Knee Joint Hyaline Cartilage Defects

1992 ◽  
Vol 16 (4) ◽  
pp. 597-603 ◽  
Author(s):  
Juerg Hodler ◽  
Marie-Josée Berthiaume ◽  
Mark E. Schweitzer ◽  
Donald Resnick
2020 ◽  
pp. 65-72
Author(s):  
K. A. Egiazaryan ◽  
G. D. Lazishvili ◽  
A. P. Ratyev ◽  
I. V. Sirotin ◽  
A. B. But-Gusaim ◽  
...  

The article is devoted to the current trend of modern orthopedics – the surgical treatment of local full-thickness defects in the hyaline cartilage of the knee joint. This pathology is diagnosed in 5-10% of patients with diseases and injuries of the knee joint.Materials and methods: The authors of the article presented one of the most modern and available technologies for the restoration of cartilage defects – the technology of matrix-induced autochondrogenesis (AMIC – autologous matrix-induced chondrogenesis). This operation technique was used in 63 patients. The article presents the indications and technique of surgery, considers possible errors, complications, criteria for evaluating treatment outcomes.Results: treatment outcomes in terms of up to 13 years were studied in 56 patients. Good treatment results were observed in 53 patients. In all cases, high-quality and regeneration of the cartilaginous surface of the femoral condyles was achieved.Conclusion: Analysis of the outcomes of treatment of patients after implantation of collagen membranes in various modifications allows the authors of the article to recommend this technique for widespread use in clinical practice.


2021 ◽  
Vol 9 (4) ◽  
pp. 397-406
Author(s):  
Sergei V. Chebotarev ◽  
Vladimir V. Khominets ◽  
Dmitry A. Zemlyanoy ◽  
Lidiya I. Kalyuzhnaya ◽  
Aleksej S. Grankin ◽  
...  

BACKGROUND: The treatment of traumatic and degenerative cartilage damage is one of the largest areas in orthopedic practice, and the therapy success remains limited. AIM: To analyze the results of surgical treatment of patients with traumatic and degenerative injuries of the knee joint hyaline cartilage using debridement and osteoperforative techniques, taking into account the time from the surgical intervention. MATERIALS AND METHODS: A statistical analysis was conducted on the treatment outcomes of servicemen with traumatic and degenerative damage in the knee joint articular hyaline cartilage. Patients underwent surgical treatment using osteoperforative techniques (abrasive chondroplasty, tunneling, and microfracturing) at the Clinic of Military Traumatology and Orthopedics of the S.M. Kirov Military Medical Academy from 2009 to 2019. The study relied on the data obtained from questioning the patients using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and LKSS questionnaires. RESULTS: The result analyses using the KOOS and LKSS scales revealed significantly higher good results in the observed group in the postoperative period from 1 to 4 years than in the groups from 4 to 8 and more than 8 years (p = 0.004). No significant differences were determined in the treatment outcomes of the groups with resection and different osteoperforative methods. CONCLUSIONS: Treatment methods for hyaline cartilage defects, such as resection and osteoperforative, are technically simple with good treatment outcomes in patients with articular cartilage injuries from 1 to 4 years postoperative. Treatment outcome deterioration was noted in 48 years postoperative, regardless of the treatment method used, which is more significant in patients in 8 years postoperative.


Author(s):  
Timur B. Minasov ◽  
Ekaterina R. Yakupova ◽  
Dilmurod Ruziboev ◽  
Ruslan M. Vakhitov-Kovalevich ◽  
Ruslan F. Khairutdinov ◽  
...  

Degenerative pathology of the musculoskeletal system is one of the main reasons for decreased mobility in patients of the older age group. Increasing the life expectancy leads to predominance non-epidemic pathology in all developed countries. Therefore, degenerative diseases of musculoskeletal system have not only medical significance but also social significance. Objective is studying the morphological features of synovial environment of the decompensated osteoarthritic (OA) knee joint. Structural features of subchondral bone, hyaline cartilage of the femur and tibia, the articular capsule, menisci and ligamentous apparatus of the knee joint were studied in 64 patients who underwent total knee arthroplasty at the Department of Traumatology and Orthopedics Bashkirian State Medical University in the period from 2015 to 2020. Material selection, preparation of histological samples, staining with hematoxylin-eosin, microscopy was performed. Adaptive signs of articular cartilage of the femoral condyles manifest in the form of cartilage tissue rearrangement, which are most pronounced in the central zone of the cartilage. At the same time, the phenomena of decompensation and significant areas of destruction are noted. Also, the subchondral bone was replaced with connective tissue with subsequent sclerosis. This sclerosis subsequently led to the decompensation of structures of the hyaline cartilage in the deep and middle zones. Destructive and dystrophic processes were noted in the knee joint menisci. Articular cartilage was replaced with granulation tissue with subsequent invasion of blood vessels. Cruciate ligaments in patients with OA show signs of adaptation due to expansion of endothenonium layers between bundles of collagen fibers and an increase in the diameter of blood vessels.


Author(s):  
Philippa Bowland ◽  
Eileen Ingham ◽  
John Fisher ◽  
Louise M Jennings

Robust preclinical test methods involving tribological simulations are required to investigate and understand the tribological function of osteochondral repair interventions in natural knee tissues. The aim of this study was to investigate the effects of osteochondral allograft implantation on the local tribology (friction, surface damage, wear and deformation) of the tissues in the natural knee joint using a simple geometry, reciprocating pin-on-plate friction simulator. In addition, the study aimed to assess the ability of osteochondral grafts to restore a low surface damage, deformation and wear articulation when compared to the native state. A method was developed to characterise and quantify surface damage wear and deformation of the opposing cartilage-bone pin surface using a non-contacting optical profiler (Alicona Infinite Focus). Porcine 12 mm diameter cartilage-bone pins were reciprocated against bovine cartilage-bone plates that had 6 mm diameter osteochondral allografts, cartilage defects or stainless steel pins (positive controls) inserted centrally. Increased levels of surface damage with changes in geometry were not associated with significant increases in the coefficient of dynamic friction. Significant damage to the opposing cartilage surface was observed in the positive control groups. Cartilage damage, deformation and wear (as measured by change in geometry) in the xenograft (2.4 mm3) and cartilage defect (0.99 mm3) groups were low and not significantly different (p > 0.05) compared to the negative control in either group. The study demonstrated the potential of osteochondral grafts to restore the congruent articular surface and biphasic tribology of the natural joint. An optical method has been developed to characterise cartilage wear, damage and deformation that can be applied to the tribological assessment of osteochondral grafts in a whole natural knee joint simulation model.


Author(s):  
Matthew DelGiudice

Chapter 102 describes indications, technique, and imaging findings of knee arthrography. Knee arthrography is selectively performed in clinical practice for MRA, typically in younger patients. Indications include evaluation for meniscal re-tear after prior repair, osteochondral injuries, and therapeutic injections (most commonly steroid). Extension of intraarticular contrast into the meniscal substance indicates a tear or re-tear. Abnormal course of the cruciate ligament fibers indicates a tear. Contrast undermines unstable osteochondral lesions and extends into the hyaline cartilage defects. Complications are rare but include infection and bleeding.


Medicina ◽  
2018 ◽  
Vol 54 (2) ◽  
pp. 21 ◽  
Author(s):  
Rimtautas Gudas ◽  
Laimonas Šiupšinskas ◽  
Agnė Gudaitė ◽  
Vladas Vansevičius ◽  
Edgaras Stankevičius ◽  
...  

Background: the main goal of the study was to investigate the prevalence of the articular cartilage defects (ACD) in the patellofemoral (PF) region of the knee joint based on the anatomical shapes of patella and its impact on the level of physical activity in the population needing arthroscopic procedures for all types of pathologies in the knee. Methods: The articular cartilage status of the PF region was obtained from 1098 arthroscopic procedures of the knee joint. The ACD were correlated to Wiberg’s shape of the patella and classified according to the degree, size and depth of the ACD in the PF region using the ICRS (International Cartilage Repair Society) system: group I consisting of patients with Wiberg type I shape (W1), group II—patients with Wiberg type II shape (W2) and group III—patients with Wiberg type III shape (W3). The Tegner physical activity scale was used to evaluate the physical activity of the patients. Results: The mean of ACD size (PF region) in the W3 group was 3.10 ± 0.99 cm2, which was a statistically significantly larger area in comparison with the W1 (1.90 ± 0.63 cm2; p < 0.0000) and W2 (1.95 ± 0.71 cm2; p < 0.0000). The patients from the W3 group (mean 3.10 ± 0.99) were less physically active (<4 Tegner) compared to the W2 group (mean of 4.48 ± 0.88; p = 0.004) and W1 group (mean of 4.55 ± 0.72; p = 0.002). Conclusions: The patients with the Wiberg type III patella shape had a higher incidence and larger size of ACD in the PF of the knee compared to the groups of Wiberg type I and II. Wiberg III patients with a lower level of physical activity had a larger size of ACD in the PF joint.


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