Minced Cartilage Procedure for One-Stage Arthroscopic Repair of Chondral Defects at the Glenohumeral Joint
| Autor: | Florian Freislederer, Gian M. Salzmann, Markus Scheibel, Christina J. Lorenz |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
030222 orthopedics
medicine.medical_specialty education.field_of_study business.industry Cartilage medicine.medical_treatment Population One stage Treatment options 030229 sport sciences Knee Joint Arthroplasty Surgery 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure medicine Technical Note Orthopedics and Sports Medicine business education Autologous chondrocyte implantation |
| Zdroj: | Arthroscopy Techniques |
| ISSN: | 2212-6287 |
| Popis: | Chondral defects of the glenohumeral joint are common but still remain a diagnostic and management challenge. Whereas arthroplasty is a reasonable treatment option in the elderly and low-demand population, joint preservation should be aimed for the remaining patients. For larger defects the current gold standard of treatment is autologous chondrocyte implantation. However, disadvantages such as high cost, the restriction in availability of specialized laboratories, and the 2-stage surgical design need to be accounted for if choosing this option. Showing first good clinical results for the knee joint, minced cartilage implantation is moreover a cost-effective procedure bringing autologous cartilage chips harvested from the defect walls and bringing them into the area of damage in a single-step open or arthroscopic approach. We describe an arthroscopic strategy of this technique to treat chondral defects at the glenohumeral joint. Technique Video Video 1 Dry arthroscopy of a left shoulder with the patient in beach-chair position. 00:13 minutes: Diagnostic arthroscopy through the standard posterior portal in a dry manner. 00:39 minutes: Suggestion of established working portals. 00:52 minutes: Collecting healthy cartilage with a 3-mm shaving device. 01:06: Creating a vertical rim of the chondral defect using a ringed curette. 01:37 minutes: Final measurement of the defect using a probing hook and final drying of the lesion side. 01:47 minutes: Mincing of the collected cartilage fragments on the back table using the 3-mm shaving device. 02:03 minutes: Disconnecting the graft net device and transferring the minced cartilage into a metal bowl. 02:32 minutes: Mixing the cartilage with ACP. 02:43 minutes: Implantation of the ACP-cartilage mixture onto the lesion side. 03:03 minutes: Applying thrombin for initial stability. 03:19 minutes: Adding a mixture of thrombin and ACP for final sealing. (ACP, autologous conditioned plasma) |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|