Osteochondral Grafting for Treatment of a Massive Chondral Defect in the Knee of a Young Adult With Anterior Cruciate Ligament Deficit

Okamoto, Yukihiro; Nakagawa, Yasuaki; Maekawa, Magojiro; Kobayashi, Masahiko; Nakamura, Takashi

doi:10.1016/j.arthro.2006.07.019

Cited by 9 publications

(4 citation statements)

References 5 publications

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“…[1][2][3][4] However, the repair of large cartilaginous lesions remains still challenging because of the low mitotic activity of chondrocytes. In cartilage regeneration techniques based on the principle of tissue engineering, optimal scaffolds should have sufficient mechanical properties and should be able to hold stem cells by themselves.…”

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confidence: 99%

Localization of vascular endothelial growth factor during the early stages of osteochondral regeneration using a bioabsorbable synthetic polymer scaffold

Sakata

Kokubu

Nagura

et al. 2011

Journal Orthopaedic Research

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Vascular endothelial growth factor (VEGF) plays a critical role in chondrogenic differentiation in the growth plate of the epiphysis. This function is necessary for chondrocyte survival in cartilage development. We investigated the localization of VEGF in the osteochondral regeneration process using a bioabsorbable polymer scaffold. Osteochondral defects (5 mm in diameter and 5 mm in depth) were made on the femoral condyle of forty-eight skeletally mature female Japanese white rabbits. In total, twenty-four defects were filled with poly(DL-lactide-co-glycolide) scaffolds and the others were left untreated. The regeneration process was investigated macroscopically, histologically, immunohistochemically, and by gene expression analysis. In the early stages of osteochondral regeneration, bone ingrowth was observed in the deep zone of the scaffold with continuous VEGF expression; cartilage regeneration was observed in the superficial zone of the scaffold with decreased VEGF expression. In contrast, when the defect was left untreated, VEGF localization was observed throughout the entire defect area, and cartilage regeneration at the articular surface was delayed. We conclude that decrease in localization of VEGF at the articular surface in the postoperative early stage is closely related to the progression of cartilage regeneration in osteochondral defects. ß

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confidence: 99%

Localization of vascular endothelial growth factor during the early stages of osteochondral regeneration using a bioabsorbable synthetic polymer scaffold

Sakata

Kokubu

Nagura

et al. 2011

Journal Orthopaedic Research

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“…Historically there are many studies that demonstrate good outcomes with osteochondral bone transfer. However, most of these studies used cylindrical plugs from non-weight-bearing areas of the knee, generally onto focal femoral condyle lesions (Hangody et al, 2008;Jakob et al, 2002;Tanaka et al, 2009) [9,11,26] , patella groove defects (Nakagawa et al, 2004) or less frequently larger cartilage defects, often in combination with ACL injuries (Erdil et al, 2013;Imade et al, 2012;Okamoto et al, 2007) [4,10,22] . In patients with osteonecrosis of the femoral head autologous osteochondral transfer is also reported to have a good outcome, but is related to a high conversion rate to total hip replacements in the late postcollapse stage (Gagala et al, 2013) [7] .…”

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confidence: 99%

Successful treatment of avascular necrosis of the distal femoral condyle with osteochondral autograft in an HIV positive woman: A case report

Lotz¹,

Deo²

2019

Int. J. Orthop. Sci.

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Treatment of avascular necrosis is challenging and requires patient individual treatment planning. A 26year-old HIV positive woman presented with increasing pain and stiffness in her left knee. We diagnosed an avascular necrosis of the knee with a severely limited range of movement. During her treatment, she also developed an avascular necrosis of both hips. To minimize the risks of prosthetic joint infection in an immunocompromised patient, we decided to perform a hip arthroplasty with an autologous fullthickness osteochondral transfer of the femoral head to the femoral condyle. Despite a lack of compliance and physiotherapy, the symptoms and range of movement significantly improved postoperatively, without the patient being pain-free. We propose that in cases of simultaneous avascular necrosis of hip and knee, a large autologous transfer is an option to prolong or prevent knee arthroplasty, especially in patients with risk factors for a poor outcome of arthroplasty.

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“…Multiple small case series [5][6][7][8][9] have described the success of osteochondral autografts for treatment of osteochondral defects in the knee, including cases of spontaneous osteonecrosis of the knee (SONK), secondary osteonecrosis, or osteochondritis dissecans. As for other small osteochondral defects, osteochondral autograft plugs are harvested from the periphery of either the ipsilateral or contralateral knees.…”

Section: Discussionmentioning

confidence: 99%

Knee Joint Osteochondral Reconstruction Using Fresh Femoral Head Autograft

Weinrauch¹

2013

J Med Cases

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We present the management of polyarticular osteonecrosis in a 17-year-old female, with marked symptoms involving both hips and one knee. As a complication of chemotherapy to treat leukaemia, the articular surfaces of both femoral heads and the right knee lateral femoral condyle collapsed, resulting in significant pain and disability. For this unusual case a novel technique was employed, using a method we believe has not been described previously. The articular surface of the knee was reconstructed using fresh bulk osteochondral autograft harvested from the ipsilateral femoral head during a simultaneous total hip arthroplasty. Reconstructive options in young patients with multiple joints involved are often restricted, and suitable osteochondral allografts can be difficult to obtain. Fresh osteochondral auto-grafting enabled rapid osseous integration and articular surface reconstruction using living host cartilage, resulting in an excellent clinical outcome. Although uncommon, concurrent avascular necrosis of multiple large joints is occasionally encountered, and management options are particularly limited in young patients. We recommend this innovative technique be considered in those patients who satisfy the criteria for bulk osteochondral grafting procedures where total hip replacement is also required.

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Osteochondral Grafting for Treatment of a Massive Chondral Defect in the Knee of a Young Adult With Anterior Cruciate Ligament Deficit

Cited by 9 publications

References 5 publications

Localization of vascular endothelial growth factor during the early stages of osteochondral regeneration using a bioabsorbable synthetic polymer scaffold

Localization of vascular endothelial growth factor during the early stages of osteochondral regeneration using a bioabsorbable synthetic polymer scaffold

Successful treatment of avascular necrosis of the distal femoral condyle with osteochondral autograft in an HIV positive woman: A case report

Knee Joint Osteochondral Reconstruction Using Fresh Femoral Head Autograft

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