor
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    ABSTRACT: The goal of this study was to compare three types of mobile-bearing posterior cruciate ligament (PCL)-sacrificing TKA. The hypothesis was that the three designs provide differences in flexion stability and femoral rollback and improved clinical score at 2-year follow-up.
    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 07/2014;
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    ABSTRACT: Good clinical results have been demonstrated in numerous clinical studies using the collagen meniscus implant (CMI); however, the MRI behaviour of the scaffold, evaluated with Genovese score, is limited to a few cases series. The purpose was to evaluate, using the Genovese score, the MRI behaviour of the CMI at different follow-up periods and investigate possible differences in the behaviour of lateral and medial CMI.
    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 07/2014;
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    ABSTRACT: To compare the clinical, objective and radiographic long-term results of patients with anterior cruciate ligament (ACL) lesion and partial medial meniscus defects, treated with ACL reconstruction and partial medial meniscectomy or medial CMI implant.
    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 07/2014;
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    ABSTRACT: The aim of this systematic review was to document the available clinical evidence to support meniscal scaffold implantation, analysing results and indications for the treatment of meniscal loss.
    International Orthopaedics 06/2014; · 2.32 Impact Factor
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    ABSTRACT: The discovery of new strategies to repair large segmental bone defects is currently an open challenge for worldwide clinicians. In the treatment of critical-sized bone defects, an alternative strategy to traditional bone grafting is always more frequently the use of tailor-made scaffolds modelled on the final size and shape of the implant site. Here, poly-ε-caprolactone-based composite scaffolds including poly-l-lactic acid continuous fibres and hyaluronan derivates (i.e. HYAFF11®) have been investigated for the peculiar 3D architecture characterized by interconnected macroporous networks and tunable mechanical properties. Composite scaffolds were immersed in simulated body fluid solution in order to support in vivo tissue in-growth. Scaffolds loaded with autologous cells (bone marrow stromal cells) plus platelet-rich plasma and osteoconductive protein such bone morphogenetic protein-7 were also tested to evaluate eventual enhancement in bone regeneration. The morphological and mechanical properties of poly-l-lactic acid-reinforced composite scaffolds have been studied to identify the optimal scaffold design to match the implant-site requirements of sheep metatarsal defects. Dynamic mechanical tests allowed to underline the viscoelastic response of the scaffold - resulting in elastic moduli from 2.5 to 1.3 MPa, suitable to temporarily support the structural function of damaged bone tissue. In vivo preliminary investigations in a sheep model of metatarsus shaft defect also showed the attitude of the scaffold to promote osteogenesis, preferentially in association with bone marrow stromal cell and platelet-rich plasma, even if the highest amount of mature bone was reached in the case of scaffold loaded with human bone morphogenetic protein-7 released via hydrolytic degradation of HYAFF11® phases in the implant site.
    Journal of Biomaterials Applications 06/2014; · 2.64 Impact Factor
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    ABSTRACT: The purpose of this systematic review was to summarise and evaluate the clinical outcomes of the collagen meniscus implant (CMI) and its complication and failure rates. These data were then used to evaluate the results of the CMI at different follow-up time periods and investigate possible differences in the behaviour of lateral and medial CMI.
    International Orthopaedics 06/2014; · 2.32 Impact Factor
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    ABSTRACT: Chronic Achilles tendinopathy is responsible for a severe reduction in physical performance and persistent pain. There is currently a number of therapeutic options and the local administration of growth factors is an emerging treatment strategy. In particular, platelet-rich plasma (PRP) is a widely used way to provide a local regenerative stimulus for tendon healing. The aim of this study was to document the mid-term results obtained after treating recalcitrant Achilles tendinopathy with injections of high concentrate, leucocyte-rich PRP.
    06/2014;
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    ABSTRACT: To analyse the modifications induced by two different platelet-rich plasma (PRP) preparations on osteoarthritis (OA) synoviocytes, by documenting changes in gene expression of factors involved in joint physiopathology.
    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 06/2014;
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    ABSTRACT: The main purpose of the present study was to determine long-term implant fixation of 15 unicompartmental knee arthroplasty (UKAs) with an all-poly tibial component using Roentgen stereophotogrammetric analysis (RSA) at a mean 10-year follow-up. The secondary purpose was to investigate whether the progressive loss of implant's fixation correlates with a reduction in Knee society score (KSS).
    Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 06/2014;
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    ABSTRACT: To prospectively investigate whether preoperative functional flexion axis in patients with osteoarthritis- and varus-alignment changes after total knee arthroplasty and whether a correlation exists both between preoperative functional flexion axis and native limb deformity. A navigated total knee arthroplasty was performed in 108 patients using a specific software to acquire passive joint kinematics before and after implant positioning. The knee was cycled through three passive range of motions, from 0° to 120°. Functional flexion axis was computed using the mean helical axis algorithm. The angle between the functional flexion axis and the surgical transepicondylar axis was determined on frontal (α (F)) and axial (α (A)) plane. The pre- and postoperative hip-knee-ankle angle, related to femur mechanical axis, was determined. Postoperative functional flexion axis was different from preoperative only on frontal plane, while no differences were found on axial plane. No correlation was found between preoperative α (A) and native limb deformity, while a poor correlation was found in frontal plane, between α (F) and preoperative hip-knee-ankle angle. Total knee arthroplasty affects functional flexion axis only on frontal plane while has no effect on axial plane. Preoperative functional flexion axis is in a more varus position respect to the transepicondylar axis both in pre- and postoperative conditions. Moreover, the position of the functional axis on frontal plane in preoperative conditions is dependent on native limb alignment, while on axial plane is not dependent on the amount of preoperative varus deformity. LEVEL OF EVIDENCE: IV.
    Knee Surgery Sports Traumatology Arthroscopy 05/2014; · 2.68 Impact Factor
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    ABSTRACT: The goal of this study was to compare the kinematics of knees before and after total knee arthroplasty (TKA) that relies on an inter-condylar 'third condyle'. The hypothesis was that the 'third condyle' provides sufficient flexion stability and induces a close to normal femoral rollback, thus granting natural joint kinematics. Intra-operative navigation data were collected from 29 consecutive cases that received a cemented TKA (HLS Noetos, Tornier SA, France) designed with an inter-condylar 'third condyle' that engages within the tibial insert beyond 35° flexion. Operations were guided by a non-image-based system (BLU-IGS, Orthokey Italia srl, Italy) that recorded relative femoral and tibial positions in native and implanted knees during: passive range of motion, anterior drawer test at 90° flexion, and varus-valgus stress tests at full extension and at 30° flexion. The total internal tibial rotation during flexion was similar for native (8.2 ± 4.2°) and implanted knees (8.0 ± 5.4°). The lateral femoral condyle was more posterior in implanted knees (1.2 ± 9.4 mm) than in native knees (9.5 ± 3.6 mm) throughout early flexion (p < 0.01), but this difference diminished beyond 100° flexion (n.s.). The implanted knees did not exhibit paradoxical external tibial rotation. Varus-valgus laxity in full extension was lower for implanted knees than for native knees (p = 0.0221), but at 30° flexion was almost identical for both native and implanted knees. Anteroposterior laxity was similar in implanted and native knees. The 'third condyle' TKA provides similar anteroposterior and mediolateral stability to the natural knee. This feature granted an adequate balance between laxity and constraint to reproduce natural joint kinematics, including smooth femoral rollback, without causing paradoxical external tibial rotation. Comparative study, Level III.
    Knee Surgery Sports Traumatology Arthroscopy 05/2014; · 2.68 Impact Factor
  • Clinical Orthopaedics and Related Research 04/2014; · 2.79 Impact Factor
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    ABSTRACT: Osteogenic Growth Peptide (OGP) motifs were tethered to SULFHYDRYL-BIND™ polystyrene plates tuning spatial presentation of the different functional domains. The effect of the different surface-tethered OGP motifs have been evaluated in mesenchymal stem cells (MSCs) osteogenesis. Culture media without any osteogenic supplements was used in order to evaluate OGP effect, avoiding any interference by additional factors. The motif YGFGG resulted to be the most interesting, strongly enhancing the expression of BMP2 that plays a fundamental role in bone regeneration. With this study we present new evidence of the role of OGP in osteogenesis and new insights on different OGP motifs able to act as best ligands for the design of innovative bioactive materials for osteogenesis promotion and regenerative medicine applications
    MedChemComm. 04/2014;
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    ABSTRACT: We report the case of a 50 years-old man who complained persisting knee pain that limited almost completely his sport performance. Since he previously underwent multiple aortocoronaric by-passes, he presented a chronic anti-aggregant therapy. In spite of this clinical history, he was still sport active and able to run long-distance races, until knee symptoms limited is activity level. Conservative treatment approaches proved to be unsuccessful, thus we decided to treat him by 3 Platelet-rich Plasma (PRP) injections even if chronic anti-aggregant therapy is generally regarded as a contra-indication for PRP, since this kind of drugs impairs platelet function and granules' release. Despite these premises, the clinical outcome was very satisfactory and the patient was able to rapidly resume intensive running activity. This experience opens new questions regarding the real potential of PRP in treating degenerative musculo-skeletal disorders, and in particular on its range of biological actions and on its limitations for clinical application.
    European review for medical and pharmacological sciences. 04/2014; 18(1 Suppl):55-9.
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    ABSTRACT: We report the case of a 31-year-old Olympic fencer, affected by complex degenerative lesions of the knee due to subtotal meniscal loss and patellar overload. The patient underwent a biological knee reconstruction including the treatment of the articular surface combined with lateral meniscal allograft transplantation and patellar realignment. This complex surgical approach significantly improved the knee function and reduced the pain. The athlete was able to get back to official competition 17 months after surgery.
    European review for medical and pharmacological sciences. 04/2014; 18(1 Suppl):76-80.
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    ABSTRACT: Focal chondral and osteochondral knee lesions are a common condition, particularly hard to treat, and often involve young active patients with high expectations in terms of symptomatic relief and return to sports. Autologous osteochondral transplantation allows the defect area to be restored with hyaline cartilage. The aim of this study is to analyse whether it represents a safe and effective treatment option for small-medium-sized knee chondral and osteochondral lesions in a young and active population. Thirty-one patients (18 men, 13 women; mean age 32 ± ten; mean BMI 24 ± 3) affected by focal knee chondral and osteochondral lesions were enrolled and treated with autologous osteochondral transplantation. They were prospectively followed-up for 24 months with the IKDC-subjective, IKDC-objective, and Tegner scores. Adverse events and failures were also reported, as well as the Bandi score to detect symptoms from the donor area. A significant increase was reported in all the clinical scores adopted. In particular, the IKDC-subjective score increased from a basal value of 40.3 ± 16.2 to 62.6 ± 18.0 at the 12 months' evaluation, with a further significant increase up to 71.6 ± 20.5 at the final 24 months' follow-up (p < 0.0005). A positive trend was also found by analysing the IKDC-objective score. The Tegner score revealed a significant improvement from a basal value of 2.2 ± 1.8 to 3.7 ± 1.5 at the final evaluation (p = 0.003), although it was not possible to regain the same pre-injury sports activity level of 5.0 ± 2.2. Two failures were reported. The Bandi score revealed patients complaining of mild and moderate symptoms, not correlated to the lesion size. The presence of symptoms ascribable to the donor area was significantly correlated with a lower clinical outcome. Autologous osteochondral transplantation proved to be, at short-term evaluation, a suitable option to treat small-medium sized chondral and osteochondral lesions. However, clinical improvement is slow and a significant percentage of patients develop symptoms attributable to the donor area, thus reducing the overall benefit of this procedure.
    International Orthopaedics 03/2014; · 2.32 Impact Factor
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    ABSTRACT: Collagen electrospun scaffolds well reproduce the structure of the extracellular matrix (ECM) of natural tissues by coupling high biomimetism of the biological material with the fibrous morphology of the protein. Structural properties of collagen electrospun fibers are still a debated subject and there are conflicting reports in the literature addressing the presence of ultrastructure of collagen in electrospun fibers. In this work collagen type I was successfully electrospun from two different solvents, trifluoroethanol (TFE) and dilute acetic acid (AcOH). Characterization of collagen fibers was performed by means of SEM, ATR-IR, Circular Dichroism and WAXD. We demonstrated that collagen fibers contained a very low amount of triple helix with respect to pristine collagen (18 and 16 % in fibers electrospun from AcOH and TFE, respectively) and that triple helix denaturation occurred during polymer dissolution. Collagen scaffolds were crosslinked by using 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide (EDC), a commonly employed crosslinker for electrospun collagen, and 1,4-butanediol diglycidyl ether (BDDGE), that was tested for the first time in this work as crosslinking agent for collagen in the form of electrospun fibers. We demonstrated that BDDGE successfully crosslinked collagen and preserved at the same time the scaffold fibrous morphology, while scaffolds crosslinked with EDC completely lost their porous structure. Mesenchymal stem cell experiments demonstrated that collagen scaffolds crosslinked with BDDGE are biocompatible and support cell attachment.
    Journal of Materials Science Materials in Medicine 03/2014; · 2.14 Impact Factor
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    ABSTRACT: The present paper describes a new minimally invasive anatomic medial patellofemoral ligament reconstruction, using a fascia lata allograft as graft source and arthroscopy to obtain balanced fixation throughout the range of motion.
    Knee Surgery Sports Traumatology Arthroscopy 03/2014; · 2.68 Impact Factor

Publication Stats

5k Citations
654.01 Total Impact Points

Institutions

  • 1993–2014
    • Istituto Ortopedico Rizzoli
      • • Laboratory of Biomechanics and Technology Innovation
      • • Movement Analysis Laboratory
      Bolonia, Emilia-Romagna, Italy
  • 1991–2013
    • University of Bologna
      • Department of Biomedical Science and Neuromotor Sciences DIBINEM
      Bolonia, Emilia-Romagna, Italy
  • 2012
    • Politecnico di Milano
      • Department of Bioengineering
      Milano, Lombardy, Italy
    • Stanford University
      • Department of Orthopaedic Surgery
      Stanford, CA, United States
    • Università degli Studi di Messina
      Messina, Sicily, Italy
  • 2011
    • Brigham and Women's Hospital
      • Department of Orthopaedic Surgery
      Boston, MA, United States
  • 2008
    • Università degli Studi di Trento
      Trient, Trentino-Alto Adige, Italy
  • 1997–2005
    • Scuola Superiore Sant'Anna
      • The Biorobotics Insititute
      Pisa, Tuscany, Italy