New methods of surgical treatment of knee joints hyaline cartilage defects in patients with knee osteoarthritis

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.

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Higher dynamic medial knee load predicts greater cartilage loss over 12 months in medial knee osteoarthritis

Annals of the Rheumatic Diseases ◽

10.1136/ard.2010.147082 ◽

2011 ◽

Vol 70 (10) ◽

pp. 1770-1774 ◽

Cited By ~ 263

Author(s):

Kim L Bennell ◽

Kelly-Ann Bowles ◽

Yuanyuan Wang ◽

Flavia Cicuttini ◽

Miranda Davies-Tuck ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Disease Progression ◽

Cartilage Volume ◽

Cartilage Defects ◽

Medial Knee ◽

Tibial Cartilage ◽

Medial Knee Osteoarthritis ◽

Structural Progression ◽

The Relationship ◽

Knee Load

ObjectiveMechanical factors, in particular increased medial knee joint load, are believed to be important in the structural progression of knee osteoarthritis. This study evaluated the relationship of medial knee load during walking to indices of structural disease progression, measured on MRI, in people with medial knee osteoarthritis.MethodsA longitudinal cohort design utilising a subset of participants (n=144, 72%) enrolled in a randomised controlled trial of lateral wedge insoles was employed. Medial knee load parameters including the peak knee adduction moment (KAM) and the KAM impulse were measured at baseline using three-dimensional gait analysis during walking. MRI at baseline and at 12 months was used to assess structural indices. Multiple regression with adjustment for covariates assessed the relationship between medial knee load parameters and the annual change in medial tibial cartilage volume. Binary logistic regression was used for the dichotomous variables of progression of medial tibiofemoral cartilage defects and bone marrow lesions (BML).ResultsA higher KAM impulse, but not peak KAM, at baseline was independently associated with greater loss of medial tibial cartilage volume over 12 months (β=29.9, 95% CI 6.3 to 53.5, p=0.01). No significant relationships were seen between medial knee load parameters and the progression of medial tibiofemoral cartilage defects or BML.ConclusionThis study suggests knee loading, in particular the KAM impulse, may be a risk factor for loss of medial tibial cartilage volume. As knee load is modifiable, load-modifying treatments may potentially slow disease progression.

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The Cost-Effectiveness of Surgical Treatment of Medial Unicompartmental Knee Osteoarthritis in Younger Patients

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.n.00925 ◽

2015 ◽

Vol 97 (10) ◽

pp. 807-817 ◽

Cited By ~ 25

Author(s):

Joseph F. Konopka ◽

Andreas H. Gomoll ◽

Thomas S. Thornhill ◽

Jeffrey N. Katz ◽

Elena Losina

Keyword(s):

Cost Effectiveness ◽

Surgical Treatment ◽

Knee Osteoarthritis ◽

Younger Patients ◽

Unicompartmental Knee ◽

The Cost

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Knee Arthrography

Musculoskeletal Imaging Volume 2 ◽

10.1093/med/9780190938178.003.0102 ◽

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.

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NEW METHODS OF SURGICAL TREATMENT OF DEGENERATIVE DISEASES OF THE ABDOMINAL AORTA

Annals of Internal Medicine ◽

10.7326/0003-4819-41-1-36 ◽

1954 ◽

Vol 41 (1) ◽

pp. 36 ◽

Cited By ~ 6

Keyword(s):

Surgical Treatment ◽

Abdominal Aorta ◽

Degenerative Diseases ◽

New Methods

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Osteochondral grafting for cartilage defects in the patellar grooves of bilateral knee joints

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2004.04.040 ◽

2004 ◽

Vol 20 ◽

pp. 32-38 ◽

Cited By ~ 11

Author(s):

Yasuaki Nakagawa ◽

Yoshitaka Matsusue ◽

Takashi Suzuki ◽

Hiroshi Kuroki ◽

Takashi Nakamura

Keyword(s):

Knee Joints ◽

Cartilage Defects ◽

Bilateral Knee ◽

Osteochondral Grafting

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Difficulties in Treating Complex Knee Injuries with Fracture of Posterior Tibial Plateau

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/01.3001.0012.6463 ◽

2018 ◽

Vol 20 (4) ◽

pp. 293-300

Author(s):

Kamil Kołodziejczyk ◽

Krzysztof Kuliński ◽

Krzysztof Fedorowicz ◽

Maciej Langner ◽

Jarosław Czubak ◽

...

Keyword(s):

Surgical Treatment ◽

Tibial Plateau ◽

Knee Injuries ◽

Tibial Plateau Fractures ◽

Knee Joints ◽

Joint Surface ◽

X Rays ◽

Posterior Tibial ◽

Fracture Management ◽

Operative Planning

Background. The aim of the study was to assess the outcomes of surgical treatment of complex knee injuries with a posterior inverted-L approach to the knee joint. Material and methods. The study retrospectively enrolled 13 patients who underwent surgical treatment due to knee injuries with posterior tibial plateau fractures in 2015-2017. Pre-operative planning was based on anteroposterior and lateral X-rays and CT images. The fracture was assessed according to Luo’s three-column classification. Radiographic postoperative assessment was based on lower limb (standing) X-rays and measurements of the MPTA, aPPTA, JLCA, and aFaT angles in the operated and healthy limbs. Clinical assessment was based on the IKDC, KOOS, and Tegner-Lysholm Knee Scoring Scale. Results. Mean follow-up duration was 11.5 months (4-25 months). Anatomical joint surface reduction was achieved in 12 patients and bone union was present in all patients. A posterior inverted-L approach was used in 9 patients and combined approaches in 8 patients. According to the three-column classification, single-column fractures were found in 3 patients, two-column fractures in 4, and three-column fractures in 6 patients. The KOOS was 82%, the IKDC score was 80%, and the Tegner-Lysholm score was 82 points. Radiographic assessments of the operated knee joints showed an MPTA of 88.64 degrees, aPPTA of 79.78 degrees, JLCA of 0.8 degrees, and aFaT of 7.9 degrees. Conclusions. 1. Anatomical reduction and stable fixation of posterior plateau fractures of the proximal tibia are crucial in fracture management. 2. A posterior inverted-L approach is very useful when treating posterior tibial plateau fractures.

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