EFFICACY OF BIOMIMETIC COLLAGEN-HYDROXYAPATITE SCAFFOLDS AND BONE MARROW STIMULATION IN ARTICULAR CARTILAGE AND BONE REGENERATION

Chondral and osteochondral lesions often progress to osteoarthritis, causing pain, disability, and significant socioeconomic burden. While bone marrow stimulation (BMS) remains a standard technique for chondral re­pair, its efficacy is limited in large or deep lesions due to fibrous repair tissue formation. Biomimetic collagen– hydroxyapatite (coll-HA) scaffolds, designed to mimic osteochondral tissue architecture, offer a promising al­ternative by supporting both cartilage and subchondral bone regeneration. A systematic literature review identi­fied four relevant clinical studies, including a randomized controlled trial and observational cohorts. Clinical outco­mes consistently demonstrated significant improvements in functional scores (IKDC, KOOS, VAS, Tegner), with particularly favorable results in patients with deep oste­ochondral defects and active athletes treated with coll- HA. Long-term follow-up confirmed sustained benefits, although imaging findings indicated variable integration. Coll-HA scaffolds, alone or in combination with bone marrow aspirate, represent a safe and effective option for complex cartilage repair, while further large-scale studies are needed to confirm long-term durability and prevention of osteoarthritic progression.