scholarly journals MODERN TRENDS IN THE TREATMENT OF FOCAL CARTILAGE DEFECTS OF THE KNEE

2020 ◽  
pp. 65-72
Author(s):  
K. A. Egiazaryan ◽  
G. D. Lazishvili ◽  
A. P. Ratyev ◽  
I. V. Sirotin ◽  
A. B. But-Gusaim ◽  
...  
Keyword(s):  
Knee Joint ◽  
Treatment Outcomes ◽  
Hyaline Cartilage ◽  
Current Trend ◽  
Cartilage Defects ◽  
Operation Technique ◽  
Treatment Results ◽  
High Quality ◽  
Collagen Membranes ◽  
Femoral Condyles

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.

scholarly journals Treatment outcomes of patients with knee hyaline cartilage damages using osteoperforative methods

2021 ◽  
Vol 9 (4) ◽  
pp. 397-406
Author(s):  
Sergei V. Chebotarev ◽  
Vladimir V. Khominets ◽  
Dmitry A. Zemlyanoy ◽  
Lidiya I. Kalyuzhnaya ◽  
Aleksej S. Grankin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Knee Joint ◽  
Treatment Outcomes ◽  
Hyaline Cartilage ◽  
Cartilage Damage ◽  
Treatment Method ◽  
Postoperative Treatment ◽  
Cartilage Defects ◽  
Military Medical Academy ◽  
Cartilage Injuries

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.

Transosseous Osteosynthesis with External Fixation Devices in Intraarticular Fractures of Knee Joint Area

2009 ◽  
Vol 16 (4) ◽  
pp. 29-34
Author(s):  
Igor' Olegovich Pankov ◽  
A L Emelin ◽  
I O Pankov ◽  
A L Emelin
Keyword(s):  
Knee Joint ◽  
Treatment Outcomes ◽  
External Fixation ◽  
Treatment Results ◽  
Compression Fractures ◽  
Articular Surfaces ◽  
Intraarticular Fractures ◽  
Fixation Devices ◽  
Severity Of Injury ◽  
Femoral Condyles

Peculiarities of transosseous osteosynthesis with pin-rod external fixation devices at treatment of various intraarticular fractures in the area of the knee joint are presented. Analysis of treatment outcomes for 108 patients with 110 fractures (18 fractures of femoral condyles and 92 fractures of tibial condyles) was performed. Excellent and good results were achieved in 83 (75.4%) cases. In polysegmental and impression-compression fractures of femoral and tibial condyles the treatment results were most often only satisfactory or unsatisfactory that was accounted for the severity of injury with massive destruction of the articular surfaces.

scholarly journals Comparison of chondro-plastic properties of the chondrogide and chondro-teck collagen membranes did not reveal reparative differences in the rat model of full thickness defect of articular cartilage

2020 ◽  
pp. 102-109
Author(s):  
Е.В. Афанасьевская ◽  
Е.В. Медведева ◽  
Б.М. Газимиева ◽  
А.Д. Куренкова ◽  
О.В. Кытько ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Hyaline Cartilage ◽  
Articular Surface ◽  
Fibrous Tissue ◽  
Cartilage Defects ◽  
Collagen Membrane ◽  
Full Thickness ◽  
Macroscopic Appearance ◽  
Defect Area ◽  
Collagen Membranes

Введение. Для заполнения костно-хрящевых дефектов широкое применение получили коллагенсодержащие импланты. Наибольшей популярностью пользуется коллагеновая мембрана Chondro-Gide® (Швейцария) Предполагается, что после пересадки она запускает естественный механизм хондрогенеза. Однако некоторые клинические исследования показывают, что отдаленные результаты не всегда положительны. В ПМГМУ им. И.М. Сеченова изготовлена коллагеновая мембрана Хондротек (рабочее название), которая в эксперименте показала хорошие результаты при выполнении реконструкции дефектов гиалинового хряща. Цель исследования - сопоставление хондропластических свойств двух коллагеновых мембран по восстановлению полнослойного дефекта суставного хряща у крыс в эксперименте и оценка возможности импортозамещения. Методика. Выполнено 3 серии экспериментов на коленных суставах 18 крыс линии Вистар: контрольная группа - без восстановления дефекта и две опытные группы с имплантацией одной из мембран в область дефекта. Полнослойный дефект хряща воспроизводили в межмыщелковой ямке коленного сустава фрезой диаметром 2,5 мм до появления кровяной росы на дне дефекта. Импланты из мембран соответствующего размера помещали в дефект и прикрывали надколенником. Дополнительной фиксации не требовалось. Срок наблюдения 2 и 4 мес. Процессы репаративной регенерации оценивали визуально с применением шкалы ICRS и с помощью гистологических методов исследования. Результаты. Применение коллагеновых мембран ускоряло восстановление тканей в области дефекта. Хондропластические свойства импортной и отечественной мембран были аналогичными. Признаков восстановления гиалинового хряща не было обнаружено ни в контрольной, ни в одной из опытных групп. Утраченные ткани замещались фиброзным хрящом. Заключение. Обе исследованные коллагеновые мембраны (отечественная Хондротек и импортная Chondro-Gide®) могут быть использованы для восстановления целостности поврежденного хряща и восстановления конгруэнтности суставных поверхностей. Процесс восстановления происходил за счет формирования фиброзного хряща, регенерация гиалинового хряща не наблюдалась ни в одной из групп. Хондропластические свойства импортной и отечественной мембран оказались аналогичными, что доказывает возможность рекомендовать применение последней в клинической практике. Полученные данные позволяют рекомендовать мембраны Хондротек для импортозамещения. Background. Collagen-based membranes and scaffolds are widely used for implantation into various bone and cartilage defects. The Chondro-Gide® (Switzerland) collagen membrane is among membranes widely used for defects of articular cartilage in orthopedic practice of the Russian Federation. This membrane is considered to trigger a natural chondrogenesis mechanism. However, some clinical studies have shown that remote results are not always beneficial. A collagen-based membrane (working name, Chondroteck), which showed properties compatible to those of Chondro-Gide® in in vitro experiments, was recently developed at the Sechenov University (1st MSMU). Aim. To compare chondrogenic properties of these two membranes in vivo and to explore a possibility of using the Chondroteck membrane for restoration of full-thickness defects in articular cartilages. Methods. The full-thickness defects were created in the intercondylar fossa of 18 adult Wistar rats by drilling a 2.5 mm diameter hole into the subchondral bone (until small blood drops appeared on the bottom of the defect). Then rats were divided into three groups, control (no membrane added) and two experimental groups, one group with Chondro-Gide® and another group with the Chondroteck membrane implanted into the defect. Membranes were cut to the appropriate size, placed into the defect and covered with the patella. No additional fixation of membranes was required. Cartilage repair was assessed using the ICRS scoring system on histological sections stained with hematoxylin/eosin or toluidine blue. Results. Both collagen membranes improved the curvature of the articular surface and macroscopic appearance of the cartilage and protected the tissues surrounding the defect area as compared to the control. However, no formation or restoration of hyaline cartilage was detected in any group. Instead, fibrous tissue was formed at the defect area, and this fibrous tissue was similar in both groups with membranes. Conclusions. Both Chondro-Gide® and Chondroteck membranes can be utilized for restoration of cartilage surface. Formation of hyaline cartilage does not occur with either membrane. Thus, chondroplastic properties of both membranes are comparable, which allows to recommend the locally made Chondroteck membrane for further testing.

Knee Joint Hyaline Cartilage Defects

1992 ◽  
Vol 16 (4) ◽  
pp. 597-603 ◽  
Author(s):  
Juerg Hodler ◽  
Marie-Josée Berthiaume ◽  
Mark E. Schweitzer ◽  
Donald Resnick
Keyword(s):  
Knee Joint ◽  
Hyaline Cartilage ◽  
Cartilage Defects

scholarly journals Experimental assessment of biological potential of collagen membranes in Reconstruction of full-thickness hyaline cartilage defects

2021 ◽  
Author(s):  
GD Lazishvili ◽  
KA Egiazaryan ◽  
DV Nikishin ◽  
AA Voroncov ◽  
DV Klinov
Keyword(s):  
Cartilage Defect ◽  
Hind Limb ◽  
Hyaline Cartilage ◽  
Cartilage Tissue ◽  
Cartilage Defects ◽  
Collagen Membrane ◽  
Full Thickness ◽  
Post Surgery ◽  
Biological Potential ◽  
Collagen Membranes

Investigation of the efficacy of collagen membranes used in the full-thickness hyaline cartilage defect surgery is extremely urgent from the point of view of everyday healthcare. However, there is no information about the collagen membrane transformation timeframe, patterns and type of tissue the membrane transforms into, nor on the quality of the newly formed cartilage, which hinders the use of collagen membranes in clinical practice. This study aimed to investigate the biological potential of collagen membranes and their capacity to transform into cartilage tissue. The study involved four pigs as subjects. We induced a full-thickness cartilage defect on their right hind limb joint and implanted an Ortokeep collagen membrane to remedy it. Two full-thickness cartilage defects were induced on the left hind limb joints of the animals, one was treated with an implanted Chondro-Gide collagen membrane, the other remained without a membrane. The animals were withdrawn from the experiment at 2, 3, 4, 6 months after the operation. This report contains results of the macroscopic and microscopic analyses revealing the character of cartilage tissue regeneration at various timepoints post-surgery. The collagen membranes proved to have a high biological potential and a capacity to transform into cartilage tissue. The cartilages were identifiable from the 3rd month of the study. Their thickness was growing significantly (p < 0.05) up to the 4th month post-surgery, gaining 18.7% in group 1 and 12.8% in group 2; afterwards, the formed tissue "matured". We have shown that the AMIC technique allows significant (p < 0.05) reduction of the bone tissue destruction area.

COMPARATIVE EVALUATION OF GUT DECOMPRESSION METHODS IN OPERATIONS ON TOXIC WIDESPREAD PERITONITIS

2019 ◽  
pp. 34-37
Author(s):  
V.I. Midlenko ◽  
N.I. Belonogov ◽  
O.V. Midlenko ◽  
A.L. Charyshkin
Keyword(s):  
Small Intestine ◽  
Treatment Outcomes ◽  
Comparative Evaluation ◽  
Comparative Assessment ◽  
Abdominal Pressure ◽  
Treatment Results ◽  
Intestinal Decompression ◽  
Bowel Decompression

The aim of the paper is to conduct a comparative assessment of bowel decompression methods in operations on toxic widespread peritonitis. Materials and Methods. The authors examined 162 patients with widespread peritonitis of various etiologies. Using generally accepted methods, they compared treatment results using one of the three methods of intestinal decompression: cecostomy, nasointestinal intubation, and cecostomy with intubation of the small intestine. Results. It was detected that in case of small intestine intubation through the cecostomy (in comparison with other methods), intra-abdominal pressure returned to normal on the 2nd day, and in case of cecostomy or nasointestinal intubation – on the 5th and 7th day, respectively. Also, decrease in intoxication indicators was observed 2 days earlier than usual. Conclusion. Intubation of the small intestine through the cecostoma provides the most adequate intestinal decompression in patients with advanced toxic peritonitis. Early normalization of intra-abdominal pressure in patients with advanced toxic peritonitis improves treatment outcomes. Keywords: widespread peritonitis, intestinal decompression. Цель – сравнительная оценка способов декомпрессии кишечника при операциях по поводу распространённого перитонита в токсической стадии. Материалы и методы. Наблюдали 162 пациента с распространённым перитонитом различной этиологии. С использованием общепринятых методик сравнивались результаты лечения при применении одного из трёх способов декомпрессии кишечника: цекостомии, назоинтестинальной интубации и наложения цекостомы с интубацией тонкой кишки. Результаты. Установлено, что при использовании интубации тонкого кишечника через цекостому, в сравнении с другими применявшимися нами способами, внутрибрюшное давление нормализовалось на второй день, а при использовании цекостомии или назоинтестинальной интубации – на 5-й и 7-й дни соответственно. Также на 2 сут раньше происходило снижение показателей интоксикации. Выводы. Наиболее адекватную декомпрессию кишечника у пациентов с распространённым перитонитом в токсической стадии обеспечивает интубация тонкого кишечника через цекостому. Ранняя нормализация внутрибрюшного давления у пациентов с распространённым перитонитом в токсической стадии позволяет улучшить результаты лечения. Ключевые слова: распространённый перитонит, декомпрессия кишечника.

scholarly journals OP0083 DORSAL ROOT GANGLIA INFILTRATING MACROPHAGES MAINTAIN OSTEOARTHRITIS PAIN

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 55.2-56
Author(s):  
R. Raoof ◽  
C. Martin ◽  
H. De Visser ◽  
J. Prado ◽  
S. Versteeg ◽  
...  
Keyword(s):  
Knee Joint ◽  
Dorsal Root Ganglia ◽  
Immune Cells ◽  
Dorsal Root ◽  
Weight Bearing ◽  
Joint Damage ◽  
Osteoarthritis Pain ◽  
Knee Pathology ◽  
Femoral Condyles ◽  
Over Time

Background:Pain is a major debilitating symptom of knee osteoarthritis (OA). However, the extent of joint damage in OA does not correlate well with the severity of pain. The mechanisms that govern OA pain are poorly understood. Immune cells infiltrating nervous tissue may contribute to pain maintenance.Objectives:Here we investigated the role of macrophages in the initiation and maintenance of OA pain.Methods:Knee joint damage was induced by an unilateral injection of mono-iodoacetate (MIA) or after application of a groove at the femoral condyles of rats fed on high fat diet. Pain-like behaviors were followed over time using von Frey test and dynamic weight bearing. Joint damage was assessed by histology. Dorsal root ganglia (DRG) infiltrating immune cells were assessed over time using flow cytometry. To deplete monocytes and macrophages, Lysmcrex Csfr1-Stop-DTR were injected intrathecal or systemically with diptheria toxin (DT).Results:Intraarticular monoiodoacetate injection induced OA and signs of persistent pain, such as mechanical hyperalgesia and deficits in weight bearing. The persisting pain-like behaviors were associated with accumulation of F4/80+macrophages with an M1-like phenotype in the lumbar DRG appearing from 1 week after MIA injection, and that persisted till at least 4 weeks after MIA injection. Macrophages infiltrated DRG were also observed in the rat groove model of OA, 12 weeks after application of a groove at the femoral condyles. Systemic or local depletion of DRG macrophages during established MIA-induced OA completely ablated signs of pain, without affecting MIA-induced knee pathology. Intriguingly when monocytes/macrophages were depleted prior to induction of osteoarthritis, pain-like behaviors still developed, however these pain-like behaviors did not persist over time.In vitro,sensory neurons innervating the affected OA joint programmed macrophages into a M1 phenotype. Local repolarization of M1-like DRG macrophages towards M2 by intrathecal injection of M2 macrophages or anti-inflammatory cytokines resolved persistent OA-induced pain.Conclusion:Overall we show that macrophages infiltrate the DRG after knee damage and acquire a M1-like phenotype and maintain pain independent of the lesions in the knee joint. DRG-infiltrating macrophages are not required for induction of OA pain. Reprogramming M1-like DRG-infiltrating macrophages may represent a potential strategy to treat OA pain.Acknowledgments:This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreements No 814244 and No 642720. Dutch Arthritis SocietyDisclosure of Interests:Ramin Raoof: None declared, Christian Martin: None declared, Huub de Visser: None declared, Judith Prado: None declared, Sabine Versteeg: None declared, Anne Heinemans: None declared, Simon Mastbergen: None declared, Floris Lafeber Shareholder of: Co-founder and shareholder of ArthroSave BV, Niels Eijkelkamp: None declared

Histological Features of Osteoarthritis in a State of Decompensation

2021 ◽  
Vol 53 ◽  
pp. 51-58
Author(s):  
Timur B. Minasov ◽  
Ekaterina R. Yakupova ◽  
Dilmurod Ruziboev ◽  
Ruslan M. Vakhitov-Kovalevich ◽  
Ruslan F. Khairutdinov ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Knee Joint ◽  
Blood Vessels ◽  
Subchondral Bone ◽  
Musculoskeletal System ◽  
Hyaline Cartilage ◽  
Material Selection ◽  
Central Zone ◽  
Cartilage Tissue ◽  
Social Significance

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.

Sign in / Sign up

Export Citation Format

Share Document