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Microfracture

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https://www.readbyqxmd.com/read/28423287/microfracture-versus-autologous-chondrocyte-implantation-for-articular-cartilage-lesions-in-the-knee-a-systematic-review-of-5-year-outcomes
#1
Matthew J Kraeutler, John W Belk, Justin M Purcell, Eric C McCarty
BACKGROUND: Microfracture (MFx) and autologous chondrocyte implantation (ACI) are 2 surgical treatment options used to treat articular cartilage injuries of the knee joint. PURPOSE: To compare the midterm to long-term clinical outcomes of MFx versus ACI for focal chondral defects of the knee. STUDY DESIGN: Systematic review. METHODS: A systematic review was performed by searching PubMed, the Cochrane Library, and Embase to locate studies (level of evidence I-III) comparing the minimum average 5-year clinical outcomes of patients undergoing MFx versus ACI...
April 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28422531/femoroacetabular-impingement-in-professional-football-players-return-to-play-and-predictors-of-career-length-after-hip-arthroscopy
#2
Travis J Menge, Sanjeev Bhatia, Shannen C McNamara, Karen K Briggs, Marc J Philippon
BACKGROUND: Previous studies have shown hip arthroscopy to be a highly effective treatment for symptomatic femoroacetabular impingement (FAI) in a wide range of athletes; however, the rate of return to play and length of career after hip arthroscopy in professional football players are unknown. PURPOSE: To determine how many athletes returned to professional football and the number of seasons they played after surgery. STUDY DESIGN: Case series; Level of evidence, 4...
April 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28419612/delayed-gadolinium-enhanced-mri-of-cartilage-dgemric-and-t2-mapping-of-talar-osteochondral-lesions-indicators-of-clinical-outcomes
#3
Christoph Rehnitz, Benita Kuni, Felix Wuennemann, Dimitrios Chloridis, Anand Kirwadi, Iris Burkholder, Hans-Ulrich Kauczor, Marc-André Weber
PURPOSE: To evaluate the utility of delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) and T2 mapping in evaluation of type II osteochondral lesions (OCLs) of the talus and define cutoff values for identifying patients with good/poor clinical outcomes. MATERIALS AND METHODS: 28 patients (mean age, 42.3 years) underwent T2 mapping and dGEMRIC at least 1.5 years (mean duration, 3.5 years) after microfracture (n = 12) or conservative (n = 16) treatment for type II OCL...
April 17, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28409105/anatomic-single-bundle-anterior-cruciate-ligament-reconstruction-using-the-modified-transtibial-technique
#4
Dhong Won Lee, Jin Goo Kim
We present a technique for anterior cruciate ligament (ACL) reconstruction using hamstring tendon autograft with a modified transtibial technique. Our modified transtibial technique has the advantages of the conventional transtibial technique that is familiar to surgeons and that allows the press-fit fixing and enables us to make a relatively long femoral tunnel. To make the femoral tunnel at the anatomic position, the triangular, funnel-shaped bony trough was made to slip the eccentrically positioned guide pin into the anticipated anatomic center with a free-hand technique after marking the anatomic ACL footprint using a microfracture awl through the anteromedial portal...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28409096/ankle-arthroscopy-with-microfracture-for-osteochondral-defects-of-the-talus
#5
Suman Medda, Ian M Al'Khafaji, Aaron T Scott
Therapeutic arthroscopy with microfracture leads to fibrocartilaginous repair and is an effective treatment of osteochondral lesions of the talus. A full diagnostic arthroscopy is performed, and then attention is turned to the osteochondral defect. We describe in detail patient positioning, ankle distraction, portal placement, steps of the diagnostic arthroscopy, and the technique of microfracture. We then discuss the special considerations to be taken regarding the use of a distractor, protection of neurovascular structures, and the indications for microfracture...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28406876/cartilage-restoration-techniques-for-the-patellofemoral-joint
#6
Robert H Brophy, Robert D Wojahn, Joseph D Lamplot
Symptomatic osteochondral lesions of the patellofemoral joint are clinically challenging to manage because of the limited healing potential of articular cartilage; the complex morphology of the patellofemoral joint; the heterogeneity of the articular surface between patients; and high stresses across the joint, which can be altered by malalignment, tilt, or maltracking. Indications for surgery include traumatic lesions, osteochondritis dissecans, and high-grade chondromalacia in association with persistent pain despite a course of nonsurgical management...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28399641/optimization-of-degradation-profile-for-new-scaffold-in-cartilage-repair
#7
Sarav S Shah, Haixiang Liang, Sandeep Pandit, Zalak Parikh, John A Schwartz, Todd Goldstein, Lawrence P Lavelle, Arindam Datta, Daniel A Grande
Objective To establish whether a novel biomaterial scaffold with tunable degradation profile will aid in cartilage repair of chondral defects versus microfracture alone in vitro and in a rat model in vivo. Design In vitro-Short- and long-term degradation scaffolds were seeded with culture expanded articular chondrocytes or bone marrow mesenchymal stem cells. Cell growth and differentiation were evaluated with cell morphological studies and gene expression studies. In vivo-A microfracture rat model was used in this study to evaluate the repair of cartilage and subchondral bone with the contralateral knee serving as the empty control...
April 1, 2017: Cartilage
https://www.readbyqxmd.com/read/28397530/comparison-of-fixation-techniques-of-3d-woven-poly-%C3%AF%C2%B5-caprolactone-scaffolds-for-cartilage-repair-in-a-weightbearing-porcine-large-animal-model
#8
James M Friedman, Mackenzie L Sennett, Marcelo B Bonadio, Kerry O Orji, Alexander L Neuwirth, Niobra Keah, James L Carey, Franklin T Moutos, Bradley T Estes, Farshid Guilak, Henning Madry, Robert L Mauck, George R Dodge
Objective To test different fixation methods of a 3-dimensionally woven poly(ϵ-caprolactone) (PCL) scaffold within chondral defects of a weightbearing large animal model. Methods Full thickness chondral defects were made in the femoral condyles of 15 adult male Yucatan mini-pigs. Two surgical approaches were compared including total arthrotomy (traditional) and a retinaculum-sparing, minimally invasive surgery (MIS) approach. Following microfracture (MFX), scaffolds were placed without fixation or were fixed with fibrin glue, suture, or subchondral anchor...
April 1, 2017: Cartilage
https://www.readbyqxmd.com/read/28395947/efficacy-of-bone-marrow-stimulating-technique-in-rotator-cuff-repair
#9
Kerem Bilsel, Fatih Yildiz, Mehmet Kapicioglu, Gokcer Uzer, Mehmet Elmadag, Anil Pulatkan, Mukaddes Esrefoglu, Ergun Bozdag, Giuseppe Milano
BACKGROUND: This study used a chronic rotator cuff (RC) tear model to investigate the effect of microfracture as a bone marrow-stimulating (BMS) technique for RC healing. METHODS: A chronic retracted RC tendon tear model was created bilaterally in the subscapularis tendons of 20 New Zealand rabbits. The tendons were repaired after 8 weeks using a single-row configuration. Tendons in the right shoulder were repaired in standard fashion (control group). Microfractures were performed in the left shoulders before repair (microfracture group)...
April 7, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28393540/microfracture-state-of-the-art-in-cartilage-surgery
#10
Florian Frehner, Jan P Benthien
Objective This study is a literature review from 2010 to 2014 concerning the quality of evidence in clinical trials about microfracture in attempt to repair articular cartilage. We have decided to focus on microfracturing, since this seems to be the best documented technique. Interest in evaluation of publication quality has risen in orthopaedic sports medicine recently. Therefore, we think it is necessary to evaluate recent clinical trials being rated for their evidence-based medicine (EBM) quality. We also compared the mean impact factor of the journals publishing the different studies as an indicator of the study's citation and evaluated for a change over the studied time frame...
April 1, 2017: Cartilage
https://www.readbyqxmd.com/read/28393539/autologous-bone-marrow-cell-stimulation-and-allogenic-chondrocyte-implantation-for-the-repair-of-full-thickness-articular-cartilage-defects-in-a-rabbit-model
#11
Sungwook Choi, Gyeong Min Kim, Young Hee Maeng, Hyunseong Kang, Chen Tai Teong, Emily E Lee, Seung Jin Yoo, Darryl D Dlima, Myung Ku Kim
OBJECTIVE: The aim of this study was to evaluate the results of autologous bone marrow cell stimulation and allogenic chondrocyte implantation using 3-dimensional gel-type fibrin matrix in an animal model. DESIGN: Eighteen rabbits were divided into 2 treatment groups. One group was treated with a microfracture and covering of it with gel-type fibrin (AutoBMS; n = 9), and the other group was treated with allogenic chondrocytes mixed gel-type fibrin at the cartilage defect (AlloCI; n = 9)...
April 1, 2017: Cartilage
https://www.readbyqxmd.com/read/28355678/surgical-correction-of-articular-damage-in-the-knee-osteoarticular-transplantation-to-joint-reconstruction
#12
Xue Susan Bai, Jonelle M Thomas, Alice S Ha
Injuries of the articular cartilage remain difficult to treat and can range from small articular cartilage defects to end-stage severe osteoarthritis. In this review, we discuss various surgical treatment options including imaging features and associated complications. Specifically, we review microfracture, acellular matrix-induced microfracture, autologous osteochondral transplantation, osteochondral allograft transplantation, autologous chondrocyte implantation, along with various forms of knee arthroplasties...
April 2017: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/28347196/distribution-of-subchondral-bone-puncture-strength-in-the-talus-and-tibial-plafond
#13
Slif D Ulrich, Brent G Parks, Michael A Tsai, Stuart D Miller
We investigated talus and tibial plafond subchondral bone puncture strength based on surface location. Puncture tests of the subchondral bone were performed in 9 equal zones on the articular surface of 12 cadaver specimens aged 49.1 years (range, 36-56 years). Compressive load was applied through a microfracture awl at 2 mm/min. Puncture strength was defined as the first load drop in load-deflection curves. In the talus, zone 1 (215 ± 91 N) and zone 2, the anterior medial and anterior middle zones, had significantly greater puncture strength than zones 7, 8, and 9, the posterior medial, middle, and lateral zones (104 ± 43 N, 115 ± 43 N, and 102 ± 35 N, respectively; P < ...
March 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28346833/arthroscopic-hip-surgery-in-the-elite-athlete-comparison-of-female-and-male-competitive-athletes
#14
Kotaro R Shibata, Shuichi Matsuda, Marc R Safran
BACKGROUND: Few studies have published the results of hip arthroscopic surgery in elite athletes and none studying a significant number of elite female athletes. PURPOSE: (1) To compare sex-based differences in the ability to return to prior competitive sports activity after arthroscopic hip surgery. (2) To compare sex-based differences in the type of sports activity, diagnosis, and treatment in athletes requiring hip arthroscopic surgery. STUDY DESIGN: Cohort study; Level of evidence, 3...
March 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28345610/early-loss-of-subchondral-bone-following-microfracture-is-counteracted-by-bone-marrow-aspirate-in-a-translational-model-of-osteochondral-repair
#15
Liang Gao, Patrick Orth, Kathrin Müller-Brandt, Lars K H Goebel, Magali Cucchiarini, Henning Madry
Microfracture of cartilage defects may induce alterations of the subchondral bone in the mid- and long-term, yet very little is known about their onset. Possibly, these changes may be avoided by an enhanced microfracture technique with additional application of bone marrow aspirate. In this study, full-thickness chondral defects in the knee joints of minipigs were either treated with (1) debridement down to the subchondral bone plate alone, (2) debridement with microfracture, or (3) microfracture with additional application of bone marrow aspirate...
March 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28345403/intralesional-osteophyte-regrowth-following-autologous-chondrocyte-implantation-after-previous-treatment-with-marrow-stimulation-technique
#16
Marco Kawamura Demange, Tom Minas, Arvind von Keudell, Sonal Sodha, Tim Bryant, Andreas H Gomoll
Objective Bone marrow stimulation surgeries are frequent in the treatment of cartilage lesions. Autologous chondrocyte implantation (ACI) may be performed after failed microfracture surgery. Alterations to subchondral bone as intralesional osteophytes are commonly seen after previous microfracture and removed during ACI. There have been no reports on potential recurrence. Our purpose was to evaluate the incidence of intralesional osteophyte development in 2 cohorts: existing intralesional osteophytes and without intralesional osteophytes at the time of ACI...
April 2017: Cartilage
https://www.readbyqxmd.com/read/28324152/good-clinical-results-with-autologous-matrix-induced-chondrogenesis-amic-technique-in-large-knee-chondral-defects
#17
Alfredo Schiavone Panni, Chiara Del Regno, Giuseppe Mazzitelli, Rocco D'Apolito, Katia Corona, Michele Vasso
PURPOSE: Autologous matrix-induced chondrogenesis (AMIC) is a treatment for focal full-thickness cartilage defects combining microfracturing with an exogenous I/III collagen matrix (Chondro-Gide). The aim of the present study was to determine the 7 years outcomes of patients treated with the AMIC technique for knee chondral defects larger than 2 cm(2). The hypothesis was that the positive short-term outcomes achieved in the previous series would not deteriorate at a 7-year follow-up...
March 21, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28321265/introducing-the-bone-screw-fastener-for-improved-screw-fixation-in-orthopedic-surgery-a-revolutionary-paradigm-shift
#18
Philip F Stahel, Nicholas A Alfonso, Corey Henderson, Todd Baldini
BACKGROUND: Conventional screws used for fracture fixation in orthopedic surgery continue to rely on the historic buttress thread design. While buttress screws generally provide solid resistance against unidirectional axial loading forces, their design suffers from several limitations, as the buttress thread does not adequately resist multiaxial forces. Furthermore, the buttress screw is prone to stripping at the bone-screw interface and can cause microfracturing of the surrounding bone due to its thread design...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28320425/patient-compliance-with-touchdown-weight-bearing-after-microfracture-treatment-of-talar-osteochondral-lesions
#19
Gökhan Polat, Gökhan Karademir, Ekin Akalan, Mehmet Aşık, Mehmet Erdil
BACKGROUND: The aim of this study was to prospectively evaluate the compliance of our patients with a touchdown weight bearing (without supporting any weight on the affected side by only touching the plantar aspect of the foot to the ground to maintain balance to protect the affected side from mechanical loading) postoperative rehabilitation protocol after treatment of talar osteochondral lesion (TOL). METHODS: Fourteen patients, who had been treated with arthroscopic debridement and microfracture, were followed prospectively...
March 20, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28302130/comparison-of-distraction-arthroplasty-alone-versus-combined-with-arthroscopic-microfracture-in-treatment-of-post-traumatic-ankle-arthritis
#20
Kaibin Zhang, Yiqiu Jiang, Jing Du, Tianqi Tao, Wang Li, Yang Li, Jianchao Gui
BACKGROUND: This study aims to compare clinical outcomes of distraction arthroplasty alone versus combined with arthroscopic microfracture in treating post-traumatic ankle arthritis. METHODS: The study cohort consisted of 96 patients (96 ankles) who underwent distraction arthroplasty alone or combined with arthroscopic microfracture between May 2005 and April 2012. Patients were divided into the distraction group (n = 46) and the combined group (n = 50)...
March 17, 2017: Journal of Orthopaedic Surgery and Research
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