Microfracture combined with osteochondral paste implantation was more effective than microfracture alone for full-thickness cartilage repair

Xing, Linzi; Jiang, Yiqiu; Gui, Jian‐Fang; Lu, Yong; Gao, Feng; Xu, Yang; Xu, Yan

doi:10.1007/s00167-012-2031-5

Cited by 30 publications

(27 citation statements)

References 14 publications

(16 reference statements)

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“…Even as fibrocartilage is expected to fill in such defects, its biomechanical properties are inferior to those of native, hyaline cartilage. 9 It is our experience that labral repair often indirectly stabilizes loose flaps of adjacent cartilage. Thus more native cartilage may be preserved by initially securing the labrum as opposed to first debriding loose, delaminated chondral flaps.…”

Section: Discussionmentioning

confidence: 99%

Management of a Large Acetabular Chondrolabral Injury in a Young Patient With Femoroacetabular Impingement

Sherman

Marcel

Postma

2014

Arthroscopy Techniques

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Patients with mixed-type femoroacetabular impingement syndrome often have concomitant chondrolabral pathology in addition to the characteristic cam and pincer lesions. Unfortunately, these patients are typically young, and the pathology is localized to the weight-bearing dome of the acetabulum. Complete preoperative characterization of labral and cartilage lesions is often not possible even with advanced imaging techniques, and the full extent of the injury may not be appreciated without direct arthroscopic visualization. Thus management decisions regarding intra-articular pathology may not be possible until the time of surgery. Often, the cartilage and labral pathology in these young patients is part of a contiguous complex of tissue that separates from the underlying subchondral bone. We present an arthroscopic management technique for young patients with this pattern of injury. This includes limited debridement of loose labral and chondral tissue, labral repair to restore the suction-seal effect, microfracture to promote reparative tissue formation, and takedown of the underlying pathoanatomic cam and pincer lesions.

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Section: Discussionmentioning

confidence: 99%

Management of a Large Acetabular Chondrolabral Injury in a Young Patient With Femoroacetabular Impingement

Sherman

Marcel

Postma

2014

Arthroscopy Techniques

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“…This clot provides the environment for the pluripotent and mesenchymal cells to differentiate and form fibrocartilaginous tissue filling the defect. 2,7 Although the new fibrocartilage lacks the biomechanical properties of native hyaline articular cartilage, specifically in its ability to tolerate sheer stresses, 8 it has been shown to relieve symptoms in 70% to 90% of patients undergoing knee microfracture. 7 The standard technique, adapted from the knee, uses longer microfracture awls to accommodate the hip joint.…”

Section: Microfracturementioning

confidence: 99%

Arthroscopic Acetabular Microfracture With the Use of Flexible Drills: A Technique Guide

Haughom

Erickson

Rybalko

et al. 2014

Arthroscopy Techniques

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Chondral injuries of the hip joint are often symptomatic and affect patient activity level. Several procedures are available for addressing chondral injuries, including microfracture. Microfracture is a marrow-stimulating procedure, which creates subchondral perforation in the bone, allowing pluripotent mesenchymal stem cells to migrate from the marrow into the chondral defect and form fibrocartilaginous tissue. In the knee, microfracture has been shown to relieve pain symptoms. In the hip, microfracture has been studied to a lesser extent, but published studies have shown promising clinical outcomes. The depth, joint congruity, and geometry of the hip joint make microfracture technically challenging. The most common technique uses hip-specific microfracture awls, but the trajectory of impaction is not perpendicular to the subchondral plate. Consequently, the parallel direction of impaction creates poorly defined channels. We describe an arthroscopic microfracture technique for the hip using a flexible microfracture drill. The drill and angled guides simplify access to the chondral defect. The microfracture drill creates clear osseous channels, avoiding compaction of the surrounding bone and obstruction of the channels. Furthermore, this technique allows for better control of the angle and depth of the drill holes, which enhances reproducibility and may yield improved clinical outcomes.

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“…[2][3][4]8 Surgeons and researchers have been testing different repair and regeneration treatments, such as marrow stimulation technique (microfracture), osteochondral autograft implantation, and autologous chondrocytes transplantation. [9][10][11][12][13] Although these treatments are effective, disadvantages exist, such as the lack of regenerative hyaline cartilage tissue, donor site morbidity, and limited available tissues. 14,15 Tissue engineering biomaterial scaffolds have emerged as a promising intervention for the repair and regeneration of osteochondral defects.…”

Section: The Authors Are From the Department Of Orthopedics (Ml Fh mentioning

confidence: 99%

Tissue Engineering Stratified Scaffolds for Articular Cartilage and Subchondral Bone Defects Repair

Liu¹,

Yu²,

Huang³

et al. 2013

Orthopedics

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Due to their good biocompatibility and mechanical integrity, tissue engineering scaffolds have become a principal method of repair and regeneration of osteochondral defects. To improve their intrinsic properties, control their degenerative times, and enhance their cell adhesion and differentiation, numerous scaffold architectures and formation methods have been developed and tested, but the ideal scaffold design is still controversial. Moreover, scaffold fixation has a significant influence on repair and regeneration after implantation. The authors analyzed relative studies to address the latest scaffold designs, including biphasic scaffold, multilayered scaffold, and continuous nonstratified scaffold, and this article compares their advantages and disadvantages. In addition, the authors introduce a novel modified method for scaffold fixation known as magnetic fixation. Both stratified and nonstratified scaffolds can repair osteochondral defects, but continuous nonstratified scaffolds are more biomimetic compared with the native osteochondral structures, and they lead to a better regeneration of hyaline-like cartilage and structured bone tissue. Therefore, the authors suggest continuous nonstratified scaffolds are an effective option for treating osteochondral defects.

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Microfracture combined with osteochondral paste implantation was more effective than microfracture alone for full-thickness cartilage repair

Cited by 30 publications

References 14 publications

Management of a Large Acetabular Chondrolabral Injury in a Young Patient With Femoroacetabular Impingement

Management of a Large Acetabular Chondrolabral Injury in a Young Patient With Femoroacetabular Impingement

Arthroscopic Acetabular Microfracture With the Use of Flexible Drills: A Technique Guide

Tissue Engineering Stratified Scaffolds for Articular Cartilage and Subchondral Bone Defects Repair

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