Return to sport after the surgical management of articular cartilage lesions in the knee: a meta-analysis

Krych, Aaron J.; Pareek, Ayoosh; King, Alexander H.; Johnson, Nick R.; Stuart, Michael J.; Williams, Riley J.

doi:10.1007/s00167-016-4262-3

Cited by 170 publications

(154 citation statements)

References 73 publications

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“…Microfracture is a very popular procedure to treat KOL. In fact, this is a simple, cheap, and usually fast-recovering operation with good results and return to sports rate [ 6 ]. However, the procedure creates a fibrocartilage with inferior biologic and biomechanical properties, which likely explains the potential worse long-term outcomes compared to cartilage regenerative techniques [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Treatment of Knee Osteochondral Lesions Using a Novel Clot of Autologous Plasma Rich in Growth Factors Mixed with Healthy Hyaline Cartilage Chips and Intra-Articular Injection of PRGF

Cugat¹,

Alentorn-Geli²,

Steinbacher

et al. 2017

Case Reports in Orthopedics

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Knee cartilage or osteochondral lesions are common and challenging injuries. To date, most symptomatic lesions warrant surgical treatment. We present two cases of patients with knee osteochondral defects treated with a one-step surgical procedure consisting of an autologous-based matrix composed of healthy hyaline cartilage chips, mixed plasma poor-rich in platelets clot, and plasma rich in growth factors (PRGF). Both patients returned to playing soccer at the preinjury activity level and demonstrated excellent defect filling in both magnetic resonance imaging and second-look arthroscopy (in one of them). The use of a clot of autologous plasma poor in platelets with healthy hyaline cartilage chips and intra-articular injection of plasma rich in platelets is an effective, easy, and cheap option to treat knee cartilage injuries in young and athletic patients.

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Section: Discussionmentioning

confidence: 99%

Treatment of Knee Osteochondral Lesions Using a Novel Clot of Autologous Plasma Rich in Growth Factors Mixed with Healthy Hyaline Cartilage Chips and Intra-Articular Injection of PRGF

Cugat¹,

Alentorn-Geli²,

Steinbacher

et al. 2017

Case Reports in Orthopedics

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“…Osteochondral autograft transfer delivers viable, mature hyaline cartilage-bone units into chondral defects. These osteochondral grafts can bear load in the early postoperative period, enabling faster rehabilitation than following other, currently available, cell-based cartilage repair strategies 26 . Osteochondral autograft transfer involves the harvesting of 'plugs' from regions of the distal femur that bear low loads (such as the intercondylar notch or medial or lateral trochlea) and, therefore, its use is reserved for small chondral defects (<2 cm 2 ) owing to limited graft availability 27 .…”

Section: Current Surgical Strategies Repairing Articular Cartilage Dementioning

confidence: 99%

“…Both osteochondral autograft transfer and osteochondral allograft transplantation have produced high rates of long-term graft survival, as well as high degrees of reported patient satisfaction and return-to-play among athletes 26,[33][34][35] . For example, a 2016 systematic review found that ~90% of patients who underwent osteochondral autograft transfer had good or excellent outcomes at up to 10 years after surgery 19 .…”

Section: Current Surgical Strategies Repairing Articular Cartilage Dementioning

confidence: 99%

Surgical and tissue engineering strategies for articular cartilage and meniscus repair

et al. 2019

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Injuries to articular cartilage and menisci can lead to cartilage degeneration that ultimately results in arthritis. Different forms of arthritis affect ~50 million people in the USA alone, and it is therefore crucial to identify methods that will halt or slow the progression to arthritis, starting with the initiating events of cartilage and meniscus defects. The surgical approaches in current use have a limited capacity for tissue regeneration and yield only short-term relief of symptoms. Tissue engineering approaches are emerging as alternatives to current surgical methods for cartilage and meniscus repair. Several cell-based and tissue-engineered products are currently in clinical trials for cartilage lesions and meniscal tears, opening new avenues for cartilage and meniscus regeneration. This Review provides a summary of surgical techniques, including tissue-engineered products, that are currently in clinical use, as well as a discussion of state-of-the-art tissue engineering strategies and technologies that are being developed for use in articular cartilage and meniscus repair and regeneration. The obstacles to clinical translation of these strategies are also included to inform the development of innovative tissue engineering approaches.

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“…16,17 However, patients treated for ACI have a higher proportion of PF lesions compared with other treatments, such as osteochondral allograft (OCA), microfracture (MFx), and osteochondral autograft tranfer (OAT). 16,18 Conversely, patients with PF cartilage lesions also more commonly undergo ACI instead of other treatments, such as OCA, MFx, and OAT, compared with patients with lesions in the femoral condyle. 19,20 A few factors contribute to this finding.…”

Section: Evaluation Of Outcomes and Long-term Recommendationsmentioning

confidence: 99%

Patellofemoral Cartilage Restoration: Indications, Techniques, and Outcomes of Autologous Chondrocytes Implantation, Matrix-Induced Chondrocyte Implantation, and Particulated Juvenile Allograft Cartilage

Hinckel

Gomoll

2017

J Knee Surg

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Focal chondral defects are common in the patellofemoral (PF) joint and can significantly impair the quality of life. The autologous chondrocytes implantation (ACI) technique has evolved over the past 20 years: the first-generation technique involves the use of a periosteal patch, the second-generation technique (collagen-cover) uses a type I/III collagen membrane, and the newest third-generation technique seeds and cultivates the collagen membrane with chondrocytes prior to implantation and is referred to as matrix-induced autologous chondrocyte implantation. Particulated juvenile allograft cartilage (PJAC) (DeNovo NT) is minced cartilage allograft from juvenile donors. A thorough physical exam is important, especially for issues affecting the PF joint, to isolate the location and source of pain, and to identify associated pathologies. Imaging studies allow further characterization of the lesions and identification of associated pathologies and alignment. Conservative management should be exhausted before proceeding with surgical treatment. Steps of surgical treatment are diagnostic arthroscopy and biopsy, chondrocytes culture and chondrocyte implantation for the three generations of ACI, and diagnostic arthroscopy and implantation for PJAC. The techniques and their outcomes will be discussed in this article.

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Return to sport after the surgical management of articular cartilage lesions in the knee: a meta-analysis

Abstract: IV.

Cited by 170 publications

References 73 publications

Treatment of Knee Osteochondral Lesions Using a Novel Clot of Autologous Plasma Rich in Growth Factors Mixed with Healthy Hyaline Cartilage Chips and Intra-Articular Injection of PRGF

Treatment of Knee Osteochondral Lesions Using a Novel Clot of Autologous Plasma Rich in Growth Factors Mixed with Healthy Hyaline Cartilage Chips and Intra-Articular Injection of PRGF

Surgical and tissue engineering strategies for articular cartilage and meniscus repair

Patellofemoral Cartilage Restoration: Indications, Techniques, and Outcomes of Autologous Chondrocytes Implantation, Matrix-Induced Chondrocyte Implantation, and Particulated Juvenile Allograft Cartilage

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