Updating on Diagnosis and Treatment of Chondral Lesion of the Knee

Cavalcanti, Filho Marcantonio Machado da Cunha; Doca, Daniel; Cohen, Moisés; Ferretti, Mário

doi:10.1016/s2255-4971(15)30339-6

Cited by 19 publications

(29 citation statements)

References 54 publications

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“…The increasing incidence of osteo-degenerative and chondro-degenerative diseases due to different factors has arisen as a major problem prompting efforts in developing more efficient strategies to face these pathologies [40][41][42]. To address this problem, we developed a novel 3D bioengineered biocomposite as a regenerative tool to treat chondrogenic defects.…”

Section: Discussionmentioning

confidence: 99%

Development of a Three-Dimensional Bioengineered Platform for Articular Cartilage Regeneration

et al. 2019

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Degenerative cartilage pathologies are nowadays a major problem for the world population. Factors such as age, genetics or obesity can predispose people to suffer from articular cartilage degeneration, which involves severe pain, loss of mobility and consequently, a loss of quality of life. Current strategies in medicine are focused on the partial or total replacement of affected joints, physiotherapy and analgesics that do not address the underlying pathology. In an attempt to find an alternative therapy to restore or repair articular cartilage functions, the use of bioengineered tissues is proposed. In this study we present a three-dimensional (3D) bioengineered platform combining a 3D printed polycaprolactone (PCL) macrostructure with RAD16-I, a soft nanofibrous self-assembling peptide, as a suitable microenvironment for human mesenchymal stem cells' (hMSC) proliferation and differentiation into chondrocytes. This 3D bioengineered platform allows for long-term hMSC culture resulting in chondrogenic differentiation and has mechanical properties resembling native articular cartilage. These promising results suggest that this approach could be potentially used in articular cartilage repair and regeneration.

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Section: Discussionmentioning

confidence: 99%

Development of a Three-Dimensional Bioengineered Platform for Articular Cartilage Regeneration

et al. 2019

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“…Articular cartilage plays an important role in absorbing stresses across the knee joint. 2 Unfortunately, due to these stresses, cartilage wear is inevitable. In 2001, it was estimated that 43 million adults in the United States suffered from arthritis.…”

Section: Introductionmentioning

confidence: 99%

“…9 Present-day solutions aim to reduce the wearing down of cartilage and promote cartilage healing. 2 Conservative measures include correcting malalignment issues with knee braces, foot orthotics and special shoes or off-loading the knee with walking sticks and crutches. 10 However, these solutions are usually not an acceptable long-term solution, especially for younger patients.…”

Section: Introductionmentioning

confidence: 99%

Biological resurfacing of grade IV articular cartilage ulcers in knee joint with Hyalofast

Tan

Tho

2020

J Orthop Surg (Hong Kong)

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Introduction: Hyalofast grafting with microfracture is a new minimally invasive treatment method being proposed for joint cartilage defects. This study was done to measure the clinical efficacy of Hyalofast grafting after microfractures. Methods: Forty-six patients were assessed for knee function using knee injury and osteoarthritis outcome score (KOOS) after undergoing microfracture and Hyalofast grafting surgery. We further divided the 46 patients into a group of 10 patients who had no associated procedures done with the microfracture and Hyalofast grafting surgery. All patients had magnetic resonance imaging (MRI) of the affected knee pre-surgery and two patients had MRI done post-surgery. Due to another unrelated injury, we were also able to obtain further arthroscopic findings of another patient’s knee 18 months after microfracture and Hyalofast grafting. Results: There was a statistically significant improvement in all categories of the KOOS (symptoms, pain, daily living, sports and quality of life) compared between years 1, 2 and 3 against pre-surgery. For the subgroup of Hyalofast only, there was a statistically significant improvement in symptoms, pain and daily living categories of the KOOS compared between years 1, 2 and 3 against pre-surgery. Conclusions: Our study shows that Hyalofast grafting after microfracture is a viable alternative to treatment for patients with grade 4 cartilage ulcers.

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“…4 Where there is extensive cartilage degeneration, total or partial joint replacement may be more appropriate. 5,6 The presence of a focal defect in the cartilage surface may cause high contact stresses 7,8 which often leads to tissue damage. Osteochondral grafts implanted flush to the cartilage surface can be used to reconstruct the articulating surface which can restore the contact pressure and area of the natural joint surface.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical assessment of the stability of osteochondral grafts implanted in porcine and bovine femoral condyles

Bowland

Cowie

Ingham

et al. 2019

Proc Inst Mech Eng H

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Osteochondral grafts are used clinically to repair cartilage and bone defects and to restore the congruent articulating surfaces of the knee joint following cartilage damage or injury. The clinical success of such osteochondral grafts is heavily reliant on the biomechanical and tribological properties of the surgical repair; however, a limited number of studies have investigated these factors. The aim of this study was to evaluate the influence of graft harvesting and implantation technique as well as bone properties on the primary stability of press-fit implanted osteochondral grafts using a series of uniaxial experimental push-in and push-out tests. Animal (porcine and bovine) knees were used to deliver models of different bone properties (elastic modulus and yield stress). The study showed the graft harvesting method using either a chisel or drill-aided trephine to have no influence on primary graft stability; however, the preparation technique for the graft recipient site was shown to influence the force required to push the graft into the host tissue. For example, when the length of the graft was equal to the recipient site (bottomed), the graft was more stable and dilation of the recipient site was shown to reduce short-term graft stability especially in immature or less dense bone tissue. The push-out tests which compared tissue of different skeletal maturities demonstrated that the maturity of both the graft and host bone tissue to influence the stability of the graft. A higher force was required to push out more skeletally mature grafts from mature bone tissue. The study demonstrates the importance of surgical technique and bone quality/properties on the primary stability and ultimately, the success of osteochondral grafts in the knee.

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Updating on Diagnosis and Treatment of Chondral Lesion of the Knee

Cited by 19 publications

References 54 publications

Development of a Three-Dimensional Bioengineered Platform for Articular Cartilage Regeneration

Development of a Three-Dimensional Bioengineered Platform for Articular Cartilage Regeneration

Biological resurfacing of grade IV articular cartilage ulcers in knee joint with Hyalofast

Biomechanical assessment of the stability of osteochondral grafts implanted in porcine and bovine femoral condyles

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