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Naoki Nakano, Chetan Gohal, Andrew Duong, Olufemi R Ayeni, Vikas Khanduja
OBJECTIVE/PURPOSE: The aim of the study was to assess the options of treatment and their related outcomes for chondral injuries in the hip based on the available evidence whilst highlighting new and innovative techniques. METHODS: A systematic review of the literature from PubMed (Medline), EMBASE, Google Scholar, British Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Allied and Complementary Medicine Database (AMED) was undertaken from their inception to March 2017 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
March 13, 2018: International Orthopaedics
J Más Martínez, J Sanz-Reig, C M Verdú Román, D Bustamante Suárez de Puga, M Morales Santías, E Martínez Giménez
INTRODUCTION AND PURPOSE: Management of injuries to the articular cartilage is complex and challenging. Our purpose was to assess outcomes of a cohort of patients who underwent hip arthroscopy with full-thickness chondral damage treated with microfracture and compare these outcomes with those from a similar cohort of patients who did not. MATERIAL AND METHODS: We prospectively gathered the data of 31 hips treated with microfracture from January 2009 to January 2016...
March 10, 2018: Revista Española de Cirugía Ortopédica y Traumatología
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
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
Cheng Wang, Haoye Meng, Yu Wang, Bin Zhao, Chenyang Zhao, Weijia Sun, Yun Zhu, Bingxing Han, Xueling Yuan, Ruoxi Liu, Xin Wang, Aiyuan Wang, Quanyi Guo, Jiang Peng, Shibi Lu
We explored the mechanism of early stage osteonecrotic femoral head collapse by analyzing and comparing different regions in human osteonecrotic femoral head samples. Eight osteonecrotic femoral heads (ARCO II-III) were obtained from patients undergoing total hip arthroplasty. Bone structure was observed and evaluated by micro-computed tomography (CT) scans and pathology. Osteoblast and osteoclast activities were detected by tartrate-resistant acid phosphatase, alkaline phosphatase, and immunofluorescent staining...
2018: International Journal of Biological Sciences
Min Wei, Yang Liu
OBJECTIVE: To evaluate the clinical effects of arthroscopic microfracture on osteochondral lesions of the talus. METHODS: Total 42 patients with osteochondral lesions of the talus, who were collected in our department from January 2011 to December 2013. The patients were 35.9 years old on average, including 28 males and 14 females. There were 34 patients who had injury histories. The debridement and microfracture were performed under arthroscopy. The function of ankle was assessed according to AOFAS Ankle Hindfoot Scale...
August 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Alexander E Weber, Philip H Locker, Erik N Mayer, Gregory L Cvetanovich, Annemarie K Tilton, Brandon J Erickson, Adam B Yanke, Brian J Cole
Background: Microfracture is a single-stage arthroscopic procedure used to treat small- and medium-sized cartilage defects, the clinical results of which have been mixed to date. Purpose: To retrospectively evaluate prospectively collected patient-reported outcomes (PROs) after microfracture as well as to determine patient-related and defect-related factors associated with clinical outcomes and which factors predict the need for additional surgery. Study Design: Case-control study; Level of evidence, 3...
February 2018: Orthopaedic Journal of Sports Medicine
Riccardo D'Ambrosi, Cristian Indino, Camilla Maccario, Luigi Manzi, Federico Giuseppe Usuelli
In recent years, regenerative techniques have been increasingly studied and used to treat osteochondral lesions of the talus. In particular, several studies have focused their attention on mesenchymal stem cells derived from adipose tissue. Adipose-derived stem cells (ADSCs) exhibit morphological characteristics and properties similar to other mesenchymal cells, and are able to differentiate into several cellular lines. Moreover, these cells are also widely available in the subcutaneous tissue, representing 10 - 30% of the normal body weight, with a concentration of 5,000 cells per gram of tissue...
January 23, 2018: Journal of Visualized Experiments: JoVE
Caio Nery, Lucas Fonseca, Fernando Raduan, Marcus Moreno, Daniel Baumfeld
BACKGROUND: Lateral ankle ligament injury is among the most common orthopedic injuries. The objective of this study is to present the preliminary prospective results of treatment using the "Inside-Out" variant of the fully arthroscopic Broström-Gould technique. METHODS: Twenty six patients were included: 20 male and 6 female, aged 19-60 years, mean 41 years. All patients had positive "anterior drawer" and "talar tilt" tests. When necessary, cartilage injuries were treated with microfracture and arthroscopic resection for anterior impingement; three patients had hindfoot varus, on whom Dwyer osteotomy was performed; one patient had peroneal tendinopathy and was treated with tendoscopic debridement and another one had partial injury of the deltoid ligament, which was treated by direct repair...
March 22, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Christopher M McAndrew, Avinesh Agarwalla, Adam C Abraham, Eric Feuchtbaum, William M Ricci, Simon Y Tang
BACKGROUND: Successful fracture fixation depends critically on the stability of the screw-bone interface. Maximum achievable screw torque reflects the competence of this interface, but it cannot be quantified prior to screw stripping. Typically, the surgeon relies on the patients' bone mineral density and radiographs, along with experience and tactile feedback to assess whether sufficient compression can be generated by the screw and bone. However, the local bone quality would also critically influence the strength of the bone-screw interface...
February 2, 2018: Clinical Biomechanics
Ulunay Kanatlı, Ali Eren, Toygun K Eren, Abdurrahman Vural
Arthroscopic techniques have recently gained popularity for the treatment of osteochondral defects of the talus. The microfracture procedure is the most commonly applied arthroscopic technique. However, it is not effective for the treatment of larger lesions. Tissue-engineered scaffolds have been used for cartilage regeneration arthroscopically, and promising results have been reported. We treated larger osteochondral lesions of the talus with polyglycolic acid-hyaluronan scaffold biomaterial (Chondrotissue, BioTissue AG, Zurich, Switzerland) in a single-step arthroscopic surgery...
October 2017: Arthroscopy Techniques
Kevin C Wang, Rachel M Frank, Eric J Cotter, David R Christian, Brian J Cole
Articular cartilage lesions of the tibial plateau are an uncommonly encountered clinical entity, and they have been comparatively less well studied than femoral condyle or patellofemoral defects. The management of these lesions is complicated by the challenging geometry, difficult surgical approach, and proximity to important anatomic structures, and thus, treating these lesions by previously established methods, such as osteochondral allograft transplantation or osteochondral autograft transfer, can be a technically challenging endeavor...
October 2017: Arthroscopy Techniques
Michael L Redondo, Adam J Beer, Adam B Yanke
The treatment of patellofemoral cartilage defects presents several distinct challenges when compared with cartilage restoration techniques used for other compartments of the knee due to the unique anatomy and distribution of forces. The etiologies of patellofemoral articular cartilage lesions include acute traumatic instability injuries, such as dislocation and subluxation, osteochondritis dissecans, and chronic degenerative changes. Regardless of the etiology, untreated patellofemoral cartilage lesions can contribute to activity-limiting anterior knee pain...
March 2018: Journal of Knee Surgery
Yu Zhang, Shuyun Liu, Weimin Guo, Mingjie Wang, Chunxiang Hao, Shuang Gao, Xueliang Zhang, Xu Li, Mingxue Chen, Xiaoguang Jing, Zehao Wang, Jiang Peng, Shibi Lu, Quanyi Guo
OBJECTIVE: As a novel and promising seed cell, human umbilical cord Wharton's jelly mesenchymal stem cells(hWJMSCs) are widely applied in tissue engineering. However, whether hWJMSCs can better repair and regenerate the articular cartilage in big animals than microfracture(MF, a predominant clinical treatment strategy for damaged cartilage) is unclear. Evaluation of the validity, and safety of hWJMSCs in a caprine model with a full-thickness femoral condyle articular cartilage defect, compared with MF is required...
January 29, 2018: Osteoarthritis and Cartilage
Marcin Kowalczuk, Volker Musahl, Freddie H Fu
No abstract text is available yet for this article.
January 2018: Clinical Orthopaedics and related Research
Kevin C Wang, Rachel M Frank, Eric J Cotter, Annabelle Davey, Maximilian A Meyer, Charles P Hannon, Timothy Leroux, Anthony A Romeo, Brian J Cole
BACKGROUND: Microfracture is an effective surgical treatment for full-thickness cartilage defects of the knee; however, little is known regarding long-term outcomes after microfracture in the shoulder. PURPOSE: To present long-term clinical outcomes of patients undergoing microfracture of full-thickness articular cartilage defects of the glenohumeral joint. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Sixteen consecutive patients (17 shoulders) were retrospectively reviewed who underwent arthroscopic microfracture of the humeral head and/or glenoid surface, with or without additional procedures between 2001 and 2008 and with a minimum follow-up of 8...
January 1, 2018: American Journal of Sports Medicine
Jessica C Rivera, Jason A Beachler
Post-traumatic arthritis (PTA) is characterized by the deterioration of articular cartilage temporally associated with an articular injury. With a paucity of literature comparing joint preservation techniques, we performed a systematic review of the literature intending to describe and summarize the results of ankle distraction arthroplasty as it compares with studies on tibio-talar microfracture, allograft, and autograft for ankle joint preservation in the post-traumatic population under 50 years of age. Research databases were searched and abstracts screened for relevance on our topic of interest...
January 23, 2018: Strategies in Trauma and Limb Reconstruction
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
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
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
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