The quality of healing: articular cartilage. Carefully updated chapters discuss the state-of-the-art in cartilage anatomy, defects and imaging, current tibiofemoral and patellofemoral surgical options, debridement and marrow stimulation, osteochondral autografts and allografts, osteotomies, cell therapy, and meniscal transplantation. Fresh osteochondral allografts in the knee: comparison of primary transplantation versus transplantation after failure of previous subchondral marrow stimulation. The dowel or press-fit technique utilizes a cylindrical reamer and coring reamer system to fashion a dowel and recipient site with a diameter ranging from 15 to 35 mm. While absolute solutions will remain elusive, the current goal is to define these barriers as the first step toward solving these problems.
Carefully updated chapters discuss the state-of-the-art in cartilage anatomy, defects and imaging, current tibiofemoral and patellofemoral surgical options, debridement and marrow stimulation, osteochondral autografts and allografts, osteotomies, cell therapy, and meniscal transplantation. Th e senior authors prefer the bridge in slot technique, as described previously, 6 because of its simplicity and secure bone fi xation, the ability to more easily perform concomitant procedures such as osteotomy and ligament reconstruction, and the advantages of main-taining the relationship of the native anterior and poste-rior horns of the meniscus. Filardo, G, Andriolo, L, Balboni, F, Marcacci, M, Kon, E. Twenty-three of the 32 knees 72% were considered failures by the definition detailed above. Bei einer missbräuchlichen Weitergabe des eBooks an Dritte ist eine Rückverfolgung an die Quelle möglich.
Coronal plane malalignment, of both varus and valgus, has important implications for cartilage repair. Overt secondary osteoarthritis is often the endpoint. Surgical management of articular cartilage defects of the knee. He studies the outcomes of established procedures such as cartilage and meniscus transplantation, as well as new procedures such as stem cell transplantation, and artificial cartilage and meniscus implants. The goal with arthroscopic methods is to preserve as much functional meniscal tissue as possible, rather than to remove it.
It can be used in isolation to mechanically stabilize a lesion by removing loose flaps. Farr has written numerous articles, book chapters and has completed and edited two cartilage books published in 2013. The common goal is to reproduce the function of the meniscus. Results All studies reported on the type of primary cartilage procedure and precise lesion location s. Marlovits, S, Singer, P, Zeller, P, Mandl, I, Haller, J, Trattnig, S. This chapter will present a broad overview of cartilage restoration from inception to present with future chapters exploring each approach in detail.
Osteochondral allograft transplantation is performed in one of two following techniques, depending on the location and extent of cartilage damage being addressed. Gomoll has lectured and published extensively on the topic of biologic joint reconstruction and joint preservation through cartilage and meniscus transplantation. A systematic review and meta-analysis. In carefully selected patients, meniscal allografts can restore nearly normal knee anatomy and biomechanics, providing excellent pain relief and improved function. Fresh osteochondral allograft transplantation for bipolar reciprocal osteochondral lesions of the knee.
Mats Brittberg, Andreas H Gomoll, José A Conseco, Jack Farr, Martin Lind, James Hui Abstract Background and purpose—Cartilage damage can develop due to trauma, resulting in focal chondral or osteochondral defects, or as more diffuse loss of cartilage in a generalized organ disease such as osteoarthritis. Early positive animal outcomes have been followed by early positive clinical outcomes. Cartilage Restoration is a valuable resource for orthopedic surgeons, residents, and fellows. However, there is wide variation and incomplete reporting on lesion size, depth, and grading. In order to rebalance the load on the knee joint, realignment osteotomy should be considered, both in isolation for more advanced degenerative changes, as well as an adjunct to cartilage repair and meniscal transplantation.
Jack Farr received his undergraduate degree in bio¬logical engineering from Rose Hulman Institute of Technology in 1975, where he also was awarded an honorary doctorate of biological engineering. Attempting to bridge the gap between the science and art of cartilage restoration, Cartilage Restoration: Practical Clinical Applications combines an overview of clinical research and methodologies with clinical cases to help guide the orthopedic treatment and care of patients presenting with cartilage issues. Of these, 14 knees 43% had further surgery after the index procedure. Attempting to bridge the gap between the science and art of cartilage restoration, Cartilage Restoration: Practical Clinical Applications combines an overview of clinical research and methodologies with clinical cases to help guide the orthopedic treatment and care of patients presenting with cartilage issues. Development and evaluation of an activity rating scale for disorders of the knee. Buying eBooks from abroad For tax law reasons we can sell eBooks just within Germany and Switzerland. He subsequently completed a Fellowship in Orthopaedic Sports Medicine at Rush University.
In the present research, chitosan scaffolds are cross-linked with hydrothermal treatment simultaneously with autoclave sterilization time of 0, 10, 20 and 30 min, which avoids application of the traditional chemical toxic materials. The John Insall Award: a minimum 10-year outcome study of autologous chondrocyte implantation. Not only are the cartilage implants changing, but also the surgical approach to using the implant. Bridging the gap between the science and art of cartilage restoration, this book offers an overview of clinical research, plus current surgical options, debridement and marrow stimulation, autograft plug transfer, cell therapy, allografts and meniscal issues. We concluded that further improvements are needed for direct repair of focal, purely traumatic defects before we can routinely use such repair techniques for the more challenging degenerative lesions. J Orthop Sports Phys Ther. These barriers may be categorized as cost, regulatory, insurance, and logistical issues.
During recent years, efforts have increasingly focused on the promotion of meniscal healing, as well as the replacement of damaged menisci with allografts, scaffolds, meniscal implants, or substitutes. A loss of cartilage function and quality is also seen with increasing age. Future clinical studies should include these important data in a consistent manner to facilitate comparison among surgical techniques. Wei Seong Toh, Mats Brittberg, Jack Farr, Casper Bindzus Foldager, Andreas H Gomoll, James Hoi Po Hui, James B Richardson, Sally Roberts, Myron Spector Abstract—It is well accepted that age is an important contributing factor to poor cartilage repair following injury, and to the development of osteoarthritis. The limb- and knee-specific contributing factors that lead to abnormal forces and contact areas are best treated in a systematic manner after first categorizing them. Several causative factors have been identified, including chronic defects, as well as prior treatment with marrow stimulation techniques. Knee Surg Sports Traumatol Arthrosc.