scholarly journals Chondral Defect Repair with Particulated Juvenile Cartilage Allograft

2017 ◽  
Vol 5 (3_suppl3) ◽  
pp. 2325967117S0012
Author(s):  
Nicole Belkin ◽  
Alissa Burge ◽  
Brenda Chang ◽  
Riley J. Williams
Keyword(s):  
Articular Cartilage ◽  
Functional Outcomes ◽  
Rating Scale ◽  
T2 Mapping ◽  
Cartilage Defects ◽  
Activity Levels ◽  
Donor Age ◽  
Outcome Scores ◽  
Activity Rating

Objectives: To evaluate the functional outcomes and morphologic appearance of repair tissue in patients with symptomatic knee articular cartilage defects treated with minced juvenile articular cartilage (DeNovo NT). Methods: Thirty-four patients underwent treatment of cartilage defects of the knee with minced juvenile articular cartilage allograft. Mean postoperative follow up was 33.6 months. MRIs were obtained at 24-months (16 patients) and 48-months or greater (13 patients). MRIs were evaluated for greyscale cartilage repair assessment score and quantitative T2 mapping. Baseline clinical outcome scores (IKDC, ADL, Marx Activity Rating Scale) were obtained prior to surgery, and at a minimum follow up interval of 24-months. Results: The mean IKDC and ADL scores significantly improved following surgery. The magnitude of improvement in IKDC scores was 30 (Std Dev 31). The Marx activity Rating Scale score demonstrated a resumption of pre-operative activity levels, Figure 1a . Donor age had no significant effect on functional outcomes scores of treated patients. MRI assessment revealed greater than 66% lesion fill (a score of 2) in 80% of patients. A trend toward significance in difference in % lesion fill was observed when patients were grouped according to donor age ≤ 5 vs. > 5 years (p = 0.09), Figure 1b . Lesion fill did not correlate with functional outcome score. Using one-way analysis of variance with post-hoc testing, a significant difference was found between T2 mapping of the deep zones of the graft and normal cartilage (p=0.003), Table 1 . [Figure: see text][Table: see text] Conclusion: Functional outcome scores significantly improved in patients treated with minced juvenile articular cartilage (De Novo NT) for the treatment of symptomatic articular cartilage lesions of the knee. Activity levels, as noted by the Marx Activity Scale were preserved. Morphologic analysis demonstrated greater than 66% lesion fill in 80% of the patients studied. T2 mapping demonstrated the sensitivity to assess differences between repair tissue and native cartilage.

Clinical, Functional, and Radiographic Assessment of Arthroscopic Abrasion Chondroplasty of the Knee

1996 ◽  
Vol 5 (2) ◽  
pp. 127-142
Author(s):  
Michael Ra ◽  
Michael Sitler ◽  
Jeff Ryan ◽  
Raymond Moyer ◽  
Paul Marchetto ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Rating Scale ◽  
Weight Bearing ◽  
Cartilage Defects ◽  
Radiographic Assessment ◽  
Radiographic Outcome ◽  
Bearing Loads ◽  
Articular Cartilage Defects ◽  
Complex Injuries

Chondral lesions often occur in the knee as isolated defects or part of more complex injuries. Articular cartilage defects decrease the ability of the knee to sustain weight-bearing loads and may accelerate degeneration of the joint when left untreated. The purpose of this study was to determine the clinical, functional, and radiographic outcome of arthroscopic abrasion chondroplasty of the knee. The Articular Cartilage Rating System was used to assess the location, size, depth, and description of the articular lesion. The Standard Knee Evaluation Form and Cincinnati Knee Rating Scale were used to assess the clinical, functional, and radiographic outcome of the procedure. Average time to postsurgery follow-up was 46 ± 26.69 months. Within the constraints of the present study, arthroscopic abrasion chondroplasty of the knee had a favorable clinical, functional, and radiographic outcome. However, more study is needed with larger samples and longer follow-up before definitive conclusions about the efficacy of the procedure can be made.

Clinical and Radiographic Outcomes After Treatment of Patellar Chondral Defects: A Systematic Review

2021 ◽  
pp. 194173812110035
Author(s):  
Charles A. Su ◽  
Nikunj N. Trivedi ◽  
Hao-Tinh Le ◽  
Lakshmanan Sivasundaram ◽  
Travis G. Maak ◽  
...  
Keyword(s):  
Systematic Review ◽  
Articular Cartilage ◽  
Functional Outcome ◽  
Functional Outcomes ◽  
Level Of Evidence ◽  
Chondral Defects ◽  
Radiographic Outcomes ◽  
Patellar Cartilage ◽  
Outcome Scores

Context: There is currently no evidence-based consensus on how to treat a full-thickness, symptomatic articular cartilage injury of the patella, although numerous treatment options are available. Objective: To systematically evaluate the functional outcomes after operative treatment of patellar cartilage lesions. Our secondary purpose was to evaluate radiographic outcomes after treatment. Data Sources: PubMed, Cochrane, and Embase Study Selection: Studies published between January 1, 1990 and December 31, 2018 that included patient-reported functional outcomes for patients after operative treatment of patellar chondral defects at a minimum 2-year follow-up were included. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: MINORS (Methodological Index for Non-Randomized Studies) score, level of evidence, sample size, demographic data, follow-up data, intervention, functional outcome scores, and magnetic resonance imaging (MRI) data were collected. Results: The review identified 10 studies and 293 patients receiving cartilage restoration procedures for patellar chondral defects with extractable clinical and radiographic results and data on complications and reoperations. All treatments (autologous chondrocyte implantation [ACI], matrix-induced ACI [MACI], autologous osteochondral transplantation [AOT]) utilized in the management of patellar chondral lesions, with the exception of isolated particulated juvenile articular cartilage, demonstrated statistically significant improvements in functional outcome scores compared with preoperative measurements at a minimum of 2-year follow-up. Postoperative MRIs were obtained in 6 studies and found that regardless of treatment, moderate-to-complete infill of patellar cartilage lesions was seen in the majority of patients. While failure rates were low for the various treatment modalities, rates of reoperation were substantial, with up to 40% to 60% reoperation rate seen after ACI. Conclusion: Patients treated with ACI, MACI, and AOT all demonstrated statistically significant improvements in functional outcome scores with radiographic evidence of healing at minimum of 2-year follow-up. Evidence is insufficient to recommend one particular treatment over another.

scholarly journals Potential predictive value of axial T2 mapping at 3 Tesla MRI in patients with untreated patellar cartilage defects over a mean follow-up of four years

2020 ◽  
Vol 28 (2) ◽  
pp. 215-222 ◽  
Author(s):  
S.R. Apprich ◽  
M.M. Schreiner ◽  
P. Szomolanyi ◽  
G.H. Welsch ◽  
U.K. Koller ◽  
...  
Keyword(s):  
Predictive Value ◽  
T2 Mapping ◽  
3 Tesla ◽  
Cartilage Defects ◽  
Patellar Cartilage ◽  
3 Tesla Mri

scholarly journals Cell-Free Osteochondral Scaffold for the Treatment of Focal Articular Cartilage Defects in Early Knee OA: 5 Years’ Follow-Up Results

2019 ◽  
Vol 8 (11) ◽  
pp. 1978 ◽  
Author(s):  
Andrea Sessa ◽  
Luca Andriolo ◽  
Alessandro Di Martino ◽  
Iacopo Romandini ◽  
Roberto De Filippis ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
International Knee Documentation Committee ◽  
Clinical Results ◽  
Activity Level ◽  
Cartilage Defects ◽  
Mri Findings ◽  
Clinical Criteria ◽  
Osteochondral Scaffold ◽  
Articular Cartilage Defects

The purpose of this study was to investigate the clinical results at five years’ follow-up of a tri-layered nanostructured biomimetic osteochondral scaffold used for focal articular cartilage defects in patients meeting the criteria of early osteoarthritis (EOA). The study population comprised 22 patients (mean age: 39 years), prospectively assessed before surgery, at 24 and 60 months’ follow-up. Inclusion criteria were: at least two episodes of knee pain for more than 10 days in the last year, Kellgren-Lawrence OA grade 0, I or II and arthroscopic or MRI findings according to the European Society of Sports Traumatology, Knee Surgery & Arthroscopy (ESSKA) criteria. Clinical results demonstrated significant improvement in International Knee Documentation Committee (IKDC) subjective and objective scores and in Tegner score, although activity level never reached the pre-injury level. The complication rate of this study was 8.3%. Two patients underwent re-operation (8.3%), while a comprehensive definition of failure (including both surgical and clinical criteria) identified four failed patients (16.6%) at this mid-term follow-up evaluation. The use of a free-cell osteochondral scaffold represented a safe and valid alternative for the treatment of focal articular cartilage defects in the setting of an EOA, and was able to permit a significant clinical improvement and stable outcome with low complication and failure rates.

The Relationship among Television Watching, Physical Activity, and Body Composition of 5- or 6-Year-Old Children

1996 ◽  
Vol 8 (1) ◽  
pp. 15-26 ◽  
Author(s):  
Robert H. DuRant ◽  
William O. Thompson ◽  
Maribeth Johnson ◽  
Tom Baranowski
Keyword(s):  
Physical Activity ◽  
Body Mass Index ◽  
Body Composition ◽  
Rating Scale ◽  
The Body ◽  
Activity Level ◽  
Television Watching ◽  
Activity Rating ◽  
The Relationship

This follow-up investigation examined the relationship among observed time of television watching, physical activity, and body composition in 5- to 6-year-old children previously studied 2 years ago. Activity level on school and nonschool days was measured with the Children’s Activity Rating Scale. Television watching time was assessed by direct observation, and body composition was measured with the body mass index, skinfold thicknesses, and waist/hip ratio. Television watching behavior, which increased from the earlier study, was not associated with body composition. Physical activity was lower during television watching than nontelevision watching time.

scholarly journals Meniscal and Articular Cartilage Predictors of Clinical Outcome After Revision Anterior Cruciate Ligament Reconstruction

2016 ◽  
Vol 44 (7) ◽  
pp. 1671-1679 ◽  
Author(s):  
◽  
Rick W. Wright ◽  
Laura J. Huston ◽  
Sam K. Nwosu ◽  
Amanda K. Haas ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Cartilage Damage ◽  
Functional Limitation ◽  
Sports Participation ◽  
Activity Level ◽  
Activity Levels ◽  
Revision Acl Reconstruction

Background: Revision anterior cruciate ligament (ACL) reconstruction has been documented to have worse outcomes compared with primary ACL reconstructions. Purpose/Hypothesis: The purpose of this study was to determine if the prevalence, location, and/or degree of meniscal and chondral damage noted at the time of revision ACL reconstruction predicts activity level, sports function, and osteoarthritis symptoms at 2-year follow-up. The hypothesis was that meniscal loss and high-grade chondral damage noted at the time of revision ACL reconstruction will result in lower activity levels, decreased sports participation, more pain, more stiffness, and more functional limitation at 2 years after revision surgery. Study Design: Cohort study; Level of evidence, 2. Methods: Between 2006 and 2011, a total of 1205 patients who underwent revision ACL reconstruction by 83 surgeons at 52 hospitals were accumulated for study of the relationship of meniscal and articular cartilage damage to outcome. Baseline demographic and intraoperative data, including the International Knee Documentation Committee (IKDC) subjective knee evaluation, Knee injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Marx activity score, were collected initially and at 2-year follow-up to test the hypothesis. Regression analysis was used to control for age, sex, body mass index, smoking status, activity level, baseline outcome scores, revision number, time since last ACL reconstruction, incidence of having a previous ACL reconstruction on the contralateral knee, previous and current meniscal and articular cartilage injury, graft choice, and surgeon years of experience to assess the meniscal and articular cartilage risk factors for clinical outcomes 2 years after revision ACL reconstruction. Results: At 2-year follow-up, 82% (989/1205) of the patients returned their questionnaires. It was found that previous meniscal injury and current articular cartilage damage were associated with the poorest outcomes, with prior lateral meniscectomy and current grade 3 to 4 trochlear articular cartilage changes having the worst outcome scores. Activity levels at 2 years were not affected by meniscal or articular cartilage pathologic changes. Conclusion: Prior lateral meniscectomy and current grade 3 to 4 changes of the trochlea were associated with worse outcomes in terms of decreased sports participation, more pain, more stiffness, and more functional limitation at 2 years after revision surgery, but they had no effect on activity levels. Registration: NCT00625885

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