Microfracture of Acetabular Rim After Segmental Labral Resection to Restore the Morphology and Function of Labrum: A Retrospective Study of More than 2 Years Follow‐up

Su, Tiao; Li, Jing; Yang, Liu; Chen, Guangxing

doi:10.1111/os.13131

Cited by 2 publications

(5 citation statements)

References 39 publications

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“…(3) symptoms and imaging findings that were localized in the patellofemoral joint; (4) patients who suffered from malignant neoplasms; (5) patients who had active infection in other parts of the body; (6) female patients who were pregnant, lactating, or preparing for pregnancy; (7) cartilage lesions caused by infectious or gouty arthritis; (8) patients who had autoimmune diseases such as rheumatoid arthritis and ankylosing spondylitis; (9) patients who had diabetes with FBG over 8 mmol/L and had poor control; (10) patients who were generally in poor condition and unable to tolerate surgery; (11) patients who had severe diseases such as cerebral hemorrhage, severe pneumonia, and multiple organ dysfunction; (12) patients with Charcot joint; (13) any conditions that might increase the patient's risk or influence the results of the experiment during the research; (14) other reasons making the patient unsuitable for this study.…”

Section: Trial Participantsmentioning

confidence: 99%

“…Articular cartilage lesions of the knee are extremely common, with a high morbidity rate of 5% in the general population, and are characterized by the progressive loss of joint function and development of pain 1–6 . Currently, traditional conservative treatments for knee cartilage lesions include nonsteroidal anti‐inflammatory drugs, glucosamine, hyaluronic acid, and glucocorticoids 7–11 . However, as these therapies have limited therapeutic efficacy in the healing of cartilage lesions, their long‐term efficacy is uncertain 12 .…”

Section: Introductionmentioning

confidence: 99%

“… 1 , 2 , 3 , 4 , 5 , 6 Currently, traditional conservative treatments for knee cartilage lesions include nonsteroidal anti‐inflammatory drugs, glucosamine, hyaluronic acid, and glucocorticoids. 7 , 8 , 9 , 10 , 11 However, as these therapies have limited therapeutic efficacy in the healing of cartilage lesions, their long‐term efficacy is uncertain. 12 In addition, while these known therapies can be effective for a short period, they can cause several adverse reactions.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Efficacy of Intra‐Articular Injection with P‐PRP Versus that of L‐PRP in Treating Knee Cartilage Lesion: A Randomized Controlled Trial

Zhou

Cao

et al. 2023

Orthopaedic Surgery

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Background: To evaluate the clinical e cacy and safety of intra-articular injection with pure platelet-rich plasma (P-PRP) versus those of leukocyte platelet-rich plasma (L-PRP) in treating knee cartilage lesions, we conducted a double-blind, randomized controlled clinical trial with a larger sample and longer followup period.Methods: From October 2019 to October 2020, 95 patients were invited to participate in our study, and 60 (63.2%) were randomized to P-PRP (n = 30) or L-PRP (n = 30) groups. Patients from the two groups were treated with knee intra-articular injections of P-PRP or L-PRP. Visual analog scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores were assessed preoperatively and at 6 weeks, 12 weeks, 6 months, and 12 months after intervention.Results: We followed up 27 cases in the P-PRP group and 26 cases in the L-PRP group. No signi cant differences in VAS and WOMAC scores were found between the two groups before the intervention (P>0.05). The WOMAC Pain and VAS-Motions scores of the P-PRP group were signi cantly lower than those of the L-PRP group at 6 weeks after the intervention (P<0.05). While the long-term clinical e cacy of both injections was similar and weakened after 12 months, more adverse events were found in the L-PRP group.Conclusions: The short-term results of our study are encouraging and demonstrate that both L-PRP and P-PRP intra-articular injections reduce pain and improve function in patients with knee cartilage lesions.Compared with the L-PRP injection, the P-PRP injection (which had a lower risk of early in ammation caused by leukocytes) showed better clinical e cacy in the early phase of postoperative rehabilitation and resulted in fewer adverse events. However, long-term clinical e cacy for both injections were similar and weakened after 12 months.Trial registration: ChiCTR1900026365. Registered on 3 October 2019, http://www.chictr.org.cn/showproj.aspx?proj=43911.(RCT) to evaluate the therapeutic e cacy of P-PRP versus that of L-PRP in treating knee cartilage lesions. Methods Trial designThis double-blind, RCT of Evidence Level I compared the safety and e cacy of P-PRP with those of L-PRP in Chinese patients with knee cartilage lesions. This clinical trial was registered at www.chictr.org.cn (ChiCTR1900026365), approved by the Clinical Research Ethics Committees of the hospital of the authors [CZEC (2017)-04], and followed the ethical standards of the institutional and national research committees and the 1964 Helsinki Declaration and its later amendments. Informed consent was obtained from all the participants in the study. From October 2019 to October 2020, 60 patients with knee cartilage lesions were recruited to participate in this study the hospital of the authors. Trial participantsThe following inclusion criteria were used for patient selection: 1. Patients between the ages of 18 and 75 years. MRI clearly indicated articular cartilage injury, and the Kellgren-Lawrence standard knee grade was not more than level-3. 3. Patients with obvi...

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Section: Trial Participantsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Efficacy of Intra‐Articular Injection with P‐PRP Versus that of L‐PRP in Treating Knee Cartilage Lesion: A Randomized Controlled Trial

Zhou

Cao

et al. 2023

Orthopaedic Surgery

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“…In addition, our preliminary clinical outcome of microfracture at the acetabular rim is promising, and radiographic results have shown that the morphology and function of the labrum could be restored to a certain extent. 26 Despite that, there is no biological evidence regarding the potential advantages of bone marrow stimulation for the treatment of complete, irreparable labral tear. The histologic property of the regrown tissue and whether its volume is sufficient to fill the labral defect area remain unknown.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

Tissue Regrowth and Its Vascularization Through Bone Marrow Stimulation: Microfracture at the Acetabular Rim for Irreparable Labral Tear in a Porcine Model

Yang

et al. 2023

Am J Sports Med

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Background: The treatment of irreparable acetabular labral tear remains a great challenge. Whether fibrocartilage-like tissue can regrow with sufficient volume to fill the labral defect area through bone marrow stimulation remains unknown. Purpose: To characterize the healing process and vascularization course of the regrown tissue after microfracture at the acetabular rim for irreparable labral tears in a porcine model. Study Design: Descriptive laboratory study. Methods: Twelve pigs randomly underwent unilateral microfracture at the acetabular rim after the resection of a 10 mm–long section of labrum from 10 to 1 o’clock. Pigs were randomly sacrificed at 6 and 12 weeks postoperatively. The regrown tissues were harvested for macroscopic evaluation and histologic assessment. The regrown tissue was zoned into 2 halves to observe the vascular distribution: the capsular half (zone I) and the articular half (zone II). Each zone was divided into 2 parts: the peripheral part (IA and IIA) and the part attached to the acetabulum (IB and IIB). Results: At 6 weeks, all regrown tissue was hypotrophic with <50% filling of the labral defect. Fibrochondrocytes were concentrated at the interface between the acetabulum and the regrown tissue. The vascularization was equal among each part within the regrown tissue. As compared with regrown tissue at 12 weeks, proteoglycan and collagen type 1 and 2 were more evident within the regrown tissue at 6 weeks. At 12 weeks, tissue disintegration occurred in all regrown tissue with <25% filling of the labral defect area. The vascular structure could barely be observed, with few fibrochondrocytes found at the area adjacent to the acetabulum. Conclusion: Fibrocartilage-like tissue did regrow with well-distributed vascular ingrowth of each part of the regrown tissue through bone marrow stimulation at the early stage. However, insufficient volume of the regrown tissue led to loss of the hip suction seal and subsequent tissue disintegration. Clinical Relevance: Microfracture at the rim of the acetabulum alone could not restore the morphology and function of the acetabular labrum. Nonetheless, microfracture at the acetabular rim might be a viable adjunct to labral reconstruction, as the well-distributed vascularization through bone marrow stimulation might overcome the obstacle of poor vascular ingrowth of the articular half of the autograft.

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Microfracture of Acetabular Rim After Segmental Labral Resection to Restore the Morphology and Function of Labrum: A Retrospective Study of More than 2 Years Follow‐up

Cited by 2 publications

References 39 publications

Clinical Efficacy of Intra‐Articular Injection with P‐PRP Versus that of L‐PRP in Treating Knee Cartilage Lesion: A Randomized Controlled Trial

Clinical Efficacy of Intra‐Articular Injection with P‐PRP Versus that of L‐PRP in Treating Knee Cartilage Lesion: A Randomized Controlled Trial

Tissue Regrowth and Its Vascularization Through Bone Marrow Stimulation: Microfracture at the Acetabular Rim for Irreparable Labral Tear in a Porcine Model

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