Marrow stimulation techniques (MST), such as abrasion arthroplasty, drilling, and microfracture, attempt to induce a reparative response by perforation of the subchondral bone after radical debridement of damaged cartilage and removal of the tide mark “calcified” zone to enhance the integration of repair tissue. Microfracture treatment results in better outcomes in patients with BMI <30. Author information: (1)Sport Medicine and Knee Research Center, Milad Hospital, Tehran, Iran. Debridement and abrasion represent the most commonly preferred surgical methods because of their easy application and less invasive nature. Therefore, various techniques have evolved to stimulate defect repair or overtly replace these defects. Brigido and Amber Shane, DPM, FACFAS, cite a study by Raikin concerning 15 patients with osteochondral lesions of the talus who had osteochondral autograft transplantation (OATS). 10.1055/b-0034-92488 The Use of Scaffolds in the Treatment of Osteochondral Lesions in the Knee: Current Concepts and Future TrendsAad A. M. Dhollander, Victor R. Guevara Sánchez, Karl F. Almqvist, René Verdonk, Gust Verbruggen, and Peter C. M. Verdonk The treatment of chondral and osteochondral lesions has become a major interest to orthopedic surgeons because most… Microfracture treatment results in better outcomes in younger patients (<30–40 years old). Damage to the articular cartilage comprises a spectrum of disease entities ranging from single, focal chondral defects to more advanced degenerative disease. Depth: the depth of a defect is a consideration in selection of treatment, and if there is underlying bone loss beneath the cartilage defect then this may need to be restored. Transchondral drilling for osteochondritis dissecans of the medial condyle of the knee, Osteochondral autograft transplantation for juvenile osteochondritis dissecans of the knee: a series of twelve cases, Juvenile Osteochondritis Dissecans of the Knee: Predictors of Lesion Stability, Extraarticular Drilling for Stable Osteochondritis Dissecans in the Skeletally Immature Knee. Osteochondral autograft transplantation is used to address small to medium defects (1–4 cm 2), often with associated bone loss. Long implicated in the subsequent development of osteoarthritis, focal chondral defects result from various causative factors. The latest generation of ACI, termed MACI (membrane associated), cultures the chondrocytes directly on the aforementioned collagen membrane, which is then implanted arthroscopically or through a mini-open approach with fibrin glue or limited suturing. Shorter duration of symptoms before cartilage repair results in better outcomes. Left untreated, Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. What Is the Best Treatment for End-Stage Hallux Rigidus? A treatment gap exists for patients with lesions not suitable for arthroplasty or biologic repair or … ACI, autologous chondrocyte implantation; ACI-c collagen-covered autologous chondrocyte implantation; BMI, body mass index; MACI, membrane-associated autologous chondrocyte implantation. Different methods have been described for the surgical treatment of patellar osteochondral lesions; however, there is a limited number of studies on this subject in the literature. Scranton PE Jr, McDermott JE. Because of the relatively high cost of ACI and the knee morbidity seen in OATS, we conclude that BMS is the treatment of choice for primary osteochondral talar lesions. 13,14 Finally, arthroscopy has the advantage of direct visu- alization of the articular surface and ability to treat the lesions, but cannot evaluate the condition of the underlying subchon- dral bone. Cartilage lesions of the knee are rather common in children and adolescents representing a more difficult pathological entity due to the young age of the patients and the risk of secondary degenerative…, Management of Osteochondritis Dissecans of the Knee, Surgical Treatment Options for Osteochondritis Dissecans of the Knee. Purpose: Surgical treatment options for the management of focal chondral and osteochondral lesions in the knee include biological solutions and focal metal implants.A treatment gap exists for patients with lesions not suitable for arthroplasty or biologic repair or who have failed prior cartilage repair surgery. Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), Presurgical Functional MappingAndrew C. Papanicolaou, Roozbeh Rezaie, Shalini Narayana, Marina Kilintari, Asim F. Choudhri, Frederick A. Boop, and James W. Wheless, the Child With SeizureDon K. Mathew and Lawrence D. Morton, and Pharmacologic Consequences of SeizuresShilpa D. Kadam and Michael V. Johnston, Self-Limited EpilepsiesDouglas R. Nordli, Jr., Colin D. Ferrie, and Chrysostomos P. Panayiotopoulos, in Epilepsy: A Network and Neurodevelopmental PerspectiveRaman Sankar and Edward C. Cooper, Hematology, Oncology and Palliative Medicine. Some features of the site may not work correctly. Hip Dislocation: How Does Delay to Reduction Affect Avascular Necrosis Rate? 2020 Feb;23(1):60-62. doi: 10.1016/j.cjtee.2019.12.001. Trauma, osteochondritis dissecans, osteonecrosis, osteochondroses, and hereditary epiphyseal abnormalities can cause osteochondral lesions in the knee joint.25, 61, 62, 72 When an osteochondral defect persists in a weightbearing portion of the knee joint, degenerative arthritis of that compartment can result. This special focus section will discuss the diagnosis and treatment options for traumatic osteochondral knee injuries, including the subset secondary to juvenile OCD lesions. This special focus section will discuss the diagnosis and treatment options for traumatic osteochondral knee injuries, including the subset secondary to juvenile OCD lesions. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. Commonly, multiple cylinders have to be transplanted to fill larger defects. Osteochondral autografting is limited by the amount of cartilage that can be harvested without violating the weight-bearing articular surface.8 The main advantage lies in its autogenicity, avoidance of disease transmission, immediate graft availability through harvesting of the patient’s own tissue, and decreased cost of this single-stage procedure. Although there are no formal treatment algorithms that have been agreed on and validated by prospective comparative trials of the emerging techniques, practice-based algorithms have been recommended based on existing evidence and by matching patient characteristics to treatment efficacy and risks. It serves as al low friction high wear resistance surface to ideal provide mobility and strength. Chin J Traumatol . 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