High Rate of Osteoarthritis After Osteochondritis Dissecans Fragment Excision Compared With Surgical Restoration at a Mean 16-Year Follow-up

Sanders, Thomas L.; Pareek, Ayoosh; Obey, Mitchel R.; Johnson, Nicholas R.; Carey, James L.; Stuart, Michael J.; Krych, Aaron J.

doi:10.1177/0363546517699846

Cited by 86 publications

(85 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…7,35,78 Even though the sandwich technique has been described in the treatment of bone lesions concomitantly with ACI, there was no agreement on its utilization, and OCA was preferred for cases that include intralesional osteophytes, revision including prior failed microfracture, prior fracture malunion, significant subchondral stress reactions also known as "bone edema," significant subchondral cyst formation, and bone loss due to fractures or osteochondritis dissecans fragment excision. 21,31,36,38,60,62,75,79 In the patellofemoral joint, morphology matching makes OCA technically more demanding than ACI. This is because of the complex topography, with highly variable shapes of the patella and trochlea.…”

Section: Indicationsmentioning

confidence: 99%

An Expert Consensus Statement on the Management of Large Chondral and Osteochondral Defects in the Patellofemoral Joint

Chahla

Hinckel

Yanke

et al. 2020

Orthopaedic Journal of Sports Medicine

Self Cite

View full text Add to dashboard Cite

Background: Cartilage lesions of the patellofemoral joint constitute a frequent abnormality. Patellofemoral conditions are challenging to treat because of complex biomechanics and morphology. Purpose: To develop a consensus statement on the functional anatomy, indications, donor graft considerations, surgical treatment, and rehabilitation for the management of large chondral and osteochondral defects in the patellofemoral joint using a modified Delphi technique. Study Design: Consensus statement. Methods: A working group of 4 persons generated a list of statements related to the functional anatomy, indications, donor graft considerations, surgical treatment, and rehabilitation for the management of large chondral and osteochondral defects in the patellofemoral joint to form the basis of an initial survey for rating by a group of experts. The Metrics of Osteochondral Allografts (MOCA) expert group (composed of 28 high-volume cartilage experts) was surveyed on 3 occasions to establish a consensus on the statements. In addition to assessing agreement for each included statement, experts were invited to propose additional statements for inclusion or to suggest modifications of existing statements with each round. Predefined criteria were used to refine statement lists after each survey round. Statements reaching a consensus in round 3 were included within the final consensus document. Results: A total of 28 experts (100% response rate) completed 3 rounds of surveys. After 3 rounds, 36 statements achieved a consensus, with over 75% agreement and less than 20% disagreement. A consensus was reached in 100.00% of the statements relating to functional anatomy of the patellofemoral joint, 88.24% relating to surgical indications, 100.00% relating to surgical technical aspects, and 100.00% relating to rehabilitation, with an overall consensus of 95.5%. Conclusion: This study established a strong expert consensus document relating to the functional anatomy, surgical indications, donor graft considerations for osteochondral allografts, surgical technical aspects, and rehabilitation concepts for the management of large chondral and osteochondral defects in the patellofemoral joint. Further research is required to clinically validate the established consensus statements and better understand the precise indications for surgery as well as which techniques and graft processing/preparation methods should be used based on patient- and lesion-specific factors.

show abstract

Section: Indicationsmentioning

confidence: 99%

An Expert Consensus Statement on the Management of Large Chondral and Osteochondral Defects in the Patellofemoral Joint

Chahla

Hinckel

Yanke

et al. 2020

Orthopaedic Journal of Sports Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…Focal articular cartilage (AC) damage can occur due to age, trauma, repetitive injury, joint misalignment, osteochondritis, and osteonecrosis and is very common, especially in the young and active population . AC is avascular, which contributes to the limited regenerative capacity of the tissue .…”

Section: Introductionmentioning

confidence: 99%

Fiber Reinforced Cartilage ECM Functionalized Bioinks for Functional Cartilage Tissue Engineering

Rathan

Dejob

Schipani

et al. 2019

Adv Healthcare Materials

108

View full text Add to dashboard Cite

Focal articular cartilage (AC) defects, if left untreated, can lead to debilitating diseases such as osteoarthritis. While several tissue engineering strategies have been developed to promote cartilage regeneration, it is still challenging to generate functional AC capable of sustaining high load‐bearing environments. Here, a new class of cartilage extracellular matrix (cECM)‐functionalized alginate bioink is developed for the bioprinting of cartilaginous tissues. The bioinks are 3D‐printable, support mesenchymal stem cell (MSC) viability postprinting and robust chondrogenesis in vitro, with the highest levels of COLLII and ACAN expression observed in bioinks containing the highest concentration of cECM. Enhanced chondrogenesis in cECM‐functionalized bioinks is also associated with progression along an endochondral‐like pathway, as evident by increases in RUNX2 expression and calcium deposition in vitro. The bioinks loaded with MSCs and TGF‐β3 are also found capable of supporting robust chondrogenesis, opening the possibility of using such bioinks for direct “print‐and‐implant” cartilage repair strategies. Finally, it is demonstrated that networks of 3D‐printed polycaprolactone fibers with compressive modulus comparable to native AC can be used to mechanically reinforce these bioinks, with no loss in cell viability. It is envisioned that combinations of such biomaterials can be used in multiple‐tool biofabrication strategies for the bioprinting of biomimetic cartilaginous implants.

show abstract

“…Non‐physiologic mechanical stress on the rim surrounding the defect is likely to play a role in the progressive deterioration of adjacent cartilage . For example, a recent study by Sanders et al found that at 16‐year follow‐up, patients that underwent excision of an osteochondritis dissecans lesion experienced significantly higher rates of osteoarthritis and joint arthroplasty than patients that had received lesion fixation or osteochondral grafts . These findings suggest a major role for altered cartilage mechanics in the pathogenesis of osteoarthritis (OA).…”

mentioning

confidence: 99%

Sprifermin treatment enhances cartilage integration in an in vitro repair model

Sennett

Meloni

Farran

et al. 2018

Journal Orthopaedic Research

View full text Add to dashboard Cite

Cartilage integration remains a clinical challenge for treatment of focal articular defects. Cartilage exhibits limited healing capacity that declines with tissue maturation. Many approaches have been investigated for their ability to stimulate healing of mature cartilage or integration of repair tissue or tissue-engineered constructs with native cartilage. Growth factors present in immature tissue may enhance chondrogenesis and promote integrative repair of cartilage defects. In this study, we assessed the role of one such factor, fibroblast growth factor 18 (FGF18). Studies using FGF18 have shown a variety of positive effects on cartilage, including stimulation of chondrocyte proliferation, matrix biosynthesis, and suppression of proteinase activity. To explore the role of FGF18 on cartilage defect repair, we hypothesized that treatment with recombinant human FGF18 (sprifermin) would increase matrix synthesis in a defect model, thus improving integration strength. To test this hypothesis, 6 mm cartilage cylinders were harvested from juvenile bovine knees. A central 3 mm defect was created in each explant, and this core was removed and replaced. Resulting constructs were cultured in control or sprifermin-containing medium (weekly 24-h exposure of 100 ng/ml sprifermin) for 4 weeks. Mechanical testing, biochemical analysis, micro-CT, scanning electron microscopy, and histology were used to assess matrix production, adhesive strength, and structural properties of the cartilage-cartilage interface. Results showed greater adhesive strength, increased collagen content, and larger contact areas between core and annular cartilage in the sprifermin-treated group. These findings present a novel treatment for cartilage injuries that have potential to enhance defect healing and lateral cartilage-cartilage integration. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2648-2656, 2018.

show abstract

High Rate of Osteoarthritis After Osteochondritis Dissecans Fragment Excision Compared With Surgical Restoration at a Mean 16-Year Follow-up

Cited by 86 publications

References 27 publications

An Expert Consensus Statement on the Management of Large Chondral and Osteochondral Defects in the Patellofemoral Joint

An Expert Consensus Statement on the Management of Large Chondral and Osteochondral Defects in the Patellofemoral Joint

Fiber Reinforced Cartilage ECM Functionalized Bioinks for Functional Cartilage Tissue Engineering

Sprifermin treatment enhances cartilage integration in an in vitro repair model

Contact Info

Product

Resources

About