scholarly journals Recent advances and future trends in articular cartilage repair

2020 ◽  
Vol 1 ◽  
pp. 159-173
Author(s):  
Deepak Goyal
Keyword(s):  
Cartilage Repair ◽  
Hyaline Cartilage ◽  
Long Term Results ◽  
Current Status ◽  
Osteochondral Lesions ◽  
Future Trends ◽  
Osteochondral Injury ◽  
Surgical Options ◽  
Near Future

Hyaline cartilage is an absolute necessity for a painless and a fully functional joint. A chondral or an osteochondral injury that doesn’t heal or doesn’t undergo a timely repair, eventually lead to arthritis. Many surgical options have been advocated and practiced in last three decades to treat the chondral and the osteochondral lesions. While some of the techniques are now available with the long term results, many techniques have evolved further to produce better results and lesser complications. Newer technologies have also been developed and they are looking promising. In 2020, it is timely to do a literature review of all the techniques suggested and practiced in last three decades and analyze their current status. It is also prudent to envisage, what can we expect in near future from the recent technologies on cartilage repair. The purpose of this paper is to update about the recent status of the established procedures and to review the future trends in cartilage repair.

scholarly journals Biphasic Bioresorbable Scaffold (TruFit Plug®) for the Treatment of Osteochondral Lesions of Talus

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Lorenzo Marcellini ◽  
Elvira Di Cave ◽  
Pierluigi Versari ◽  
David Luzon
Keyword(s):  
Cartilage Repair ◽  
Treatment Method ◽  
Long Term Results ◽  
Osteochondral Lesions ◽  
Repair Tissue ◽  
Randomized Controlled Clinical Trials ◽  
Postoperative Mri ◽  
Mri Scans

Category: Ankle, Ankle Arthritis Introduction/Purpose: The ideal treatment of osteochondral lesions of the talus (OLT) is debatable. The TruFit plug has been investigated as a potential treatment method for osteochondral defects. This is a biphasic scaffold designed to stimulate cartilage and subchondral bone formation. The purpose of this retrospective study was to investigate the long-term functional and MRI outcomes of the TruFit Plug for the treatment of OLT. Methods: We evaluated 12 consecutive patients treated from March 2007 to April 2009 for OLT. Clinical examination included the American Orthopaedic Foot and Ankle Society (AOFAS) ankle score and the visual analog scale (VAS) for pain. MRI scans were optained pre-treatment and at last follow-up. The Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was used to assess cartilage incorporation. Results: Mean follow-up was 7.5 years (range, 6.5 to 8.7 years). The average age was of 38.6 years (range, 22 to 57 years). The sex ratio between males and females was 3:1 (9 males, 3 females). The mean AOFAS score improved from a preoperative score of 47.2 ± 10.7 to 84.4 ± 8 (p< 0.05). According to the postoperative AOFAS scores 1 case obtained excellent results, 9 were classified as good, and 2 were fair. VAS score improved from a preoperative value of 6.9 ± 1.4 points to 1.2 ± 1.1 points at last follow-up (p< 0.05). The MOCART score for cartilage repair tissue on postoperative MRI averaged 61.1 points (range, 25-85 points). Conclusion: The long-term results suggest that the technique of Trufit Plug for OLT is safely and demonstrates good post- operative scores including improvement of pain and function, with discordant MRI results. However, randomized controlled clinical trials comparing TruFit Plug with an established treatment method are needed to improve synthetic biphasic implants as therapy for osteochondral lesions.

scholarly journals AB0858 TREATMENT ALGORITHM FOR ANKLE OSTEOCHONDRAL LESIONS AND DEFECTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1736.2-1736
Author(s):  
O. Burianov ◽  
L. Khimion ◽  
T. Omelchenko ◽  
E. Levitskyi ◽  
V. Lyanskorynsky
Keyword(s):  
Bone Marrow ◽  
Ankle Joint ◽  
Bone Marrow Cells ◽  
Traditional Approach ◽  
Treatment Algorithm ◽  
Main Group ◽  
Long Term Results ◽  
Osteochondral Lesions ◽  
Traditional Treatment

Background:traumatic ankle joint osteochondral lesions and defects (OHLD) is frequent cause of OA, chronic pain and loss of joint function; results of traditional treatment strategy are often unsatisfyingObjectives:to develop treatment algorithm for OHLD based on evaluation of previously determined main prognostic factors.Methods:the analysis of long-term (36 ± 4.5 months) treatment results of 239 patients after traumatic ankle joint OHLD revealed the following factors with the greatest predictive value (defined by PC – prognostic coefficient) for good result of treatment (defined as AOFAS function score 75-100 points): age < 40 years (PC = 8.5); size of OHLD ≤ 1.0 cm2; volume ≤ 1.5 cm3(PC = 8.0); osteoarthritis stage ≤ II (PC = 7.2). Based on these factors, a step-by-step, discrete and alternative algorithm for the choice of treatment tactics was created. The algorithm includes use of arthroscopic or open debridement, abrasive chondroplasty, bone marrow regeneration stimulation (microfracturing or tunneling), mosaic osteochondroplasty, arthroplasty or arthrodesis, the use of cellular regenerative technologies (bone marrow cells, platelet riched plasma), and others. Patients of older age with advanced OA need complex, step up approach, surgical treatment combined with regenerative cell technologies. The effectiveness of the differentiated approach to treatment was studied in 72 patients with OHLD (main group) in comparing to 72 patients in whom traditional treatment approaches were used, based on the stage of injury according to the Berndt & Hardy classification (comparison group).Results:compared to the traditional approach, the developed algorithm and treatment system allowed to half terms of hospitalization, to reduce the intensity of pain syndrome (by NRS) and increase the functional activity (by AOFAS) by 25%. In 3 years after trauma good/excellent results of treatment demonstrated 86% patients of main group and 32,2% of patients from comparing group (p<0,05).Conclusion:implementation of the developed treatment algorithm increases the number of good and excellent long-term results by 2.6 times and reduces the number of complications and unsatisfactory results by 4.9 times.Disclosure of Interests:None declared

scholarly journals 13-year Follow-up of Treatment of Osteochondral Lesions with MACI

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0004 ◽  
Author(s):  
Chris Kreulen ◽  
Trevor Shelton ◽  
Jacqueline Nguyen ◽  
Eric Giza ◽  
Martin Sullivan
Keyword(s):  
Social Functioning ◽  
Physical Functioning ◽  
Bodily Pain ◽  
Long Term Results ◽  
Osteochondral Lesions ◽  
Sf 36 ◽  
Significant Difference ◽  
And Function

Category: Ankle, Arthroscopy, Hindfoot, Sports, Trauma Introduction/Purpose: Surgical management of osteochondral lesions of the talus (OLT) present an ongoing treatment challenge. Previously, matrix-induced autologous chondrocyte implantation (MACI) demonstrated improved pain and function at 7-years postoperative, providing evidence that MACI is a reliable method for treating cartilage. However, it is unknown the long- term results of MACI in OLT. The purpose of this study was to assess 13-year clinical follow-up data and the long-term success of this implant by comparing patient reported outcome measures (PROMs) pre-operatively, at 7-years post-operative, and at 13- years post-operative. Methods: A prospective investigation of MACI was performed on 10 patients with OLTs who had failed previous arthroscopic treatment. Of the 10 patients, 9 were available for 7-year and 13-year follow-up. Short Form Health Survey (SF-36) and the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot evaluation were utilized at pre-operative, 7-year, a 13-year postoperative. For each patient, a paired t-test was used to compare 13-year post-operative PROMs to pre-operative PROMs. A single factor analysis of variance (ANOVA) determined whether PROMs were different between pre-operative, 7-year post- operative, and 13-year post-operative time intervals. When a significant difference was detected, a post-hoc Tukey’s determined which time periods were different. Results: SF-36 data at 13-years showed significant improvements in Physical Functioning (p=0.012), Lack of Bodily Pain (p=0.017), and Social Functioning (p=0.007) compared with preoperative data. There were no differences in other components of the SF-36 outcomes (p>0.05). Although the AOFAS was on average 12 points higher at 13-years postoperative, this was not statistically significant (p=0.173). As for comparing PROMs over time, 13-years post-operative PROMs were comparable to 7-years post- operative (Table 1). There were better PROMs for Physical Functioning, Bodily Pain, and Social Functioning at 7- and 13-years post-operative compared to pre-operative while Physical Role Functioning was also better at 7-years post-operative compared to pre-operative. Conclusion: This study shows MACI provides greater pain relief and function at 13-years post-operative with stable long-term follow-up. MACI should be considered for osteochondral lesions that fail initial microfracture.

scholarly journals The earlier, the better or the worse? Towards accurate management of patients with arthralgia at risk for RA

2020 ◽  
Vol 79 (3) ◽  
pp. 312-315 ◽  
Author(s):  
Annette van der Helm-van Mil ◽  
Robert B M Landewé
Keyword(s):  
Daily Practice ◽  
Long Term Results ◽  
Current Status ◽  
Controlled Trials ◽  
Future Studies ◽  
Clinical Arthritis ◽  
The One ◽  
Firm Evidence ◽  
Early Phases

The favourable long-term results of early treatment in patients with classified rheumatoid arthritis have resulted in an increasing interest in the diseases phases preceding clinical arthritis. The hypothesis to test is that an intervention in these early phases may better prevent or reduce disease persistence than an intervention when arthritis has become clinically manifest. While several placebo-controlled trials are still ongoing, to date there is no firm evidence that this hypothesis truly holds. Therefore, it is important to reflect on the current status of arthralgia preceding clinical arthritis. Inherent to every new field of research, attitudes are conflicting, with opinions propagating innovation (based on the fear of undertreatment) on the one hand, and critical sounds pleading for more restraint (fear of overtreatment) on the other hand. In this Viewpoint, we will examine these divergent opinions, relate them to a preferred ultimate scenario and provide considerations for future studies and daily practice.

scholarly journals Developing Astronomy Research and Education in the Philippines

2012 ◽  
Vol 10 (H16) ◽  
pp. 568-568
Author(s):  
R. M. D. Sese ◽  
M. B. N. (Thijs) Kouwenhoven
Keyword(s):  
White Paper ◽  
The Philippines ◽  
Current Status ◽  
Asian Countries ◽  
International Astronomical ◽  
Research And Education ◽  
Near Future ◽  
Education Outreach ◽  
Astronomy And Astrophysics

AbstractIn the past few years, the Philippines has been gradually developing its research and educational capabilities in astronomy and astrophysics. In terms of astronomy development, it is still lagging behind several neighboring Southeast Asian countries such as Indonesia, Thailand and Malaysia, while it is advanced with respect to several others. One of the main issues hampering progress is the scarcity of trained professional Filipino astronomers, as well as long-term visions for astronomy development. Here, we will be presenting an overview of astronomy education and research in the country. We will discuss the history and current status of astronomy in the Philippines, including all levels of education, outreach and awareness activities, as well as potential areas for research and collaborations. We also discuss issues that need to be addressed to ensure sustainable astronomy development in the Philippines. Finally, we discuss several ongoing and future programs aimed at promoting astronomy research and education. In essence, the work is a precursor of a possible white paper which we envision to submit to the Department of Science and Technology (DOST) in the near future, with which we aim to further convince the authorities of the importance of astrophysics. With the support of the International Astronomical Union (IAU), this may eventually lead to the creation of a separate astronomy agency in the Philippines.

Cartilage repair in the young knee

2011 ◽  
Author(s):  
Tim Spalding ◽  
Lars Peterson
Keyword(s):  
Articular Cartilage ◽  
Cartilage Repair ◽  
Clinical Analysis ◽  
Short Term ◽  
High Quality ◽  
The Future ◽  
Surgical Options

♦ Articular cartilage has a poor capacity to heal by itself♦ Left alone, large areas are likely to progress into osteoarthritis♦ The goal of cartilage repair is both short term improvement in function and long term durability♦ There are several available strategies including non-surgical options, and these are formulated into an algorithm♦ Cartilage repair is an advancing field and the future lies in bioengineering and high quality comparative clinical analysis.

Osteochondral Transplantation in the Elbow Leads to Good Clinical and Radiologic Long-term Results

2011 ◽  
Vol 39 (12) ◽  
pp. 2619-2625 ◽  
Author(s):  
Stephan Vogt ◽  
Sebastian Siebenlist ◽  
Daniel Hensler ◽  
Lizzy Weigelt ◽  
Patrick Ansah ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Case Series ◽  
Magnetic Resonance Images ◽  
Weight Lifting ◽  
Long Term Results ◽  
Osteochondral Lesions ◽  
Osteochondral Transplantation ◽  
Level Of Evidence

Background: In the long-term follow-up after debridement, microfracture, or drilling of osteochondral lesions in the elbow, subsequent osteoarthritis is a problem. Osteochondral transplantation for these defects has become a more common procedure. However, long-term results are unknown. Purpose: This study was undertaken to evaluate long-term clinical and radiologic outcomes of advanced osteochondral lesions in the elbow treated with osteochondral transplantation. Study Design: Case series; Level of evidence, 4. Methods: The study included 8 patients with osteochondral lesions in the elbow who were treated by autologous osteochondral transplantation between 1996 and 2002. Patients (average age, 17 years) were evaluated pre- and postoperatively by Broberg-Morrey score to assess elbow function and by American Shoulder and Elbow Surgeons (ASES) score for pain analysis. In addition, radiographs (at the first postoperative day, and at 5-year and 10-year follow-up) and magnetic resonance images (8 to 12 weeks postoperatively, and at 5-year and 10-year follow-up) were made to evaluate the joint status. At last follow-up (range, 8-14 years postoperatively), 7 of 8 patients were seen for clinical examination and radiologic analysis. Results: The Broberg-Morrey score increased from an average of 75.9 ± 13.1 to 96.4 ± 2.4 and ASES score significantly improved as follows: worst pain, 7.9 ± 1.1 to 1.6 ± 1.9; rest pain, 3.14 ± 2.7 to 0.6 ± 1.5; weight-lifting pain, 7.6 ± 0.8 to 3.1 ± 1.6; and repetitive movement pain, 5.3 ± 2.4 to 1.6 ± 1.5. Compared with the contralateral side, there was a mean preoperative flexion lag of 12.5° ± 11.6°. At the final follow-up, flexion was free. The mean extension lag was reduced from average 5.4° ± 5.7° to 0°. Radiographs of 2 patients made at final follow-up showed mild signs of osteoarthritis (Kellgren and Lawrence grade I). Postoperative magnetic resonance images showed graft viability in all and a congruent chondral surface in 6 of 7 patients. Conclusion: Clinical long-term results after osteochondral transplantation in the elbow are good to excellent and comparable with midterm results in the literature. Therefore, this technique is a reliable option for satisfactory long-term results regarding treatment of advanced osteochondral lesions in the elbow.

scholarly journals Current status of presurgical infant orthopaedic treatment for cleft lip and palate patients: A critical review

2014 ◽  
Vol 47 (03) ◽  
pp. 293-302 ◽  
Author(s):  
P. Priyanka Niranjane ◽  
R. H. Kamble ◽  
S. Pallavi Diagavane ◽  
S. Sunita Shrivastav ◽  
Puneet Batra ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Scientific Evidence ◽  
Subsequent Development ◽  
Long Term Results ◽  
Current Status ◽  
Treatment Modalities ◽  
Aesthetic Results ◽  
Pubmed Search

ABSTRACTRehabilitation of cleft lip and palate (CLP) patients is a challenge for all the concerned members of the cleft team, and various treatment modalities have been attempted to obtain aesthetic results. Presurgical infant orthopaedics (PSIO) was introduced to reshape alveolar and nasal segments prior to surgical repair of cleft lip. However, literature reports lot of controversy regarding the use of PSIO in patients with CLP. Evaluation of long-term results of PSIO can provide scientific evidence on the efficacy and usefulness of PSIO in CLP patients. The aim was to assess the scientific evidence on the efficiency of PSIO appliances in patients with CLP and to critically analyse the current status of PSIO. A PubMed search was performed using the terms PSIO, presurgical nasoalveolar moulding and its long-term results and related articles were selected for the review. The documented studies report no beneficial effect of PSIO on maxillary arch dimensions, facial aesthetics and in the subsequent development of dentition and occlusion in CLP patients. Nasal moulding seems to be more beneficial and effective in unilateral cleft lip and palate patients with better long-term results.

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