Comparison of four chondral repair techniques in the hip joint: a biomechanical study using a physiological human cadaveric model

Cassar-Gheiti, Adrian J.; Byrne, Danielle; Kavanagh, Eoin C.; Mulhall, Kevin

doi:10.1016/j.joca.2015.02.012

Cited by 22 publications

(14 citation statements)

References 52 publications

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Section: Discussionmentioning

confidence: 99%

“…24,25 However, biomechanical testing has shown that gluing on its own provides insufficient fixation of the chondral flaps. 26 A more physiological clot produced by subchondral drilling might sufficiently stabilse the cartilage flap. Second, previous studies found evidence that even though the chondral flaps appear normal macroscopically, the biochemical properties and percentage of live chondrocytes are significantly reduced and variable stages of matrix and chondrocyte damage are present.…”

Section: Discussionmentioning

confidence: 99%

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Subchondral drilling for chondral flaps reduces the risk of total hip arthroplasty in femoroacetabular impingement surgery at minimum five years follow-up

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Subchondral drilling for chondral flaps reduces the risk of total hip arthroplasty in femoroacetabular impingement surgery at minimum five years follow-up

et al. 2018

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“…Cassar-Gheiti et al [76] compared four chondral repair techniques in a cadaver model. The authors created chondral flaps in 24 cadavers, treating six hips each with either fibrin glue, cyanoacrylate, a suture technique or an agarose hydrogel scaffold sealed with fibrin glue.…”

Section: Treatment Modalitiesmentioning

confidence: 99%

Chondral lesions in the hip: a review of relevant anatomy, imaging and treatment modalities

Dallich

Rath

Atzmon

et al. 2019

Journal of Hip Preservation Surgery

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The diagnosis and treatment of chondral lesions in the hip is an ongoing challenge in orthopedics. Chondral lesions are common and several classification systems exist to classify them based on severity, location, radiographic parameters, and potential treatment options. When working up a patient with a potential hip chondral lesion, a complete history, thorough physical exam, and ancillary imaging are necessary. The physical exam is performed with the patient in standing, supine, prone, and lateral positions. Plain film radiographs are indicated as the first line of imaging; however, magnetic resonance arthrogram is currently the gold standard modality for the diagnosis of chondral lesions outside of diagnostic arthroscopy. Multiple treatment modalities to address chondral lesions in the hip exist and new treatment modalities continue to be developed. Currently, chondroplasty, microfracture, cartilage transplants (osteochondral autograft transfer, mosaicplasty, Osteochondral allograft transplantation) and incorporation of orthobiologics (Autologous chondrocyte implantation, Autologous matrix-induced chondrogenesis, Mononuclear concentrate in platelet-rich plasma) are some techniques that have been successfully applied to address chondral pathology in the hip. Further refinement of these modalities and research in novel techniques continues to advance a surgeon’s ability to address chondral lesions in the hip joint.

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“…Biomechanical data published on chondral repair techniques has shown improve resistance to shear forces across the chondral surface when compared to fibrin adhesive repair in cadaveric models [109]. Furthermore we have identified early biomechanical failure in fibrin adhesive repair, which failed at only 50 cycles, while suture of chondral flaps were more biomechanically stable throughout the 1500 cycle testing [109]. The small number of reported outcomes and early laboratory failure may limit fibrin glue clinical use, however, both fibrin glue, suture and cyanoacrylate repair warrant further investigation.…”

Section: Cyanoacrylatementioning

confidence: 99%

Chondral Lesion in the Hip Joint and Current Chondral Repair Techniques

Cassar-Gheiti¹,

Burke²,

Cassar-Gheiti³

et al. 2018

Cartilage Repair and Regeneration

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This chapter gives a detailed review of the composition, structure and biomechanics of articular cartilage in the joint. W have looked at the most common types of cartilage lesions and at the existing methods of articular cartilage repair techniques in the hip joint. Articular cartilage is specialized hyaline cartilage which makes a firm, smooth and slippery surface that resists plastic deformation. It has a unique structure and mechanical properties that provide joints with a surface that combines low friction, shock absorption and wear resistance, while bearing large repetitive loads throughout an individual's lifetime. Cartilage lesions in the hip are most common on the acetabular side and typically present as focal area of delamination or chondral flap. Joint preserving techniques are becoming increasingly common. The spectrum of options includes palliative procedures such as joint lavage and chondral debridement, reparative procedures such as microfracture and direct chondral repair, and restorative procedures such as mosaicoplasty. Preservation of the host tissue is most attractive solution to cartilage damage, particularly in young active individuals. Tissue engineering offers one solution but many problems have to be overcome before these techniques become a reality.

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Comparison of four chondral repair techniques in the hip joint: a biomechanical study using a physiological human cadaveric model

Cited by 22 publications

References 52 publications

Subchondral drilling for chondral flaps reduces the risk of total hip arthroplasty in femoroacetabular impingement surgery at minimum five years follow-up

Subchondral drilling for chondral flaps reduces the risk of total hip arthroplasty in femoroacetabular impingement surgery at minimum five years follow-up

Chondral lesions in the hip: a review of relevant anatomy, imaging and treatment modalities

Chondral Lesion in the Hip Joint and Current Chondral Repair Techniques

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