O uso do transplante osteocondral a fresco no tratamento das lesões osteocondrais do joelho

Tírico, Luis Eduardo Passarelli; Demange, Marco Kawamura

doi:10.1590/s0102-36162012000600003

Cited by 6 publications

(4 citation statements)

References 35 publications

(39 reference statements)

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“…Currently, extensive commercial cell culture therapies, such as autologous chondrocyte transplantation, are not available in the country. 12 The availability of allogeneic transplantation 13 , 14 and collagen membranes is also limited. The instruments for autologous osteochondral transplantation are not available in most centers of the Brazilian Unified Health System.…”

Section: Discussionmentioning

confidence: 99%

Femoral condyle osteochondral fracture treated with bone suture after acute patellar dislocation: a case report

Cavalheiro

Gobbi

Hinckel

et al. 2018

Revista Brasileira de Ortopedia (English Edition)

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Osteochondral fracture after acute patellar dislocation in teenagers is relatively common (up to 60% of cases of patellar dislocation), but poorly diagnosed. There are several treatments proposed for this type of injury, but none well defined in the literature.A male patient, 13 years old, with a diagnosis of osteochondral fracture of the lateral femoral condyle after acute dislocation of the right patella. He underwent surgical treatment of the chondral injury, which consisted of suturing of the chondral fragment to the cartilage defect and, in a second approach, reconstruction of the medial patellotibial ligament and medial patellofemoral ligament with autologous flexor graft. Currently, the patient has been followed up for 16 months postoperatively for the suture of the chondral fragment and for 8 months for the ligament reconstruction. He has been evaluated through functional scores and T2 weighted magnetic resonance imaging. Acute fixation through direct bone suturing of a purely chondral fragment can be considered in special situations.

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Section: Discussionmentioning

confidence: 99%

Femoral condyle osteochondral fracture treated with bone suture after acute patellar dislocation: a case report

Cavalheiro

Gobbi

Hinckel

et al. 2018

Revista Brasileira de Ortopedia (English Edition)

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“… 43 However, another study warned that lesions caused by corticosteroids, bipolar lesions, and degenerative disease present inferior long-term outcomes when using fresh grafts. 44 …”

Section: Treatmentmentioning

confidence: 99%

“… 43 Entretanto, outro estudo alertou lesões ocorridas por uso de corticosteróides, lesões bipolares e doença degenerativa apresentam resultados inferiores em longo prazo utilizando enxerto a fresco. 44 …”

Section: Transplante Osteocondralunclassified

Tratamento das lesões condrais no joelho

Filho,

Sousa

2023

Rev Bras Ortop (Sao Paulo)

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ResumoAs lesões da cartilagem articular são comuns e levam à deterioração precoce da articulação e ao desenvolvimento da osteoartrite. As técnicas de reparo da cartilagem articular visam a formação de um neo-tecido cartilaginoso capaz de suportar carga articular e evitar a progressão da degeneração. Há várias técnicas disponíveis para esse fim, como a microfratura e o transplante de condrócitos. Entretanto muitas vezes o desfecho do procedimento é a formação de fibrocartilagem, que não possui a mesma resistência mecânica do tecido cartilaginoso. Em outros procedimentos, nos quais é realizado enxerto osteocondral autólogo, há risco de morbidade associada ao procedimento, além da disponibilidade limitada de tecido. Por esse motivo, o transplante osteocondral, utilizando enxertos a fresco ou congelados tem sido utilizado para lesões de maior volume. Por fim, novas técnicas utilizando fragmentos de cartilagem picada ou particulada, assim como o uso de células tronco mesenquimais se apresentam como promissores. O objetivo desse artigo é realizar uma atualização dos procedimentos para tratamento das lesões condrais do joelho.

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“…To the best of the authors’ knowledge, there are no studies or case reports on the use of the FOA technique in Brazil, because until 2009 the laws regulating tissue banks did not allow fresh tissues to be used for transplantation in time for the release of cultures; it was necessary to wait for the results of these tests before use. 23 …”

Section: Introductionmentioning

confidence: 99%

Fresh osteochondral knee allografts in Brazil with a minimum two-year follow-up

Tírico

Demange

Santos

et al. 2017

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveThe present study aimed to report the results of the first series of cases of fresh ostechondral allografts in the knee joint in Brazil with a minimum follow-up of two years.MethodsA protocol of procurement, harvesting, processing, and utilization of fresh osteochondral allografts in the knee joint was established, beginning with legislation modifications, graft harvesting techniques, immediate processing, storage of fresh grafts, and utilization of two surgical techniques of osteochondral transplantation. Eight patients were treated and followed-up for a minimum of two years.ResultsPatients were evaluated with subjective IKDC, KOOS, and modified Merle D’Aubigne and Postel questionnaires. Mean subjective IKDC score was 31.99 ± 13.4 preoperative and 81.26 ± 14.7 at the latest follow-up; preoperative KOOS score was 46.8 ± 20.9 and postoperative was 85.24 ± 13.9, indicating a significant improvement over time (p < 0.01). Mean modified Merle D’Aubigne-Postel score was 8.75 ± 2.25, preoperatively, and 16.1 ± 2.59 postoperatively. Friedman test for non-parametric samples demonstrated a significant improvement in postoperative scores (p < 0.01).ConclusionThe use of fresh osteochondral allografts in Brazil is a safe procedure, with good clinical results in the short- and medium-term for the treatment of osteochondral lesions greater than 4 cm2 in the knee joint.

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O uso do transplante osteocondral a fresco no tratamento das lesões osteocondrais do joelho

Abstract: ABSTRACTwith excellent results. In this article we are going to review the basic science, indications, surgical techniques and possible complications of fresh osteochondral allograft transplantation in the knee joint. We will also describe some surgeries performed in the Institute.

Cited by 6 publications

References 35 publications

Femoral condyle osteochondral fracture treated with bone suture after acute patellar dislocation: a case report

Femoral condyle osteochondral fracture treated with bone suture after acute patellar dislocation: a case report

Tratamento das lesões condrais no joelho

Fresh osteochondral knee allografts in Brazil with a minimum two-year follow-up

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