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Clinics in Sports Medicine

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https://www.readbyqxmd.com/read/28577716/articular-cartilage-the-search-for-the-holy-grail-of-treatment-and-restoration
#1
EDITORIAL
Eric C McCarty
No abstract text is available yet for this article.
July 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28577715/articular-cartilage
#2
EDITORIAL
Mark D Miller
No abstract text is available yet for this article.
July 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28577714/the-early-osteoarthritic-knee-implications-for-cartilage-repair
#3
REVIEW
Chaitu Malempati, Cale A Jacobs, Christian Lattermann
Patients with early osteoarthritis (OA) have been reported to have inferior outcomes with an increased prevalence of early failure after cartilage procedures. The underlying reasons for this failure are likely multifactorial, including a chronic synovial and chondrogenic process, which is confounded by persistent muscle weakness and altered pain processing for those with increased preoperative symptom duration. Pain, radiographic changes, patient-reported outcomes, and macroscopic changes on arthroscopic evaluation or MRI can assist clinicians in identifying the early OA knee to both aid in clinical decision making and create realistic postoperative expectations for patients...
July 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28577713/a-critical-review-management-and-surgical-options-for-articular-defects-in-the-hip
#4
REVIEW
Eric C Makhni, Austin V Stone, Gift C Ukwuani, William Zuke, Tigran Garabekyan, Omer Mei-Dan, Shane J Nho
Patients with articular cartilage lesions of the hip may present with pain and symptoms that may be vague in nature and onset. Therefore, a thorough history and physical examination should be performed for every patient presenting with hip pain and/or disability. The management may be operative or nonoperative. Nonoperative management includes a trial of rest and/or activity modification, along with anti-inflammatory medications, physical therapy, and biologic injections. Operative treatment in the form of arthroscopic techniques continues to decrease morbidity and offer innovative solutions and new applications for microfracture, ACT, and AMIC...
July 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28577712/management-and-surgical-options-for-articular-defects-in-the-shoulder
#5
REVIEW
Bryan M Saltzman, Timothy Leroux, Brian J Cole
Isolated, full-thickness chondral lesions of the glenohumeral joint are a significant pathology encountered by laborers, athletes, and the elderly. A thorough history should be obtained in any patient presenting to the office with shoulder pain and concern for the etiology being an articular cartilage defect. The first-line imaging should include plain radiographs of the glenohumeral joint; MRI and CT can be ordered as necessary to provide greater detail. Typically, the initial treatment of glenohumeral chondral disease is nonsurgical; however, many surgical treatment options have been refined to provide pain relief, create reparative tissue, or restore the articular surface...
July 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28577711/autologous-chondrocytes-and-next-generation-matrix-based-autologous-chondrocyte-implantation
#6
REVIEW
Betina B Hinckel, Andreas H Gomoll
Focal chondral defects of the knee are common and can significantly impair quality of life. The autologous chondrocyte implantation technique has evolved over the past 20 years; the newest third-generation technique is matrix-induced autologous chondrocyte implantation. Physical examination is important to characterize location and source of pain and identify associated injuries. Imaging studies allow characterization of the lesions, identification of associated lesions, and alignment. Conservative measures should be exhausted before proceeding with surgical treatment...
July 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28577710/allografts-osteochondral-shell-and-paste
#7
REVIEW
Frank B Wydra, Philip J York, Armando F Vidal
There is an increasing need for articular cartilage restoration procedures. Hyaline cartilage lacks intrinsic healing capacity. Persistent osteochondral defects can lead to early and rapid degenerative changes. Microfracture and autologous chondrocyte implantation provide reasonable outcomes for smaller defects without bone loss. However, these techniques have limited effectiveness for lesions greater than 4 cm(2) or with significant bony involvement. Ostochondral allografts provide an option for these lesions...
July 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28577709/microfracture-and-microfracture-plus
#8
REVIEW
Jay C Albright, Ariel Kiyomi Daoud
Articular cartilage damage remains a significant cause for early osteoarthritis in adolescents and young adults. After chondroplasty alone, the mainstay procedure for cartilage injuries is microfracture. Although in small lesions this may be successful long-term, positive results of treating larger lesions this way are less certain. This inconsistency in outcomes has led to augmentation of these defects with scaffolding for autograft regeneration or for allograft cartilage to fill the defect with a hyaline cartilage...
July 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28577708/osteochondral-autologous-transplantation
#9
REVIEW
Seth L Sherman, Emil Thyssen, Clayton W Nuelle
Osteochondral autologous transplantation (OAT) is a treatment strategy for small and medium sized focal articular cartilage defects in the knee. This article reviews the indications, surgical techniques, outcomes, and limitations of OAT for the management of symptomatic chondral and osteochondral lesions in the knee joint.
July 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28577707/management-of-osteochondritis-dissecans-lesions-of-the-knee-elbow-and-ankle
#10
REVIEW
Kathryn L Bauer, John D Polousky
Although osteochondritis dissecans (OCD) has been a recognized condition for more than 100 years, our understanding of the etiology, natural history, and treatment remains poorly characterized. OCD most commonly affects the knee, followed by the elbow and ankle. Adolescents and young adults are most commonly affected. Patients present with vague, often intermittent symptoms and generally have no history of acute injury. Although diagnosis can be made with plain radiographs, treatment decisions are generally based on MRI...
July 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28577706/biologic-options-for-articular-cartilage-wear-platelet-rich-plasma-stem-cells-bone-marrow-aspirate-concentrate
#11
REVIEW
Matthew J Kraeutler, Jorge Chahla, Robert F LaPrade, Cecilia Pascual-Garrido
Biological treatments for articular cartilage repair have gained in popularity in the past decade. Advantages of these therapies include minimal invasiveness, improved healing time, and faster recovery. Biological therapies for cartilage repair include platelet-rich plasma, bone marrow aspirate concentrate, and cell-based therapies. These methods have the added benefit of containing growth factors and/or stem cells that aid in recovery and regeneration. The purpose of this article is to review the current cartilage treatment options and the existing literature on outcomes, complications, and safety profile of these products for use in the knee and hip joints...
July 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28577705/nonoperative-options-for-management-of-articular-cartilage-disease
#12
REVIEW
Sourav K Poddar, Luke Widstrom
Nonoperative options for articular cartilage injury are pervasive but have not shown to be curative. Recommendations for low-impact exercise and weight loss provide benefit and are a foundation for the treatment of osteoarthritis. Judicious use of NSAIDs and acetaminophen can be appropriate for pain management. Topical NSAIDs may be a treatment option with fewer side effects than its oral counterpart. Additionally, viscosupplementation injections are useful for mild to moderate knee osteoarthritis, whereas short-term pain relief is provided by intra-articular corticosteroid injections...
July 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28577704/imaging-of-cartilage-in-the-athlete
#13
REVIEW
Christopher M Coleman, Jonathan A Flug, Nancy Major
MRI remains the optimal imaging modality to evaluate cartilage injuries in the athlete. As these injuries have no intrinsic healing capacity, early and accurate noninvasive diagnosis remains integral to determining the most appropriate treatment option in this class of patients. Although surgical success depends primarily on clinical outcomes, MRI evaluation can provide pertinent information regarding the status of the surgical repair and the progression of cartilage disease.
July 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28577703/basic-science-of-articular-cartilage
#14
REVIEW
Camila B Carballo, Yusuke Nakagawa, Ichiro Sekiya, Scott A Rodeo
The most challenging aspects in treating articular cartilage injury include identifying the cellular and molecular mechanism(s) that lead to matrix changes and the differentiation and dedifferentiation behavior of chondrocytes, and understanding how they affect the structural integrity of the articular cartilage and tissue remodeling. Several treatment strategies have been proposed. A better understanding of the signaling pathways and growth and transcription factors for genes responsible for chondrogenesis is an important component in the development of new therapies to prevent cartilage degeneration or promote repair to replicate the physiologic and functional properties of the original cartilage...
July 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28314424/foreword
#15
EDITORIAL
Mark D Miller
No abstract text is available yet for this article.
April 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28314423/dental-and-orofacial-injuries
#16
REVIEW
Paul Piccininni, Anthony Clough, Ray Padilla, Gabriella Piccininni
Oral and facial injuries are very common in sport, and can be very expensive to treat. Many of these injuries are preventable with proper pre-competition assessment and suitable well-designed protection. Prompt sideline identification and management of orofacial injuries and appropriate follow-up are crucial to successful outcomes. There have been significant recent advances in both trauma management and mouth guard design and fabrication techniques. Athletes have a unique set of challenges-including collisions, finances, travel and training, dehydration, sport beverages, and high carbohydrate diets-that may compromise their oral health...
April 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28314422/maxillofacial-and-mandibular-fractures-in-sports
#17
REVIEW
Christopher F Viozzi
Sports account for 3% to 29% of facial injuries and 10% to 42% of facial fractures. Fractures of the facial skeleton most commonly occur owing to interpersonal violence or motor vehicle crashes. Facial fractures from sporting activities has clearly decreased over time owing to better preventive measures. However, this decreasing trend is offset by the emergence of more dangerous sports activities, or "pushing the envelope" of traditional sports activities. Fractures can occur from contact between athletes, and between athletes and their surroundings...
April 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28314421/nasal-injuries-in-sports
#18
REVIEW
Alexander P Marston, Erin K O'Brien, Grant S Hamilton
Nasal trauma is a common consequence of athletic competition. The nasal bones are the most commonly fractured facial bone and are particularly at risk during sports participation. Acute management of trauma to the nose includes thorough evaluation of all injuries and may require immediate management for repair of facial lacerations, epistaxis control, or septal hematoma drainage. Nasal fractures can often be addressed with closed reduction techniques; however, in the setting of complex nasal trauma, an open approach may be indicated...
April 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28314420/sport-injuries-of-the-ear-and-temporal-bone
#19
REVIEW
L Mariel Osetinsky, Grant S Hamilton, Matthew L Carlson
In cases of head trauma, the ear should be evaluated in all of its components. A good understanding of otologic and skull base anatomy enables a thorough trauma assessment of this complex anatomic region. Auricular laceration, abrasion, avulsion, hematoma, frostbite, otitis externa, exostosis, tympanic membrane perforation, ossicular discontinuity, perilymphatic fistula, labyrinthine concussion, temporal bone fracture, facial nerve paresis, and sensorineural hearing loss are a few of the more common otologic injuries seen in active patients...
April 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28314419/eye-and-orbital-injuries-in-sports
#20
REVIEW
Jonathan A Micieli, Michael Easterbrook
Sports-related eye and orbital injuries continue to occur regularly and may have serious consequences. They are completely preventable when appropriate protection is worn, particularly with polycarbonate lenses. Eye protection is available for most sports and should be worn in accordance with the standards of regional authorities. It is important for first responders to identify red flags in the history and physical examination of an injured athlete for urgent referral to an ophthalmologist. Common sports-related eye injuries include corneal abrasion, subconjunctival hemorrhage, hyphema, vitreous hemorrhage, retinal tears and detachment...
April 2017: Clinics in Sports Medicine
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