Articular Cartilage Lesions of the Knee

Br, Mandelbaum; Je, Browne; Fu, Fang; Micheli, Lyle J.; Jb, Mosely; Erggelet, Christoph; Minas, T.; Peterson, Lars

doi:10.1177/03635465980260062201

Cited by 329 publications

(224 citation statements)

References 24 publications

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“…Matava and Brown [20] described arthroscopic fixation with resorbable pins to stabilize patellar OCD and retain a congruent articulation until healing occurs. Marrow stimulation techniques using abrasion and/or drilling to penetrate the subchondral bone technique were described by Mandelbaum et al [19], whereas Pridie [25] reported the use of microfracture techniques to stimulate the development of a fibrocartilaginous layer.…”

Section: Introductionmentioning

confidence: 99%

Cell-based Therapy Improves Function in Adolescents and Young Adults With Patellar Osteochondritis Dissecans

Teo

Buhary

Tai

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Recent advances have been made in using chondrocytes and other cell-based therapy to treat cartilage defects in adults. However, it is unclear whether these advances should be extended to the adolescent and young adult-aged patients. Questions/purposes We assessed cell-based surgical therapy for patellar osteochondritis dissecans (OCD) in adolescents and young adults by (1) determining function with the International Knee Documentation Committee (IKDC) subjective and Lysholm-Gillquist scores; and (2) evaluating activity level using the Tegner-Lysholm scale. Methods We retrospectively reviewed 23 patients between 12 and 21 years of age (mean 16.8 years) treated for OCD lesions involving the patella from 2001 to 2008. Twenty patients had autologous chondrocyte implantation and three patients had cultured bone marrow stem cell implantation. There were 19 males and four females. We obtained preoperative CT scans to assess patella subluxation, tilt, and congruence angle to determine choice of treatment. We obtained IKDC subjective knee evaluation scores, Tegner-Lysholm activity levels, and LysholmGillquist knee scores preoperatively and at 6, 12, and 24 months postoperatively. Results Mean IKDC score, Tegner-Lysholm outcomes, and Lysholm-Gillquist scale improved from 45, 2.5, and 50, respectively, at surgery to 75, 4, and 70, respectively, at 24-month followup. Complications include periosteal hypertrophy observed in two patients. Conclusion Cell-based therapy was associated with shortterm improvement in function in adolescents and young adults with patellar

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Section: Introductionmentioning

confidence: 99%

Cell-based Therapy Improves Function in Adolescents and Young Adults With Patellar Osteochondritis Dissecans

Teo

Buhary

Tai

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…Consequently, surgical repositioning and fixation of fragments is the preferred method of treatment. Numerous techniques have been described, with screw and pin fixations being the most common (23)(24)(25)(26)(27)(28). However, traditional metallic implants can cause mechanical damage of the joint if the surrounding bone collapses or cartilage wears out and removal of the implants may be necessary (29).…”

Section: Discussionmentioning

confidence: 99%

Biodegradable poly-L-lactide-co-glycolide copolymer pin fixation of a traumatic patellar osteochondral fragment in an 11-year-old child: A novel surgical approach

Sinikumpu

Serlo

2016

Experimental and Therapeutic Medicine

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Abstract. Treating displaced patellar bone fractures in growing children remains a challenge for orthopedic surgeons. Removal of loose bone fragments may prolong healing time and result in early onset osteoarthrosis. Therefore, primary fixation of osteochondral fragments is preferred. Metallic pin and screw implants are typically used for fixation, as there is little evidence available regarding the use of modern biodegradable implants in traumatic patellar fractures of a premature skeleton. The present report describes a novel operative technique using headless poly-L-lactide-co-glycolide (PLGA) pins in treating an 11-year-old girl with a patellar fracture from a cycling injury. The surgical technique of this procedure is described in detail in the current report. Excellent subjective outcomes were achieved from this surgery, with superb bone healing according to follow-up radiographic and computerized tomography scans. In conclusion, the results of this case indicate that, similarly to osteochondritis, intra-articular osteochondral fractures in children may be fixed using biodegradable PLGA pins. Randomized clinical trials should be performed to confirm this finding and evaluate the use of PLGA pins as a treatment for adolescent osteochondral fractures.

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“…Regarding osteochondral defects of the knee, several articles have reported that containment of the lesion is an important factor affecting the clinical outcomes. [13][14][15] Cuttica et al 7 described the containment of OLTs. Lesions involving the shoulder of the talar dome were defined as uncontained.…”

Section: Discussionmentioning

confidence: 99%

The “Cup-Shaped” Technique for Uncontained Osteochondral Lesion of the Talus

Yoshimura

Hagio

Naito

2013

Arthroscopy Techniques

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The arthroscopic bone marrow stimulation technique is defined as the first-line procedure for an osteochondral lesion of the talus. The containment of the lesion has been reported as 1 of the prognostic factors for clinical outcomes of arthroscopic bone marrow stimulation. It was surmised that lesions without a stable rim lose the protective border, thereby making stable formation of fibrocartilage less likely. The purpose of the cup-shaped technique is to improve the stability of blood clots after arthroscopic bone marrow stimulation in an uncontained lesion. The geometry of the lesion changes from "uncontained" to "contained like," which improves the stability of the blood clots.

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Articular Cartilage Lesions of the Knee

Cited by 329 publications

References 24 publications

Cell-based Therapy Improves Function in Adolescents and Young Adults With Patellar Osteochondritis Dissecans

Cell-based Therapy Improves Function in Adolescents and Young Adults With Patellar Osteochondritis Dissecans

Biodegradable poly-L-lactide-co-glycolide copolymer pin fixation of a traumatic patellar osteochondral fragment in an 11-year-old child: A novel surgical approach

The “Cup-Shaped” Technique for Uncontained Osteochondral Lesion of the Talus

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