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Knee And Microfractures

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https://www.readbyqxmd.com/read/30083564/a-controlled-comparison-of-microfracture-debridement-and-no-treatment-of-concomitant-full-thickness-cartilage-lesions-in-anterior-cruciate-ligament-reconstructed-knees-a-nationwide-prospective-cohort-study-from-norway-and-sweden-of-368-patients-with-5-year
#1
Svend Ulstein, Asbjørn Årøen, Lars Engebretsen, Magnus Forssblad, Stein Håkon Låstad Lygre, Jan Harald Røtterud
Background: The effect of microfracture (MF) or surgical debridement of concomitant full-thickness cartilage lesions in anterior cruciate ligament-reconstructed knees on patient-reported outcomes remains to be determined. Purpose: To evaluate the effect of debridement or MF compared with no surgical treatment of concomitant full-thickness cartilage lesions on patient-reported outcomes 5 years after anterior cruciate ligament reconstruction (ACLR). Study Design: Cohort study; Level of evidence, 2...
August 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/30067073/histological-evaluation-of-early-phase-changes-in-the-osteochondral-unit-after-microfracture-in-a-full-thickness-cartilage-defect-rat-model
#2
Seiju Hayashi, Tomoyuki Nakasa, Masakazu Ishikawa, Atsuo Nakamae, Shigeru Miyaki, Nobuo Adachi
BACKGROUND: The microfracture (MF) technique is an established surgical treatment for cartilage injury. However, the early-phase histological changes in full-thickness cartilage defects (FTCDs) after MF and the concomitant changes in the subchondral bone are still unknown. PURPOSE: To determine the early-phase histological changes in FTCD associated with subchondral bone remodeling after MF in rat model. STUDY DESIGN: Controlled laboratory study...
August 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29979806/reoperation-rates-after-cartilage-restoration-procedures-in-the-knee-analysis-of-a-large-us-commercial-database
#3
Rachel M Frank, Frank McCormick, Sam Rosas, Kelms Amoo-Achampong, Brandon Erickson, Bernard R Bach, Brian J Cole
The purpose of this study is to describe the rate of return to the operating room (OR) following microfracture (MFX), autologous chondrocyte implantation (ACI), osteochondral autograft transplantation (OATS), and osteochondral allograft (OCA) procedures at 90 days, 1 year, and 2 years. Current Procedural Terminology codes for all patients undergoing MFX, ACI, OATS, and OCA were used to search a prospectively collected, commercially available private payer insurance company database from 2007 to 2011. Within 90 days, 1 year, and 2 years after surgery, the database was searched for the occurrence of these same patients undergoing knee diagnostic arthroscopy with biopsy, lysis of adhesions, synovectomy, arthroscopy for infection or lavage, arthroscopy for removal of loose bodies, chondroplasty, MFX, ACI, OATS, OCA, and/or knee arthroplasty...
June 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29962234/articular-cartilage-repair-of-the-pediatric-and-adolescent-knee-with-regard-to-minimal-clinically-important-difference-a-systematic-review
#4
Rosa S Valtanen, Armin Arshi, Benjamin V Kelley, Peter D Fabricant, Kristofer J Jones
Objective To perform a systematic review of clinical outcomes following microfracture (MFX), autologous chondrocyte implantation (ACI), osteochondral allograft transplantation (OCA), and osteochondral autograft transplantation system (OATS) to treat articular cartilage lesions in pediatric and adolescent patients. We sought to compare postoperative improvements for each cartilage repair method to minimal clinically important difference (MCID) thresholds. Design MEDLINE, Web of Science, Scopus, and Cochrane Library databases were searched for studies reporting MCID-validated outcome scores in a minimum of 5 patients ≤19 years treated for symptomatic knee chondral lesions with minimum 1-year follow-up...
June 1, 2018: Cartilage
https://www.readbyqxmd.com/read/29942815/outcomes-of-joint-preservation-procedures-for-cartilage-injuries-in-the-hip-a-systematic-review-and-meta-analysis
#5
REVIEW
Michaela O'Connor, Anas A Minkara, Robert W Westermann, James Rosneck, T Sean Lynch
Background: The detection and management of chondral injuries of the hip, especially in a younger patient population, may preempt joint degeneration. Although the outcomes of preservation techniques have been well described for other weightbearing joints, such as the knee, evidence for hip joint preservation after procedures such as microfracture and autologous chondrocyte implantation remains in its infancy. Purpose: To evaluate outcomes of joint preservation procedures in the hip, including the success rate and patient-reported outcomes (PROs)...
June 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29926745/long-term-survival-after-microfracture-and-mosaicplasty-for-knee-articular-cartilage-repair-a-comparative-study-between-two-treatments-cohorts
#6
Eirik Solheim, Janne Hegna, Eivind Inderhaug
Objective To investigate survival of cartilage repair in the knee by microfracture (MFX; n = 119) or mosaicplasty osteochondral autograft transfer (OAT; n = 84). Design For survival analyses, "failure" was defined as the event of a patient reporting a Lysholm score <65 or undergoing an ipsilateral knee replacement. The Kaplan-Meier method was used for construction of a survival functions plot for the event "failure." Log rank (Mantel-Cox) test was used for comparison of survival distributions in the 2 groups...
June 1, 2018: Cartilage
https://www.readbyqxmd.com/read/29913540/-significance-of-matrix-augmented-bone-marrow-stimulation-for-treatment-of-cartilage-defects-of-the-knee-a-consensus-statement-of-the-dgou-working-group-on-tissue-regeneration
#7
Philipp Niemeyer, Christoph Becher, Matthias Buhs, Stefan Fickert, Kolja Gelse, Daniel Günther, Raphael Kaelin, Peter Kreuz, Jörg Lützner, Stefan Nehrer, Henning Madry, Stefan Marlovits, Julian Mehl, Henning Ott, Matthias Pietschmann, Gunther Spahn, Thomas Tischer, Martin Volz, Markus Walther, Götz Welsch, Johannes Zellner, Wolfgang Zinser, Peter Angele
Surgical principles for treatment of full-thickness cartilage defects of the knee include bone marrow stimulation techniques (i.e. arthroscopic microfracturing) and transplantation techniques (i.e. autologous chondrocyte implantation and osteochondral transplantation). On the basis of increasing scientific evidence, indications for these established therapeutical concepts have been specified and clear recommendations for practical use have been given. Within recent years, matrix-augmented bone marrow stimulation has been established as a new treatment concept for chondral lesions...
June 18, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29909583/clinical-and-radiographical-ten-years-long-term-outcome-of-microfracture-vs-autologous-chondrocyte-implantation-a-matched-pair-analysis
#8
Robert Ossendorff, Kilian Franke, Benjamin Erdle, Markus Uhl, Norbert P Südkamp, Gian M Salzmann
PURPOSE: To compare the clinical and radiographical long-term outcome of microfracture (MFX) and first-generation periosteum-covered autologous chondrocyte implantation (ACI-P). METHODS: All subjects (n = 86) who had been treated with knee joint ACI-P or microfracture (n = 76) with a post-operative follow-up of at least ten years were selected. Clinical pre- and post-operative outcomes were analyzed by numeric analog scale (NAS) for pain, Lysholm, Tegner, IKDC, and KOOS score...
June 16, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29905361/treatment-of-osteoarthritis-with-collagen-based-scaffold-a-porcine-animal-model-with-xenograft-mesenchymal-stem-cells
#9
Wo-Ran Tzeng, Shu-Wei Huang, Chih-Hsiang Fang, Lih-Tao Hsu, Chih-Yu Chen, Hsin-Hsin Shen, Jenny Zwei-Chieng Chang, Jui-Sheng Sun, Feng-Huei Lin
OBJECTIVE: With the goal to explore a new approach to treat the early degenerative lesions of hyaline cartilage, we implanted in a porcine OA model a collagen-based scaffold containing chondroprogenitor cells derived from human bone marrow mesenchymal stem cells (hBM-MSCs). EXPERIMENTAL DESIGN: Porcine knee joints were subjected to anterior cruciate ligament (ACL) transection to surgically induce OA. After 4 months, the time necessary for the development of cartilage surface damage, animals were treated either with trephination bone plug wrapped with the chondroprogenic hBM-MSCs-embedded collagen scaffold or microfractures alone...
June 15, 2018: Histology and Histopathology
https://www.readbyqxmd.com/read/29900170/the-stromal-vascular-fraction-from-fat-tissue-in-the-treatment-of-osteochondral-knee-defect-case-report
#10
Ramil Z Salikhov, Ruslan F Masgutov, Mikhail A Chekunov, Leysan G Tazetdinova, Galina Masgutova, Oleg V Teplov, Damir Galimov, Yuri Plakseichuk, Ramil Yagudin, Igor O Pankov, Albert Rizvanov
In this study we applied autologous fat tissue stromal vascular fraction (SVF) cells in combination with microfracturing technique in a 36-year-old man with an osteochondral lesion of the medial femoral condyle 8 months after the injury. Cell material was generated by fat tissue liposuction from the anterior abdominal wall with subsequent extraction of the SVF and injected through a mini-arthrotomy portal with subsequent fibrin sealant fixation. The follow-up period was 2 years. Clinical score improved from 23 to 96 according to IKDC and from 10 to 90 according to EQ-VAS at 24 months follow-up...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29868405/arthroscopic-treatment-of-hip-chondral-defect-with-microfracture-and-platelet-rich-plasma-infused-micronized-cartilage-allograft-augmentation
#11
Michael S Schallmo, Alejandro Marquez-Lara, T David Luo, Samuel Rosas, Allston J Stubbs
Over the past decade, arthroscopic microfracture has become increasingly popular to treat full-thickness (Outerbridge grade IV) chondral defects of the hip. This procedure borrows marrow stimulation treatment principles and techniques from knee arthroscopy, with similar mixed clinical outcomes that may be more favorable in the short term (<2 years) and poorer in the long term. Despite these varied outcomes, microfracture remains the most frequently used technique to treat small focal chondral defects because of the relative ease and cost-effectiveness of the procedure...
April 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29865924/poor-outcome-after-a-surgically-treated-chondral-injury-on-the-medial-femoral-condyle-early-evaluation-with-dgemric-and-17-year-radiographic-and-clinical-follow-up-in-16-knees
#12
Jon Tjörnstrand, Paul Neuman, Björn Lundin, Jonas Svensson, Leif E Dahlberg, Carl Johan Tiderius
Background and purpose - The optimal treatment for traumatic cartilage injuries remains unknown. Contrast-enhanced MRI of cartilage (dGEMRIC) evaluates cartilage quality and a low dGEMRIC index may predict radiographic osteoarthritis (OA). The purpose of this study was (a) to explore the results 17 years after surgical treatment of an isolated cartilage knee injury and (b) to evaluate the predictive value of dGEMRIC. Patients and methods - 16 knees with an isolated traumatic cartilage injury of the medial femoral condyle had cartilage repair surgery either by microfracture or autologous cartilage implantation...
August 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29752207/a-cross-sport-comparison-of-performance-based-outcomes-of-professional-athletes-following-primary-microfracture-of-the-knee
#13
Michael S Schallmo, Sameer K Singh, Kathryn A Barth, Ryan D Freshman, Harry T Mai, Wellington K Hsu
BACKGROUND: The purpose of this study was to compare performance-based outcomes among professional athletes in four major North American sports following microfracture to treat symptomatic chondral defects of the knee. METHODS: Major League Baseball (MLB), National Basketball Association (NBA), National Football League (NFL), and National Hockey League (NHL) athletes who underwent primary unilateral microfracture of the knee were identified through a previously reported protocol based on public sources...
August 2018: Knee
https://www.readbyqxmd.com/read/29731319/the-influence-of-tibial-slope-on-the-graft-in-combined-high-tibial-osteotomy-and-anterior-cruciate-ligament-reconstruction
#14
Philipp Schuster, Markus Geßlein, Michael Schlumberger, Philipp Mayer, Jörg Richter
BACKGROUND: Young patients with severe medial osteoarthritis, varus malalignment and insufficiency of the anterior cruciate ligament (ACL) are difficult to treat. The tibial slope has gained attention with regard to osteotomies and ligamentous instability. The purpose was to evaluate the outcome of combined high tibial osteotomy (HTO), ACL reconstruction and chondral resurfacing (CR, abrasion plus microfracture), and to analyse graft failure rates with regard to the tibial slope. METHODS: Fifty cases (48...
August 2018: Knee
https://www.readbyqxmd.com/read/29678170/self-reported-functional-recovery-after-reconstruction-versus-repair-in-acute-anterior-cruciate-ligament-rupture-rotor-a-randomized-controlled-clinical-trial
#15
Barbara C Boer, Roy A G Hoogeslag, Reinoud W Brouwer, Anna Demmer, Rianne M H A Huis In 't Veld
BACKGROUND: Anterior cruciate ligament (ACL) reconstruction is today's surgical gold standard for ACL rupture. Although it provides satisfactory results, not all patients return to their previous activity level and moreover, early posttraumatic osteoarthritis is not prevented. As such, a renewed interest has emerged in ACL suture repair combined with dynamic augmentation. Compared to ACL reconstruction, the hypothesized advantages of ACL suture repair are earlier return to sports, reduction of early posttraumatic osteoarthritis and preservation of the patient's native ACL tissue and proprioceptive envelope of the knee...
April 20, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29619397/treatment-of-failed-articular-cartilage-reconstructive-procedures-of-the-knee-a-systematic-review
#16
REVIEW
Joseph D Lamplot, Kevin A Schafer, Matthew J Matava
Background: Symptomatic articular cartilage lesions of the knee are common and are being treated surgically with increasing frequency. While many studies have reported outcomes following a variety of cartilage restoration procedures, few have investigated outcomes of revision surgery after a failed attempt at cartilage repair or reconstruction. Purpose: To investigate outcomes of revision cartilage restoration procedures for symptomatic articular cartilage lesions of the knee following a previously failed cartilage reconstructive procedure...
March 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29589953/ten-year-results-of-medial-open-wedge-high-tibial-osteotomy-and-chondral-resurfacing-in-severe-medial-osteoarthritis-and-varus-malalignment
#17
Philipp Schuster, Markus Geßlein, Michael Schlumberger, Philipp Mayer, Raul Mayr, Damian Oremek, Sebastian Frank, Martin Schulz-Jahrsdörfer, Jörg Richter
BACKGROUND: High tibial osteotomy (HTO) is a widely used treatment option for medial osteoarthritis and varus malalignment, especially in young patients with early osteoarthritis. Limited outcome data are available for this procedure in severe osteoarthritis, and no long-term data are available using newer implants. PURPOSE: To determine survivorship and functional results of medial open-wedge HTO combined with a chondral resurfacing (CR) procedure (abrasion plus microfracture) in severe medial osteoarthritis (Kellgren-Lawrence grade 3 and 4) and varus malalignment...
May 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29565642/matrix-applied-characterized-autologous-cultured-chondrocytes-versus-microfracture-five-year-follow-up-of-a-prospective-randomized-trial
#18
Mats Brittberg, David Recker, John Ilgenfritz, Daniel B F Saris
BACKGROUND: Matrix-based cell therapy improves surgical handling, increases patient comfort, and allows for expanded indications with better reliability within the knee joint. Five-year efficacy and safety of autologous cultured chondrocytes on porcine collagen membrane (MACI) versus microfracture for treating cartilage defects have not yet been reported from any randomized controlled clinical trial. PURPOSE: To examine the clinical efficacy and safety results at 5 years after treatment with MACI and compare these with the efficacy and safety of microfracture treatment for symptomatic cartilage defects of the knee...
May 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29525030/knee-cartilage-repair-and-restoration-common-problems-and-solutions
#19
REVIEW
Kristina Linnea Welton, Stephanie Logterman, Justin H Bartley, Armando F Vidal, Eric C McCarty
Focal cartilage defects in the knee are commonly found on MRI and arthroscopically. When these lesions are symptomatic and fail nonoperative management several surgical strategies are available. Common surgical techniques include reparative (ie, microfracture) and restorative procedures (ie, autologous chondrocyte implantation, particulated juvenile allograft cartilage, osteochondral autograft transfer, and osteochondral allograft). Each of these surgical procedures have shared and novel complications associated with their use...
April 2018: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/29490400/trends-in-knee-articular-cartilage-treatments-an-american-board-of-orthopaedic-surgery-database-study
#20
Kyle John Hancock, Robert R Westermann, Alan Gregory Shamrock, Kyle R Duchman, Brian R Wolf, Annunziato Amendola
This study aims to evaluate the trends in treatment of knee articular cartilage lesions over the past decade using data obtained from the American Board of Orthopaedic Surgery (ABOS) Part II database. The ABOS Part II database was queried from 2004 to 2013 for chondroplasty, microfracture, and osteochondral grafting procedures. All cases were analyzed for patient age and operating surgeon's fellowship training status. Univariate analysis including chi-square test for categorical variables and Student's t -test for continuous variables was performed to determine if any significant changes in practice patterns were present...
February 28, 2018: Journal of Knee Surgery
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