Does it clinically matter if an elevated osteochondral allograft plug is leveled and partially resected?

Resection-Induced Leveling of Elevated Plug Cartilage in Osteochondral Autologous Transplantation of the Knee Achieves Acceptable Clinical Results.

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/29161095

http://journals.sagepub.com/doi/abs/10.1177/0363546517739614?journalCode=ajsb

De:

Article Information

Volume: 46 issue: 3, page(s): 617-622

Article first published online: November 21, 2017; Issue published: March 1, 2018

https://doi.org/10.1177/0363546517739614

Kohei Nishitani, MD, PhD*^,†, Yasuaki Nakagawa, MD, PhD‡, Shinichiro Nakamura, MD, PhD†, Shogo Mukai, MD, PhD‡, Shinichi Kuriyama, MD, PhD†, Shuichi Matsuda, MD, PhD†

†Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan

‡Department of Orthopaedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan

Abstract

BACKGROUND:

Plug protuberance occasionally occurs in osteochondral autologous transplantation (OAT). The incongruity of plugs results in poor clinical outcomes, especially in cases of protuberance. However, a surgical procedure to deal with this problem has not been reported. Purpose/Hypothesis: The purpose was to evaluate the efficacy and safety of cartilage resection of elevated plugs, with the hypothesis that patients whose elevated plugs were resected and leveled would achieve clinical outcomes equivalent to those of patients with flush plugs.

CONCLUSION:

Resection of the elevated plug surface did not negatively affect patient outcomes in the midterm follow-up period.

KEYWORDS:

cartilage; knee; osteochondral autologous transplantation; surgical technique

Resumen

ANTECEDENTES:

La protuberancia del tapón se produce ocasionalmente en el trasplante autólogo osteocondral (OAT). La incongruencia de los tapones tiene resultados clínicos pobres, especialmente en casos de protuberancia. Sin embargo, no se informó un procedimiento quirúrgico para tratar este problema. Propósito / Hipótesis: El propósito fue evaluar la eficacia y la seguridad de la resección del cartílago de los tapones elevados, con la hipótesis de que los pacientes cuyos tapones elevados fueron resecados y nivelados alcanzarían resultados clínicos equivalentes a los de los pacientes con tapones rasantes.

CONCLUSIÓN:

La resección de la superficie elevada del tapón no afectó negativamente los resultados del paciente en el período de seguimiento de medio término.

PALABRAS CLAVE:

cartílago; rodilla; trasplante autólogo osteocondral; técnica quirúrgica

PMID: 29161095 DOI: 10.1177/0363546517739614

Clinical and Radiological Regeneration of Large and Deep Osteochondral Defects of the Knee by Bone Augmentation Combined With Matrix-Guided Autologous Chondrocyte Transplantation.

Fuente

Este artículo es publicado originalmente en:

https://www.ncbi.nlm.nih.gov/pubmed/28777662

http://journals.sagepub.com/doi/10.1177/0363546517717679

De:

Zellner J¹, Grechenig S¹, Pfeifer CG¹, Krutsch W¹, Koch M¹, Welsch G², Scherl M¹, Seitz J³, Zeman F⁴, Nerlich M¹, Angele P^1,⁵.

Am J Sports Med. 2017 Aug 1:363546517717679. doi: 10.1177/0363546517717679. [Epub ahead of print]

Copyright © 2017 by American Orthopaedic Society for Sports Medicine

Abstract

BACKGROUND:

Large osteochondral defects of the knee are a challenge for regenerative treatment. While matrix-guided autologous chondrocyte transplantation (MACT) represents a successful treatment for chondral defects, the treatment potential in combination with bone grafting by cancellous bone or bone block augmentation for large and deep osteochondral defects has not been evaluated.

PURPOSE:

To evaluate 1- to 3-year clinical outcomes and radiological results on magnetic resonance imaging (MRI) after the treatment of large osteochondral defects of the knee with bone augmentation and MACT. Special emphasis is placed on different methods of bone grafting (cancellous bone grafting or bone block augmentation).

CONCLUSION:

Large and deep osteochondral defects of the knee joint can be treated successfully with bone augmentation and MACT. The treatment of shallow bony defects with cancellous bone grafting and deep bony defects with bone block augmentation shows promising results.

KEYWORDS:

bone block augmentation; cancellous bone grafting; matrix-guided autologous chondrocyte transplantation (MACT); osteochondral defects

Resumen

ANTECEDENTES:

Los grandes defectos osteocondrales de la rodilla son un desafío para el tratamiento regenerativo. Mientras que el trasplante de condrocitos autólogos guiado por matriz (MACT) representa un tratamiento exitoso para defectos condrales, no se ha evaluado el potencial de tratamiento en combinación con injerto óseo por hueso esponjoso o aumento de bloqueo óseo para defectos osteocondrales grandes y profundos.

PROPÓSITO:
Evaluar resultados clínicos de 1 a 3 años y resultados radiológicos en resonancia magnética (RM) después del tratamiento de grandes defectos osteocondrales de la rodilla con aumento óseo y MACT. <span title=»Special emphasis is placed on different methods of bone grafting (cancellous bone grafting or bone block augmentation).

«>Se hace especial hincapié en los diferentes métodos de injerto óseo (injerto óseo esponjoso o aumento del bloque óseo).

CONCLUSIÓN:
Los defectos osteocondrales grandes y profundos de la articulación de la rodilla pueden tratarse con éxito con el aumento óseo y MACT. El tratamiento de los defectos óseos poco profundos con injerto de hueso esponjoso y defectos óseos profundos con aumento de bloqueo óseo muestra resultados prometedores.

PALABRAS CLAVE:
Aumento de bloqueo óseo; Injerto óseo esponjoso; Trasplante autólogo de condrocitos guiado por matriz (MACT); Defectos osteocondrales

PMID: 28777662 DOI: 10.1177/0363546517717679

¿Importa clínicamente si un aloinjerto osteocondral elevado se nivela y se reseca parcialmente?

Does it clinically matter if an elevated osteochondral allograft plug is leveled and partially resected?

Resection-Induced Leveling of Elevated Plug Cartilage in Osteochondral Autologous Transplantation of the Knee Achieves Acceptable Clinical Results.

https://www.ncbi.nlm.nih.gov/pubmed/29161095

http://journals.sagepub.com/doi/abs/10.1177/0363546517739614?journalCode=ajsb

Article Information

Abstract

BACKGROUND:

CONCLUSION:

KEYWORDS:

Resumen

ANTECEDENTES:

CONCLUSIÓN:

PALABRAS CLAVE:

Regeneración Clínica y Radiológica de Defectos Osteocondrales Grandes y Profundos de la Rodilla por Aumento de Hueso Combinado con Trasplante de Condrocitos Autólogos Guiados por Matriz

Clinical and Radiological Regeneration of Large and Deep Osteochondral Defects of the Knee by Bone Augmentation Combined With Matrix-Guided Autologous Chondrocyte Transplantation.

https://www.ncbi.nlm.nih.gov/pubmed/28777662

http://journals.sagepub.com/doi/10.1177/0363546517717679

Zellner J¹, Grechenig S¹, Pfeifer CG¹, Krutsch W¹, Koch M¹, Welsch G², Scherl M¹, Seitz J³, Zeman F⁴, Nerlich M¹, Angele P^1,⁵.

Am J Sports Med. 2017 Aug 1:363546517717679. doi: 10.1177/0363546517717679. [Epub ahead of print]

Copyright © 2017 by American Orthopaedic Society for Sports Medicine

Abstract

BACKGROUND:

PURPOSE:

CONCLUSION:

KEYWORDS:

Does it clinically matter if an elevated osteochondral allograft plug is leveled and partially resected?

Resection-Induced Leveling of Elevated Plug Cartilage in Osteochondral Autologous Transplantation of the Knee Achieves Acceptable Clinical Results.

https://www.ncbi.nlm.nih.gov/pubmed/29161095

http://journals.sagepub.com/doi/abs/10.1177/0363546517739614?journalCode=ajsb

Article Information

Abstract

BACKGROUND:

CONCLUSION:

KEYWORDS:

Resumen

ANTECEDENTES:

CONCLUSIÓN:

PALABRAS CLAVE:

Clinical and Radiological Regeneration of Large and Deep Osteochondral Defects of the Knee by Bone Augmentation Combined With Matrix-Guided Autologous Chondrocyte Transplantation.

https://www.ncbi.nlm.nih.gov/pubmed/28777662

http://journals.sagepub.com/doi/10.1177/0363546517717679

Zellner J1, Grechenig S1, Pfeifer CG1, Krutsch W1, Koch M1, Welsch G2, Scherl M1, Seitz J3, Zeman F4, Nerlich M1, Angele P1,5.

Am J Sports Med. 2017 Aug 1:363546517717679. doi: 10.1177/0363546517717679. [Epub ahead of print]

Copyright © 2017 by American Orthopaedic Society for Sports Medicine

Abstract

BACKGROUND:

PURPOSE:

CONCLUSION:

KEYWORDS:

Zellner J¹, Grechenig S¹, Pfeifer CG¹, Krutsch W¹, Koch M¹, Welsch G², Scherl M¹, Seitz J³, Zeman F⁴, Nerlich M¹, Angele P^1,⁵.