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https://www.readbyqxmd.com/read/28915523/-biologic-reconstruction-of-full-sized-cartilage-defects-of-the-hip-a-guideline-from-the-dgou-group-clinical-tissue-regeneration-and-the-hip-committee-of-the-aga
#1
Stefan Fickert, Matthias Aurich, Dirk Albrecht, Peter Angele, Lorenz Büchler, Michael Dienst, Christoph Erggelet, Jürgen Fritz, Christoph Gebhart, Hans Gollwitzer, Moritz Kindler, Christoph Lampert, Henning Madry, Gregor Möckel, Phillip Niemeyer, Jörg Schröder, Christian Sobau, Gunter Spahn, Wolfgang Zinser, Stefan Landgraeber
Background Symptomatic pre-arthritic deformities such as femoroacetabular impingement (FAI) or hip dysplasia often lead to localised cartilage defects and subsequently to osteoarthritis. The present review of the working group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Trauma (DGOU) and the hip committee of the AGA (German speaking Society for Arthroscopy and Joint Surgery) provides an overview of current knowledge of the diagnosis and surgical treatment of cartilage defects, in order to infer appropriate therapy recommendations for the hip...
September 15, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28913600/a-multilayer-biomaterial-for-osteochondral-regeneration-shows-superiority-vs-microfractures-for-the-treatment-of-osteochondral-lesions-in-a-multicentre-randomized-trial-at-2-years
#2
Elizaveta Kon, Giuseppe Filardo, Mats Brittberg, Maurizio Busacca, Vincenzo Condello, Lars Engebretsen, Stefan Marlovits, Philipp Niemeyer, Patrik Platzer, Michael Posthumus, Peter Verdonk, Renè Verdonk, Jan Victor, Willem van der Merwe, Wojciech Widuchowski, Claudio Zorzi, Maurilio Marcacci
PURPOSE: The increasing awareness on the role of subchondral bone in the etiopathology of articular surface lesions led to the development of osteochondral scaffolds. While safety and promising results have been suggested, there are no trials proving the real potential of the osteochondral regenerative approach. Aim was to assess the benefit provided by a nanostructured collagen-hydroxyapatite (coll-HA) multilayer scaffold for the treatment of chondral and osteochondral knee lesions. METHODS: In this multicentre randomized controlled clinical trial, 100 patients affected by symptomatic chondral and osteochondral lesions were treated and evaluated for up to 2 years (51 study group and 49 control group)...
September 14, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28868088/chondral-defects-of-the-glenohumeral-joint-long-term-outcome-after-microfracturing-of-the-shoulder
#3
Sophia M Hünnebeck, Petra Magosch, Peter Habermeyer, Markus Loew, Sven Lichtenberg
INTRODUCTION: An increasing number of young patients are diagnosed with chondral lesions. Minimally invasive surgical techniques are important in order to delay progression of the early stages of osteoarthritis and the need for total joint replacement. MATERIALS AND METHODS: Patients (n = 32) who had received microfracturing of the shoulder were retrospectively enrolled, of whom 5 had received shoulder replacements after a mean time of 47 months. Of these patients, 23 completed the Disabilities of the Arm, Shoulder and Hand (DASH) and Constant-Murley Scores in addition to an additional subjective questionnaire...
2017: Obere Extremität
https://www.readbyqxmd.com/read/28867054/advances-in-ankle-cartilage-repair
#4
REVIEW
Alan Ng, Andrew Bernhard, Kaitlyn Bernhard
Repair of osteochondral lesions of the talus can be difficult. Smaller lesions respond well to simple arthroscopy and microfracture, whereas larger cystic lesions may require allograft talus replacement or ankle fusions. The lesions in between are more difficult to treat. Autologous chondrocyte implantation and matrix-associated autologous chondrocyte implantation have shown promising results. Future research may include new techniques, pharmacologic intervention, and cell-based therapies, and may be better served with prospective observational studies instead of costly randomized controlled studies...
October 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28865575/single-step-arthroscopic-repair-with-cell-free-polymer-based-scaffold-in-osteochondral-lesions-of-the-talus-clinical-and-radiological-results
#5
Ulunay Kanatlı, Ali Eren, Toygun Kağan Eren, Abdurrahman Vural, Dilan Ece Geylan, Ali Yusuf Öner
PURPOSE: To report the clinical and radiological results of patients with talar osteochondral lesions who were treated by microfracture and cell-free scaffold implantation in a single-step arthroscopic surgery. METHODS: Forty patients, treated with a single-step arthroscopic surgery, were evaluated in this single-center-based retrospective study. Patients with degenerative arthritis (n = 1), history of ankle fracture (n = 1), kissing lesions (n = 1), lower extremity deformity (n = 1), and lesions <1...
September 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28852793/-cartilage-repair-of-the-knee-joint
#6
REVIEW
B Rath, J Eschweiler, M Betsch, G Gruber
BACKGROUND: Cartilage defects around the knee joint frequently occur in the region of the medial femoral condyle and the retropatellar cartilage surface. The distinction between local cartilage defects and large area degenerative cartilage lesions is very important for both prognosis and surgical therapy. The size and position of the lesion, the underlying pathomechanism and the age of the patient are very important factors which should be considered in the therapy algorithm for optimal cartilage defect restoration...
August 29, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28822634/development-and-efficacy-testing-of-a-hollow-awl-that-leads-to-patent-bone-marrow-channels-and-greater-mesenchymal-stem-cell-mobilization-during-bone-marrow-stimulation-cartilage-repair-surgery
#7
Byoung-Hyun Min, Minh-Dung Truong, Hyung Keun Song, Jae Ho Cho, Do Young Park, Heon Ju Kweon, Jun Young Chung
PURPOSE: To investigate whether microfracture with a cannulated hollow awl can yield more patent marrow channels and allow greater mobilization of the reparable cells to the defect compared to the conventional awl with blunt end in human knee joints. METHODS: Patients who were planned for 1-stage bilateral total knee arthroplasty due to degenerative osteoarthritis with well-preserved lateral femoral condylar cartilage were retrospectively included. A 10-mm × 20-mm, rectangular, full-thickness chondral defect was made on the lateral femoral condyle on each knee joint...
August 16, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28817971/effects-of-solid-acellular-type-i-iii-collagen-biomaterials-on-in-vitro-and-in-vivo-chondrogenesis-of-mesenchymal-stem-cells
#8
Liang Gao, Patrick Orth, Magali Cucchiarini, Henning Madry
Type-I/III collagen membranes are advocated for clinical use in articular cartilage repair as being able of inducing chondrogenesis, a technique termed autologous matrix-induced chondrogenesis (AMIC). Area covered: The current in vitro and translational in vivo evidence for chondrogenic effects of solid acellular type-I/III collagen biomaterials. Expert commentary: In vitro, mesenchymal stem cells (MSCs) adhere to the fibers of the type-I/III collagen membrane. No in vitro study provides evidence that a type-I/III collagen matrix alone may induce chondrogenesis...
August 18, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28807394/preterm-prelabor-rupture-of-the-membranes-a-disease-of-the-fetal-membranes
#9
Ramkumar Menon, Lauren S Richardson
Preterm prelabor rupture of the membranes (pPROM) remains a significant obstetric problem that affects 3-4% of all pregnancies and precedes 40-50% of all preterm births. pPROM arises from complex, multifaceted pathways. In this review, we summarize some old concepts and introduce some novel theories related to pPROM pathophysiology. Specifically, we introduce the concept that pPROM is a disease of the fetal membranes where inflammation-oxidative stress axis plays a major role in producing pathways that can lead to membrane weakening through a variety of processes...
August 11, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28806097/opioid-demand-before-and-after-anterior-cruciate-ligament-reconstruction
#10
Chris A Anthony, Robert W Westermann, Nicholas Bedard, Natalie Glass, Matt Bollier, Carolyn M Hettrich, Brian R Wolf
BACKGROUND: Surgeons and health care systems have received a call to action in an effort to curtail the current opioid epidemic. PURPOSE: To (1) define the natural history of opioid demand after anterior cruciate ligament reconstruction (ACLR), (2) consider how filling preoperative opioid prescriptions affects opioid demand after ACLR, and (3) evaluate the effect of additional procedures during ACLR and patient age on postoperative opioid demand. STUDY DESIGN: Cohort study; Level of evidence, 3...
August 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28783472/is-there-a-role-for-internal-bracing-and-repair-of-the-anterior-cruciate-ligament-a-systematic-literature-review
#11
Carola F van Eck, Orr Limpisvasti, Neal S ElAttrache
BACKGROUND: Renewed interest has arisen in arthroscopic anterior cruciate ligament (ACL) repair techniques. HYPOTHESIS: ACL repair with or without some form of internal bracing could lead to good outcomes in a carefully selected subset of patients. STUDY DESIGN: Systematic review. METHODS: An electronic database search was performed to identify 89 papers describing preclinical and clinical studies on the outcome of ACL repair...
August 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28782498/results-of-arthroscopic-treatment-of-chondral-delamination-in-femoroacetabular-impingement-with-bone-marrow-stimulation-and-bst-cargel-%C3%A2
#12
Mahmoud Tahoun, Tamer Aly Shehata, Inmaculada Ormazabal, Jesús Mas, Javier Sanz, Marc Tey Pons
OBJECTIVES: The purpose of this study is to show the preliminary results of using chitosan-based scaffold (BST-CarGel(®)) with microfracture for treatment of acetabular chondral delamination associated with femoroacetabular impingement. METHODS: A prospective study was performed on 13 hips. Patients were selected in the age group between 18 and 50 years. Patients with delamination of acetabular cartilage associated with femoroacetabular impingement received arthroscopic debridement and microfracture technique...
2017: SICOT-J
https://www.readbyqxmd.com/read/28752185/the-subchondral-bone-healing-after-fixation-of-an-osteochondral-talar-defect-is-superior-in-comparison-with-microfracture
#13
Mikel L Reilingh, Kaj T A Lambers, Jari Dahmen, Kim T M Opdam, Gino M M J Kerkhoffs
PURPOSE: Arthroscopic bone marrow stimulation (BMS) has been considered the primary surgical treatment for osteochondral defects (OCDs) of the talus. However, fixation has been considered as a good alternative. Recently, a new arthroscopic fixation technique was described: the lift, drill, fill and fix procedure (LDFF). The purpose of this study was to evaluate the clinical and radiological results between arthroscopic LDFF and arthroscopic BMS in primary fixable talar OCDs at 1-year follow-up...
July 27, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28747146/age-dependent-subchondral-bone-remodeling-and-cartilage-repair-in-a-minipig-defect-model
#14
Christian G Pfeifer, Matthew B Fisher, Vishal Saxena, Minwook Kim, Elizabeth A Henning, David R Steinberg, George R Dodge, Robert Leon Mauck
Following cartilage injury and repair, the subchondral bone plate remodels. Skeletal maturity likely impacts both bone remodeling and inherent cartilage repair capacity. The objective of this study was to evaluate subchondral bone remodeling as a function of injury type, repair scenario and skeletal maturity in a Yucatan minipig model. Cartilage defects (4mm) were created bilaterally in the trochlear groove. Treatment conditions included a full thickness chondral defect (FCD, n=3adult/3juvenile), a partial thickness (~50%) chondral defect (PCD, n=3/3), and FCD treated with microfracture (MFX, n=3/3)...
July 26, 2017: Tissue Engineering. Part C, Methods
https://www.readbyqxmd.com/read/28720091/clinical-and-imaging-outcome-of-osteochondral-lesions-of-the-talus-treated-using-autologous-matrix-induced-chondrogenesis-technique-with-a-biomimetic-scaffold
#15
Domenico Albano, Nicolò Martinelli, Alberto Bianchi, Carmelo Messina, Francesco Malerba, Luca Maria Sconfienza
BACKGROUND: The purpose of our study was to assess the clinical and imaging outcome of autologous matrix-induced chondrogenesis (AMIC) technique consisting of microfractures followed by the filling of osteochondral lesions of the talus (OLTs) with a cell-free biphasic collagen-hydroxyapatite osteochondral scaffold (MaioRegen). METHODS: Sixteen patients (eight males, age: 42.6 ± 18.4, range 14-74) with OLT repaired using AMIC technique, with implantation of MaioRegen, were clinically evaluated through the American Orthopedic Foot and Ankle Society Score (AOFAS) and a 10-point Visual Analogue Scale (VAS) pain score after a mean follow-up of 30 ± 16...
July 18, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28713920/low%C3%A2-dose-halofuginone-inhibits-the-synthesis-of-type-i-collagen-without-influencing-type-ii-collagen-in-the-extracellular-matrix-of-chondrocytes
#16
Zeng Li, Hao Fei, Zhen Wang, Tianyi Zhu
Full‑thickness and large area defects of articular cartilage are unable to completely repair themselves and require surgical intervention, including microfracture, autologous or allogeneic osteochondral grafts, and autologous chondrocyte implantation. A large proportion of regenerative cartilage exists as fibrocartilage, which is unable to withstand impacts in the same way as native hyaline cartilage, owing to excess synthesis of type I collagen in the matrix. The present study demonstrated that low‑dose halofuginone (HF), a plant alkaloid isolated from Dichroa febrifuga, may inhibit the synthesis of type I collagen without influencing type II collagen in the extracellular matrix of chondrocytes...
September 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28706807/labral-gracilis-tendon-allograft-reconstruction-and-cartilage-regeneration-scaffold-for-an-uncontained-acetabular-cartilage-defect-of-the-hip
#17
Laurel E MacInnis, Ahmed Al Hussain, Catherine Coady, Ivan H Wong
Hip cartilage injuries are very common, with rates as high as 50% having been reported in some series; abnormal femoral acetabular contact can result in a full-thickness cartilage defect or labral lesion. The prevalence of labral lesions can be as high as 55%. This Technical Note describes an arthroscopic technique to reconstruct an uncontained, full-thickness, focal cartilage defect of the acetabulum, with reconstruction of the missing labrum using a gracilis allograft and use of a biological liquid scaffold for cartilage reconstruction...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28697530/modern-cartilage-imaging-of-the-ankle
#18
Marc-André Weber, Felix Wünnemann, Pia M Jungmann, Benita Kuni, Christoph Rehnitz
Background Talar osteochondral lesions are an important risk factor for the development of talar osteoarthritis. Furthermore, osteochondral lesions might explain persistent ankle pain. Early diagnosis of accompanying chondral defects is important to establish the optimal therapy strategy and thereby delaying or preventing the onset of osteoarthritis. The purpose of this review is to explain modern cartilage imaging with emphasis of MR imaging as well as the discussion of more sophisticated imaging studies like CT-arthrography or functional MR imaging...
October 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/28692374/is-there-a-role-for-stem-cells-in-treating-articular-injury
#19
Yusuf H Mirza, Sam Oussedik
Articular cartilage is a specialized tissue with a high prevalence of injuries. The complex architecture of articular cartilage means that injuries are difficult to treat. The sequelae of such injuries include post-traumatic osteoarthritis. Current treatments include microfracture, microdrilling, osteochondral transplantation and matrix autologous chondral implantation. However, current surgical therapies have a number of disadvantages. Mesenchymal stem cells have been suggested as a potential alternative therapy, with a theoretical ability to regenerate articular cartilage...
July 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28688892/vascular-ossification-pathology-mechanisms-and-clinical-implications
#20
Michael A Fuery, Lusha Liang, Frederick S Kaplan, Emile R Mohler
In recent years, the mechanisms and clinical significance of vascular calcification have been increasingly investigated. For over a century, however, pathologists have recognized that vascular calcification is a form of heterotopic ossification. In this review, we aim to describe the pathology and molecular processes of vascular ossification, to characterize its clinical significance and treatment options, and to elucidate areas that require further investigation. The molecular mechanisms of vascular ossification involve the activation of regulators including bone morphogenic proteins and chondrogenic transcription factors and the loss of mineralization inhibitors like fetuin-A and pyrophosphate...
July 5, 2017: Bone
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