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Microfracture

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https://www.readbyqxmd.com/read/29349034/arthroscopic-microfracture-of-hip-chondral-lesions
#1
H Atil Atilla, T David Luo, Allston J Stubbs
Microfracture of hip chondral lesions has been performed for more than a decade with modified treatment principles and techniques from knee arthroscopy. This note and accompanying video review the pertinent techniques, pearls, and pitfalls of the microfracture procedure in the treatment of hip chondral lesions. After debridement of damaged chondral tissue, the size of the lesion is approximated to determine the number of microfracture holes to create. The working portal may be adjusted based on the site of the lesion...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29342064/minimally-manipulated-bone-marrow-concentrate-compared-with-microfracture-treatment-of-full-thickness-chondral-defects-a-one-year-study-in-an-equine-model
#2
Constance R Chu, Lisa A Fortier, Ashley Williams, Karin A Payne, Taralyn M McCarrel, Megan E Bowers, Diego Jaramillo
BACKGROUND: Microfracture is commonly performed for cartilage repair but usually results in fibrocartilage. Microfracture augmented by autologous bone marrow concentrate (BMC) was previously shown to yield structurally superior cartilage repairs in an equine model compared with microfracture alone. The current study was performed to test the hypothesis that autologous BMC without concomitant microfracture improves cartilage repair compared with microfracture alone. METHODS: Autologous sternal bone marrow aspirate (BMA) was concentrated using a commercial system...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29323942/comparison-of-juvenile-allogenous-articular-cartilage-and-bone-marrow-aspirate-concentrate-versus-microfracture-with-and-without-bone-marrow-aspirate-concentrate-in-arthroscopic-treatment-of-talar-osteochondral-lesions
#3
Sydney C Karnovsky, Bridget DeSandis, Amgad M Haleem, Carolyn M Sofka, Martin O'Malley, Mark C Drakos
BACKGROUND: The purpose of this study was to compare the functional and radiographic outcomes of patients who received juvenile allogenic chondrocyte implantation with autologous bone marrow aspirate (JACI-BMAC) for treatment of talar osteochondral lesions with those of patients who underwent microfracture (MF). METHODS: A total of 30 patients who underwent MF and 20 who received DeNovo NT for JACI-BMAC treatment between 2006 and 2014 were included. Additionally, 17 MF patients received supplemental BMAC treatment...
January 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29322906/distal-femoral-medial-closing-wedge-osteotomy-for-degenerative-valgus-knee%C3%A2-mid-term-results-in-active-patients
#4
R Buda, F Castagnini, G Gorgolini, M Baldassarri, F Vannini
Distal femoral medial closing wedge osteotomy (DFMCWO) may be a valuable treatment for arthritic valgus knees in young and active adults, with the possible aim of procrastinating knee replacement. 32 valgus knees (mean age : 41.4±11.2) treated with DFMCWO were retrospectively reviewed. All the knees had a lateral compartment osteoarthritis graded I-II-III according to Kellgren Lawrence classification. 20 knees had osteochondral lesions, treated with microfractures (8) or bone marrow derived cells transplantation (12)...
March 2017: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29305041/arthroscopic-treatment-of-osteochondral-lesions-of-the-talus-using-juvenile-articular-cartilage-allograft-and-autologous-bone-marrow-aspirate-concentration
#5
Bridget A DeSandis, Amgad M Haleem, Carolyn M Sofka, Martin J O'Malley, Mark C Drakos
Juvenile allogenic chondrocyte implantation (JACI; DeNovo NT Natural Tissue Graft®; Zimmer, Warsaw, IN) with autologous bone marrow aspirate concentrate (BMAC) is a relatively new all-arthroscopic procedure for treating critical-size osteochondral lesions (OCLs) of the talus. Few studies have investigated the clinical and radiographic outcomes of this procedure. We collected the clinical and radiographic outcomes of patients who had undergone JACI-BMAC for talar OCLs to assess treatment efficacy and cartilage repair tissue quality using magnetic resonance imaging (MRI)...
January 2, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29300225/articular-cartilage-injury-pathways-and-treatment-options
#6
Timothy M Simon, Douglas W Jackson
Articular cartilage injury and degeneration is a frequent occurrence in synovial joints. Treatment of these articular cartilage lesions are a challenge because this tissue is incapable of quality repair and/or regeneration to its native state. Nonoperative treatments endeavor to control symptoms, and include anti-inflammatory medication, viscosupplementation, bracing, orthotics, and activity modification. Techniques to stimulate the intrinsic repair (fibrocartilage) process include drilling, abrasion, and microfracture of the subchondral bone...
March 2018: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/29241343/can-biologic-augmentation-improve-clinical-outcomes-following-microfracture-for-symptomatic-cartilage-defects-of-the-knee-a-systematic-review
#7
Armin Arshi, Peter D Fabricant, Derek E Go, Riley J Williams, David R McAllister, Kristofer J Jones
Objective To perform a systematic review of clinical outcomes following microfracture augmented with biological adjuvants (MFX+) compared with microfracture (MFX) alone. Design The MEDLINE, Scopus, and Cochrane databases were searched for clinical studies on MFX+ for chondral defects of the knee. Study characteristics and clinical outcome score data were collected. Subjective synthesis was performed using data from randomized controlled studies to determine effect size of MFX+ procedures performed with either injectable or scaffold-based augmentation compared with MFX alone...
December 1, 2017: Cartilage
https://www.readbyqxmd.com/read/29219025/the-effect-of-growth-hormone-on-chondral-defect-repair
#8
Natalie R Danna, Bryan G Beutel, Austin J Ramme, Thorsten Kirsch, Oran D Kennedy, Eric Strauss
Objective Focal chondral defects alter joint mechanics and cause pain and debilitation. Microfracture is a surgical technique used to treat such defects. This technique involves penetration of subchondral bone to release progenitor cells and growth factors from the marrow to promote cartilage regeneration. Often this results in fibrocartilage formation rather than structured hyaline cartilage. Some reports have suggested use of growth hormone (GH) with microfracture to augment cartilage regeneration. Our objective was to test whether intra-articular (IA) GH in conjunction with microfracture, improves cartilage repair in a rabbit chondral defect model...
January 2018: Cartilage
https://www.readbyqxmd.com/read/29198590/clinical-outcomes-of-single-anteromedial-bundle-biologic-augmentation-sambba-technique-for-anterior-cruciate-ligament-reconstruction-with-consideration-of-tibial-remnant-size
#9
Hervé Ouanezar, William G Blakeney, Levi Reina Fernandes, Amrut Borade, Charles Latrobe, Eduardo Frois Temponi, Bertrand Sonnery-Cottet
PURPOSE: The primary aim of this study was to evaluate the functional outcomes, knee stability, complications, and reoperations associated with anatomic anterior cruciate ligament (ACL) reconstruction using the single anteromedial bundle biological augmentation (SAMBBA) technique in a consecutive series of 128 patients with a minimum follow-up of 24 months. A secondary aim was to compare larger preserved ACL remnants with smaller preserved remnants. METHODS: Patients who underwent primary anatomic ACL reconstruction using the SAMBBA technique from July 2013 to October 2014 were analyzed...
November 30, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29198017/low-ph-irrigation-fluids-have-positive-effect-on-intra-articular-chondral-healing
#10
Tekin Kerem Ulku, Baris Kocaoglu, Arel Gereli, Serap Uslu, Ufuk Nalbantoglu
PURPOSE: The aim of this study was to evaluate the effect of Ringer's lactate (RL) solutions with different pH values on early histologic healing in a microfracture model in vivo. The null hypothesis of the presented study is that irrigation fluids with lower pH (6.4) have negative effects on fibrous cartilage healing. METHODS: Eighteen Wistar albino rats were randomly divided into three groups. Anterior midline incision was performed. Microfracture procedure was performed with a 1...
December 2, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29195732/does-treatment-of-the-tibia-matter-in-bipolar-chondral-defects-of-the-knee-clinical-outcomes-with-greater-than-two-years-follow-up
#11
Charles P Hannon, Alexander E Weber, Matthew Gitelis, Maximillian A Meyer, Adam B Yanke, Brian J Cole
PURPOSE: To compare the osteochondral allograft (OCA) outcomes of bipolar defects with isolated femoral defects and to investigate the optimal treatment of bipolar defects by comparing femoral OCA with tibial debridement to femoral OCA and tibial microfracture. METHODS: A series of patients with 2-year follow-up from March 2004 to September 2015 after femoral OCA for bipolar chondral defects was identified. Group 1 contained patients with tibial defects treated with debridement and group 2 contained patients with microfractured tibial defects...
November 28, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29192936/outcomes-of-femoral-head-marrow-stimulation-techniques-at-minimum-2-year-follow-up
#12
David E Hartigan, Itay Perets, Edwin O Chaharbakhshi, John P Walsh, Leslie C Yuen, Benjamin G Domb
This study compared patients who underwent femoral head microfracture with a control group of patients who did not require microfracture. Patients had more than 2 years of follow-up. The patient groups had similar demographic and radiographic features, including sex, age within 5 years, body mass index within 5 points, equal Tönnis grade, lateral center edge angle within 5°, labral treatment, and capsular closure vs release. Inclusion criteria were a minimum of 2 years of follow-up, Outerbridge grade IV cartilage damage, and femoral head marrow stimulation technique performed at the time of arthroscopy...
November 30, 2017: Orthopedics
https://www.readbyqxmd.com/read/29165318/unidirectional-bmp2-loaded-collagen-scaffolds-induce-chondrogenic-differentiation
#13
Michiel W Pot, Laurie M G de Kroon, Peter M van der Kraan, Toin H van Kuppevelt, Willeke F Daamen
Microfracture surgery may be improved by the implantation of unidirectional collagen scaffolds that provide a template for mesenchymal stem cells to regenerate cartilage. Incorporation of growth factors in unidirectional scaffolds may further enhance cartilage regeneration. In scaffolds, immobilization of growth factors is required to prolong in vivo activity, to limit diffusion and to reduce the amount of growth factor needed for safe clinical application. We investigated the immobilization of bone morphogenetic protein 2 (BMP2) to unidirectional collagen scaffolds and the effect on in vitro chondrogenesis...
November 22, 2017: Biomedical Materials
https://www.readbyqxmd.com/read/29161138/autologous-matrix-induced-chondrogenesis-a-systematic-review-of-the-clinical-evidence
#14
Liang Gao, Patrick Orth, Magali Cucchiarini, Henning Madry
BACKGROUND: The addition of a type I/III collagen membrane in cartilage defects treated with microfracture has been advocated for cartilage repair, termed "autologous matrix-induced chondrogenesis" (AMIC). PURPOSE: To examine the current clinical evidence regarding AMIC for focal chondral defects. STUDY DESIGN: Systematic review. METHODS: A systematic review was performed by searching PubMed, ScienceDirect, and Cochrane Library databases...
November 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29152521/isokinetic-strength-deficit-6-months-after-adductor-canal-blockade-for-anterior-cruciate-ligament-reconstruction
#15
James E Christensen, Natalie E Taylor, Scott J Hetzel, John A Shepler, Tamara A Scerpella
Background: Recent evidence shows a delayed return to sport in children and delayed quadriceps recovery in both adults and children who have undergone anterior cruciate ligament (ACL) reconstruction with concomitant femoral nerve blockade (FNB) compared with those who had no blockade. We evaluated the use of adductor canal blockade (ACB), as an alternative to FNB, at the time of ACL reconstruction. Hypothesis: Patients who receive ACB will have greater isokinetic strength at 6 months postoperative compared with patients who receive FNB at the time of ACL reconstruction...
November 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29144772/subchondral-bone-degradation-after-microfracture-for-osteochondral-lesions-of-the-talus-an-mri-analysis
#16
Yoshiharu Shimozono, Max Coale, Youichi Yasui, Amanda O'Halloran, Timothy W Deyer, John G Kennedy
BACKGROUND: Microfracture is the most common cartilage-reparative procedure for the treatment of osteochondral lesions of the talus (OLTs). Damage to the subchondral bone (SCB) during microfracture may irreversibly change the joint-loading support of the ankle, leading to reparative fibrocartilage degradation over time. PURPOSE: To investigate the morphological change in the SCB after microfracture for OLT by developing a novel magnetic resonance imaging (MRI) scoring system specifically for evaluating the SCB...
November 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29138920/concurrent-arthroscopic-osteochondral-lesion-treatment-and-lateral-ankle-ligament-repair-has-no-substantial-effect-on-the-outcome-of-chronic-lateral-ankle-instability
#17
Dong Jiang, Yin-Fang Ao, Chen Jiao, Xing Xie, Lin-Xin Chen, Qin-Wei Guo, Yue-Lin Hu
PURPOSE: The purpose of the study was to evaluate the effect of concurrent arthroscopic osteochondral lesion (OCL) treatment and lateral ankle ligament repair on the outcome of chronic lateral ankle instability. It was hypothesized that the arthroscopic OCL treatment might have some negative effect on the outcome of chronic lateral ankle instability (CLAI) by compromising the rehabilitation program. METHODS: Ankle arthroscopy and anatomic lateral ankle ligament repair with suture anchors were performed for 70 patients with CLAI between 2010 and 2012...
November 14, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29137027/morphobiochemical-diagnosis-of-acute-trabecular-microfractures-using-gamma-correction-tc-99m-hdp-pinhole-bone-scan-with-histopathological-verification
#18
Yong-Whee Bahk, Seok-Ha Hwang, U-Young Lee, Yong-An Chung, Joo-Young Jung, Hyeonseok S Jeong
We prospectively performed gamma correction pinhole bone scan (GCPBS) and histopathologic verification study to make simultaneous morphobiochemical diagnosis of trabecular microfractures (TMF) occurred in the femoral head as a part of femoral neck fracture.Materials consisted of surgical specimens of the femoral head in 6 consecutive patients. The specimens were imaged using Tc-99m hydroxymethylene diphosphonate (HDP) pinhole scan and processed by the gamma correction. After cleansing with 10% formalin solution, injured specimen surface was observed using a surgical microscope to record TMF...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29135269/return-to-play-after-hip-arthroscopic-surgery-for-femoroacetabular-impingement-in-professional-soccer-players
#19
Renato Locks, Hajime Utsunomiya, Karen K Briggs, Shannen McNamara, Jorge Chahla, Marc J Philippon
BACKGROUND: Arthroscopic hip surgery has been shown to be effective in returning professional athletes back to play at a high level of performance in different sports. Limited information exists regarding professional soccer players and their return to play. PURPOSE: To determine the rate and time to return to sport for professional soccer players after hip arthroscopic surgery for the treatment of femoroacetabular impingement (FAI) and to identify possible risk factors associated with a delay in returning to play...
November 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29132387/theoretically-proposed-optimal-frequency-for-ultrasound-induced-cartilage-restoration
#20
April D Miller, Anuradha Subramanian, Hendrik J Viljoen
BACKGROUND: Matching the frequency of the driving force to that of the system's natural frequency of vibration results in greater amplitude response. Thus we hypothesize that applying ultrasound at the chondrocyte's resonant frequency will result in greater deformation than applying similar ultrasound power at a frequency outside of the resonant bandwidth. Based on this resonant hypothesis, our group previously confirmed theoretically and experimentally that ultrasound stimulation of suspended chondrocytes at resonance (5 MHz) maximized gene expression of load inducible genes...
November 14, 2017: Theoretical Biology & Medical Modelling
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