Treatment of Osteoarthritis of the Middle-aged Athlete

McKeon, Brian; Rand, Jason D.

doi:10.1097/jsa.0b013e31827ddd5e

Cited by 7 publications

(4 citation statements)

References 26 publications

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“…In fact, in these cases, an untreated ACL tear may be the cause for further progression of degenerative changes due to recurrent instability leading to posterior femoral subluxation [ 12 , 25 ]. This surgical option may suit younger and more active patients, whose goal is to achieve a high level of activity with more stability and less pain and prevent future surgeries [ 26 , 27 ].…”

Section: Indications and Preoperative Considerationsmentioning

confidence: 99%

Management of Medial Femorotibial Knee Osteoarthritis in Conjunction with Anterior Cruciate Ligament Deficiency: Technical Note and Literature Review

Legnani,

Ventura,

Mangiavini

et al. 2024

JCM

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In recent years, there has been increased interest in the management of medial femorotibial knee osteoarthritis (OA) in conjunction with anterior cruciate ligament (ACL) deficiency. Traditional treatment modalities included conservative therapy, high tibial osteotomy with or without ACL reconstruction, and total knee replacement. Since younger patients with higher physical demands are more likely to suffer from this pathological condition, reduced invasiveness, faster recovery time, and improved knee kinematics are preferred to allow for satisfying clinical and functional outcomes. Thus, a new surgical strategy combining medial unicompartmental knee replacement (UKR) and ACL reconstruction has been proposed to allow bone stock preservation, to reduce surgical morbidity and recovery time, and ultimately to improve joint kinematics and clinical outcomes. Based on the data present in the literature, in the setting of unicompartmental OA in association with ACL deficiency, UKR combined with ACL reconstruction provided encouraging early results. Studies evaluating the outcomes of combined ACL reconstruction and UKR demonstrate promising results in select patient populations. Improved knee stability, pain relief, functional recovery, and patient satisfaction improved after surgery. Moreover, the combined approach offered advantages such as reduced surgical trauma, faster rehabilitation, and preservation of native knee anatomy compared with traditional treatment strategies. However, still, high-level studies on this topic are lacking; therefore, more comparative studies reporting long-term outcomes are needed to support the potential of this combined procedure to become mainstream. In this paper, we discuss the relevant features and rationale behind the indications and technique of this combined surgical procedure, to help surgeons choose the correct therapeutic approach for a patient with concomitant medial OA and ACL insufficiency. Continued advancements in surgical techniques, patient selection criteria, and rehabilitation strategies will further enhance the success of this combined approach, offering hope to individuals with concomitant ACL injuries and unicompartmental knee OA.

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Section: Indications and Preoperative Considerationsmentioning

confidence: 99%

Management of Medial Femorotibial Knee Osteoarthritis in Conjunction with Anterior Cruciate Ligament Deficiency: Technical Note and Literature Review

Legnani,

Ventura,

Mangiavini

et al. 2024

JCM

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“…Chronic or acute inflammation of the joint, whether it be through injury or disease such as osteoarthritis (OA), can be debilitating. A wide spectrum of treatments are available, from non-pharmacological modalities to dietary supplements and pharmacological therapies, as well as minimally invasive procedures involving injections of various substances aimed at restoring joint homeostasis and providing clinical improvement and possible disease modifying effects [34][35][36][37][38][39][40][41][42][43][44][45] . These injections are sometimes painful and are oftentimes combined with local anesthetics to alleviate the discomfort of the injection.…”

Section: Anti-inflammatory Effects Of Prpmentioning

confidence: 99%

Learning about PRP using cell-based models

Beitzel¹,

McCarthy

Russell

et al. 2019

Muscle Ligaments and Tendons J

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Studies using in vitro cell models enable evaluation of the effects of different PRP products under very controlled and standardized conditions. Therefore the results of such studies build the basis for understanding the variable results of clinical studies on the use of PRPs. The main lessons learned through the use of in vitro cell models are that many different PRP products exist and researchers have to report on component variation within each product. These different products may have distinctive effects on the various cells treated in musculoskeletal injuries; therefore, some products might be more beneficial in certain indication than others. In its utilization in cell models, PRP may generate a variety of positive effects on cell proliferation, recovery, and inflammatory response. There might also be a benefit to adding PRP to current pharmacological therapies (e.g. corticosteroids) to prevent their commonly known negative effects on e.g. tendon and cartilage tissue.

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“…The designers of Oxford UKA argue that the possible reasons for this high number of revisions are that revising UKA is easier than revising TKA and surgeons are overly alarmed about the development of radiolucent lines (RLLs) underneath the tibia plateaus of UKA. In this context, in cemented UKAs, RLLs have been reported to be up to 90% (5), while increased RLLs associated with cementless UKAs have been observed (6). However, there is no correlation between the presence nor absence of RLLs and loosening and/or impairment of the functional status (7).…”

Section: Introductionmentioning

confidence: 96%

A prospective study of 93 unicompartmental knee prosthesis emphasises the appearance of radiolucencies under the tibial component

Reynders-Frederix¹,

Reynders-Frederix²,

Schiopu³

et al. 2022

Acta Orthop Belg

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Background and study aims: Here, we report the presence of radiolucent lines in a consecutive group of 93 partial knee replacements (UKA). Materials and methods: The prospective study was conducted from 2011 to 2019 with a minimum follow-up of two years. Clinical data and radiographs were recorded. Of the 93 UKA, 65 were cemented. The Oxford Knee Score was recorded before and two years after surgery. In 75 cases, the follow-up was conducted at > 2 years. A lateral knee replacement was performed in 12 cases. In one case, a medial UKA with patellofemoral prosthesis was performed. Results: In eight patients (8.6%), a radiolucent line (RLL) underneath the tibia component was observed. In four of these eight patients, RLLs were non-progressive, without clinical implications. In two cemented UKAs, RLLs were progressive and were revised with total knee arthroplasty. Early severe osteopenia of the tibia (zone 1 to 7) in the frontal view was observed in two cementless medial UKA cases. The demineralisation occurred spontaneously five months after surgery. We diagnosed two early deep infections, one of which was treated locally. Conclusions: RLLs were present in 8.6% of the patients. Even in severe cases of osteopenia, spontaneous recovery of RLLs is possible with cementless UKAs.

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Treatment of Osteoarthritis of the Middle-aged Athlete

Cited by 7 publications

References 26 publications

Management of Medial Femorotibial Knee Osteoarthritis in Conjunction with Anterior Cruciate Ligament Deficiency: Technical Note and Literature Review

Management of Medial Femorotibial Knee Osteoarthritis in Conjunction with Anterior Cruciate Ligament Deficiency: Technical Note and Literature Review

Learning about PRP using cell-based models

A prospective study of 93 unicompartmental knee prosthesis emphasises the appearance of radiolucencies under the tibial component

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