scholarly journals Treatment of Knee Osteochondral Lesions Using a Novel Clot of Autologous Plasma Rich in Growth Factors Mixed with Healthy Hyaline Cartilage Chips and Intra-Articular Injection of PRGF

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Ramón Cugat ◽  
Eduard Alentorn-Geli ◽  
Gilbert Steinbacher ◽  
Pedro Álvarez-Díaz ◽  
Xavier Cuscó ◽  
...  
Keyword(s):  
Growth Factors ◽  
Hyaline Cartilage ◽  
Activity Level ◽  
Osteochondral Lesions ◽  
Resonance Imaging ◽  
Knee Cartilage ◽  
Autologous Plasma ◽  
Cartilage Injuries ◽  
One Step ◽  
Defect Filling

Knee cartilage or osteochondral lesions are common and challenging injuries. To date, most symptomatic lesions warrant surgical treatment. We present two cases of patients with knee osteochondral defects treated with a one-step surgical procedure consisting of an autologous-based matrix composed of healthy hyaline cartilage chips, mixed plasma poor-rich in platelets clot, and plasma rich in growth factors (PRGF). Both patients returned to playing soccer at the preinjury activity level and demonstrated excellent defect filling in both magnetic resonance imaging and second-look arthroscopy (in one of them). The use of a clot of autologous plasma poor in platelets with healthy hyaline cartilage chips and intra-articular injection of plasma rich in platelets is an effective, easy, and cheap option to treat knee cartilage injuries in young and athletic patients.

scholarly journals Eighty Percent Survival of Resurfacing Implants in the Knee After 10 Years: A Nationwide Cohort Study on 379 Procedures from the Danish Knee Arthroplasty Registry

Cartilage ◽  
2021 ◽  
pp. 194760352110309
Author(s):  
Bjørn B. Christensen ◽  
Anders El-Galaly ◽  
Jens Ole Laursen ◽  
Martin Lind
Keyword(s):  
Cohort Study ◽  
Survival Rate ◽  
Cartilage Repair ◽  
Knee Arthroplasty ◽  
Treatment Method ◽  
Osteochondral Lesions ◽  
Free Survival ◽  
Secondary Osteoarthritis ◽  
Arthroplasty Registry ◽  
Cartilage Injuries

Objective Focal cartilage injuries are debilitating and difficult to treat. Biological cartilage repair procedures are used for patients younger than 40 years, and knee arthroplasties are generally reserved for patients older than 60 years. Resurfacing implants are well suited for patients in this treatment gap. The objective was to investigate the 10-year survival of resurfacing implants in the Danish Knee Arthroplasty Registry. Design In this retrospective cohort study, patients treated with resurfacing implants were followed longitudinally in the Danish Knee Arthroplasty Registry from 1997 to 2020. The primary endpoint was revision surgery. The survival of the resurfacing implants was analyzed by Kaplan-Meier method. Results A total of 379 resurfacing implant procedures were retrieved from the Danish Knee Arthroplasty Registry. The mean age and weight of patients were 50 years (SD = 11) and 84 kg (SD = 17), respectively. The indications for surgery were as follows: secondary osteoarthritis (42%), primary osteoarthritis (32%), and osteochondral lesions (20%). Within the follow-up period, 70 (19%) of the implants were revised to arthroplasties. The 1-, 5-, and 10-year revision-free survival estimation was 0.95 (95% CI 0.93-0.97), 0.84 (95% CI 0.80-0.88), and 0.80 (95% CI 0.75-0.84), respectively. The median time to revision was 2 years. Conclusion The 10-year revision-free survival rate for resurfacing implants was 80%. Based on the revision rates, this treatment offers a viable alternative to biological cartilage repair methods in patients aged 40 to 60 years with focal cartilage pathology. Improved patient selection could further improve the implant survival rate. Further studies are needed to investigate this treatment method.

scholarly journals Return to Sports After Bone Marrow–Derived Cell Transplantation for Osteochondral Lesions of the Talus

Cartilage ◽  
2016 ◽  
Vol 8 (1) ◽  
pp. 80-87 ◽  
Author(s):  
Francesca Vannini ◽  
Marco Cavallo ◽  
Laura Ramponi ◽  
Francesco Castagnini ◽  
Simone Massimi ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Cell Transplantation ◽  
Case Series ◽  
Clinical Results ◽  
Osteochondral Lesions ◽  
Return To Sports ◽  
One Step ◽  
American Orthopaedic ◽  
Return To Activity

Objective Arthroscopic “one-step” technique based on bone marrow–derived cell transplantation (BMDCT) have achieved good results in repairing osteochondral lesions of the talus (OLT), overcoming important drawbacks of older techniques. It may be particularly adequate for the treatment of athletes in order to permit a safe and stable return to sports. The aim of this study was to report the results at 48 months of a series of athletes and the factors influencing the return to sports. Design Case series. A total of 140 athletes underwent a “one-step” BMDCT repair of OLT. All the patients had the cells harvested from the iliac crest, condensed and loaded on a scaffold, and then implanted. Patients were evaluated clinically by the American Orthopaedic Foot and Ankle Society (AOFAS) scores and Halasi score. Results AOFAS score improved from 58.7 ± 13.5 preoperatively to 90.6 ± 8.6 ( P < 0.005) at 24 months, and to 90.9 ± 10.7 at 48 months. Halasi score was 6.88 ± 1.8 preinjury, 4.08 ± 1.7 preoperatively, and 5.56 ± 2.0 at final follow-up. At the final follow-up, all the patients (beside 1 failure and 3 lost) were able to return to activity and 72.8% were able to resume sports at preinjury level. Conclusions “One-step” BMDCT repair of OLT had good clinical results that was durable over time in athletes, permitting a return to sports at preinjury level in the majority of patients. The preoperative presence of impingement and articular degeneration were the main negative prognostic factors.

Arthroscopy-Assisted Retrograde Drilling of Osteochondral Lesions of the Talar Dome

2005 ◽  
Vol 95 (1) ◽  
pp. 91-96 ◽  
Author(s):  
Scott C. Nelson ◽  
Darryl M. Haycock
Keyword(s):  
Clinical Presentation ◽  
Osteochondral Lesion ◽  
Final Diagnosis ◽  
Osteochondral Lesions ◽  
Resonance Imaging ◽  
Talar Dome ◽  
Advanced Imaging ◽  
Retrograde Drilling ◽  
High Index Of Suspicion

Traumatic ankle conditions can lead to long-term sequelae if a pathologic process is misdiagnosed. The clinical presentation of an osteochondral lesion of the talar dome requires the clinician to have a high index of suspicion, and advanced imaging is often necessary to make the final diagnosis. Treatment should be initiated once the lesion is appropriately staged by radiologic or magnetic resonance imaging. We discuss the use of arthroscopy-assisted retrograde drilling of the medial talar dome that spares the articular cartilage within the talotibial articulation. (J Am Podiatr Med Assoc 95(1): 91–96, 2005)

scholarly journals Use of Particulated Juvenile Articular Cartilage Allograft for Osteochondral Lesions of the Wrist

Hand ◽  
2016 ◽  
Vol 12 (5) ◽  
pp. NP62-NP67 ◽  
Author(s):  
Daniel E. Hess ◽  
Brian C. Werner ◽  
D. Nicole Deal
Keyword(s):  
Articular Cartilage ◽  
Case Reports ◽  
New Technology ◽  
Full Range ◽  
Osteochondral Lesions ◽  
Appropriate Treatment ◽  
Cartilage Injuries ◽  
Articular Cartilage Injuries ◽  
Outerbridge Grade ◽  
Active Patients

Background: Articular cartilage injuries are a common injury among young, active patients, and the most appropriate treatment for these injuries remains controversial. A promising new technology in the treatment of high-grade cartilage injuries is particulated juvenile articular cartilage (PJAC) allograft (DeNovo NT, Zimmer, Warsaw, Indiana). This has been shown to be successful in multiple joints including the knee, talus, and elbow. No studies or case reports exist in supporting or discouraging its use in injuries of the wrist, in specific, the scaphoid. Methods: The use of PJAC allograft is described for the treatment of an active 21-year-old male with an Outerbridge Grade IV chondral lesion on the proximal pole of his right scaphoid and right distal radius scaphoid facet who had failed conservative management. The patient was followed clinically and radiographically for 21 months. Results: The patient had return to full sport (jujutsu) and full range-of-motion, both of which represented an improvement from his preoperative exam. Radiographically, the chondral lucency seen had decreased in size and was almost completely absent on radiographs after 21 months. Conclusions: The results of this case suggest that PJAC can be used safely and effectively in the wrist thereby potentially broadening the indications for its use.

scholarly journals Growth Factors & Stem Cells Entrapment in Bio Compatible & Biodegradable Nano Particles to Prevent Early Degradation & Facilitate Gradual Release

2021 ◽  
Author(s):  
ANURUDDHA A. H. M. P. ◽  
C. A. N. FERNANDO ◽  
YOSHIHISA SAIDA ◽  
MINORU SAKURABA
Keyword(s):  
Stem Cells ◽  
Growth Factors ◽  
Extraction Process ◽  
Nano Particles ◽  
The Core ◽  
Experimental Process ◽  
One Step ◽  
Treatment Procedures ◽  
Early Degradation ◽  
Gradual Release

Abstract The use of growth factors and stem cells as the core treating agents is one step into creating a biocompatible Solid Lipid Nano Particles (SLNP) for treatments. Apart from obtaining these growth factors and stem cells from the patients, using the bi-product of the extraction process which is the lipid of the patient for the production of the SLNP assures the final product to be biocompatible and of a unique structure. The use of autologous cells and proteins from the patients makes the entire process medically ethical and more viable for treatment procedures. This article, thus discusses on the experimental process of developing such SLNP and the introduction of the relevant medical contraption designed uniquely for the procedure inclusive of a specified membrane.

Knee Arthrography

2019 ◽  
pp. 158-159
Author(s):  
Matthew DelGiudice
Keyword(s):  
Clinical Practice ◽  
Hyaline Cartilage ◽  
Cruciate Ligament ◽  
Cartilage Defects ◽  
Osteochondral Lesions ◽  
Imaging Findings ◽  
Younger Patients ◽  
Osteochondral Injuries ◽  
Knee Arthrography

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.

Hand Joint Space Narrowing and Osteophytes Are Associated with Magnetic Resonance Imaging-defined Knee Cartilage Thickness and Radiographic Knee Osteoarthritis: Data from the Osteoarthritis Initiative

2011 ◽  
Vol 39 (1) ◽  
pp. 161-166 ◽  
Author(s):  
IDA K. HAUGEN ◽  
SEBASTIAN COTOFANA ◽  
MARTIN ENGLUND ◽  
TORE K. KVIEN ◽  
DONATUS DREHER ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Joint Space Narrowing ◽  
Joint Space ◽  
Cartilage Thickness ◽  
Resonance Imaging ◽  
Knee Cartilage ◽  
Knee Oa ◽  
Osteoarthritis Initiative ◽  
Hand Radiographs

Objective.To evaluate whether features of radiographic hand osteoarthritis (OA) are associated with quantitative magnetic resonance imaging (MRI)-defined knee cartilage thickness, radiographic knee OA, and 1-year structural progression.Methods.A total of 765 participants in Osteoarthritis Initiative (OAI; 455 women, mean age 62.5 yrs, SD 9.4) obtained hand radiographs (at baseline), knee radiographs (baseline and Year 1), and knee MRI (baseline and Year 1). Hand radiographs were scored for presence of osteophytes and joint space narrowing (JSN). Knee radiographs were scored according to the Kellgren-Lawrence (KL) scale. Cartilage thickness in the medial and lateral femorotibial compartments was measured quantitatively from coronal FLASHwe images. We examined the cross-sectional and longitudinal associations between features of hand OA (total osteophyte and JSN scores) and knee cartilage thickness, 1-year knee cartilage thinning (above smallest detectable change), presence of knee OA (KL grade ≥ 3), and progression of knee OA (KL change ≥ 1) by linear and logistic regression. Both hand OA features were included in a multivariate model (if p ≤ 0.25) adjusted for age, sex, and body mass index (BMI).Results.Hand JSN was associated with reduced knee cartilage thickness (ß = −0.02, 95% CI −0.03, −0.01) in the medial femorotibial compartment, while hand osteophytes were associated with the presence of radiographic knee OA (OR 1.10, 95% CI 1.03–1.18; multivariate models) with both hand OA features as independent variables adjusted for age, sex, and BMI). Radiographic features of hand OA were not associated with 1-year cartilage thinning or radiographic knee OA progression.Conclusion.Our results support a systemic OA susceptibility and possibly different mechanisms for osteophyte formation and cartilage thinning.

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