Algorithm for Treatment of Focal Cartilage Defects of the Knee: Classic and New Procedures.

Autor:	Hinckel BB; Department of Orthopedic Surgery, William Beaumont Hospital, Taylor, MI, USA., Thomas D; UNC Orthopedics and Sports Medicine at Lenoir, Kinston, NC, USA., Vellios EE; Sports Medicine and Shoulder Surgeon Southern California Orthopedic Institute (SCOI), Van Nuys, CA, USA., Hancock KJ; Desert Orthopaedic Center, Las Vegas, NV, USA., Calcei JG; Department of Orthopaedic Surgery, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH, USA., Sherman SL; Division of Sports Medicine, Department of Orthopedic Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA., Eliasberg CD; Hospital for Special Surgery, New York, NY, USA., Fernandes TL; University of São Paulo, Institute of Orthopedics and Traumatology, Sports Medicine-FIFA, São Paulo, SP, Brazil., Farr J; OrthoIndy Knee Preservation and Cartilage Restoration Center, School of Medicine, Indiana University, Indianapolis, IN, USA., Lattermann C; Division of Sports Medicine, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA., Gomoll AH; Hospital for Special Surgery, New York, NY, USA.
Jazyk:	angličtina
Zdroj:	Cartilage [Cartilage] 2021 Dec; Vol. 13 (1_suppl), pp. 473S-495S. Date of Electronic Publication: 2021 Mar 20.
DOI:	10.1177/1947603521993219
Abstrakt:	Objective: To create a treatment algorithm for focal grade 3 or 4 cartilage defects of the knee using both classic and novel cartilage restoration techniques. Design: A comprehensive review of the literature was performed highlighting classic as well as novel cartilage restoration techniques supported by clinical and/or basic science research and currently being employed by orthopedic surgeons. Results: There is a high level of evidence to support the treatment of small to medium size lesions (<2-4 cm 2 ) without subchondral bone involvement with traditional techniques such as marrow stimulation, osteochondral autograft transplant (OAT), or osteochondral allograft transplant (OCA). Newer techniques such as autologous matrix-induced chondrogenesis and bone marrow aspirate concentrate implantation have also been shown to be effective in select studies. If subchondral bone loss is present OAT or OCA should be performed. For large lesions (>4 cm 2 ), OCA or matrix autologous chondrocyte implantation (MACI) may be performed. OCA is preferred over MACI in the setting of subchondral bone involvement while cell-based modalities such as MACI or particulated juvenile allograft cartilage are preferred in the patellofemoral joint. Conclusions: Numerous techniques exist for the orthopedic surgeon treating focal cartilage defects of the knee. Treatment strategies should be based on lesion size, lesion location, subchondral bone involvement, and the level of evidence supporting each technique in the literature.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu