Articular cartilage repair using autologous collagen-induced chondrogenesis (ACIC): a pragmatic and cost-effective enhancement of a traditional technique

AbstractPurposeThe autologous collagen-induced chondrogenesis technique is described, and the results of a 6-year follow-up clinical study using this technique are presented.Methods30 patients with International Cartilage Repair Society (ICRS) Grade III/IVa symptomatic chondral defects of the knee treated with enhanced microdrilling using atelocollagen were prospectively examined in this clinical series. The median age of the patients was 39.0  years (range 19–61 years). Patients were followed up to 72 months. Clinical evaluation was performed using functional knee scores and radiologically. Both quantitative and qualitative assessments were performed.ResultsStatistically significant and clinically relevant improvement was observed in 2  years and was sustained for the 6 years of the study observation. At 6 years, the mean Lysholm score was 79.7 (SD 6.8) compared to 52.6 (SD 10.7) pre-operatively (p
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research

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DiscussionThe consensus was generated to present the best possible recommendations for the treatment of traumatic meniscus tears and provides some groundwork for a clinical decision-making process regarding the treatment of meniscus tears. Preservation of the meniscus should be the first line of treatment when possible, because the clinical and radiological long-term outcomes are worse after partial meniscectomy than after meniscus preservation. The consensus clearly states that numerous meniscus tears that were considered irreparable should be repaired, e.g., older tears, tears in obese patients, long tears, etc.Level of evidenceII
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
ConclusionThe progression of post-traumatic chondral damage may occur at a faster rate in patients who require ACL reconstruction and meniscal repair than in patients with intact menisci.
Source: Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology - Category: Sports Medicine Source Type: research
Meniscal root tears function as a complete meniscectomy, with loss of hoop stress due to the detachment of the meniscus. Root tears have been increasingly recognized recently with improvements in diagnostic imaging and the understanding of meniscal biomechanics. Patients have a high rate of progression of osteoarthritis and subsequent knee replacement after a meniscal root tear. Recent advances in repair techniques, arthroscopic instrumentation, and biological augmentation strategies continue to offer surgeons ways to manage historically “irreparable” meniscal tears.
Source: Arthroscopy - Journal of Arthroscopic and Related Surgery - Category: Surgery Authors: Tags: Editorial Commentary Source Type: research
J Knee Surg DOI: 10.1055/s-0039-1700978To improve the long-term outcomes of high tibial osteotomy (HTO) for gonarthritis, many cartilage repair procedures appeared, but their effects were controversial. To evaluate the efficacy of cartilage repair procedures during HTO for gonarthritis, we performed this update meta-analysis. We performed the system retrieval for clinical trials using various databases and then pooled the outcomes of the included studies. Fifteen studies were involved. The pooled results indicated that there were no significant differences in Kellgren and Lawrence (KL) scale (mean difference [MD] =&...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research
Publication date: Available online 31 December 2019Source: Arthroscopy TechniquesAuthor(s): Sophia Sarang Shin Yin, Angelica Marie Remigio van Gogh, Gun Min Youn, Alyssa Alvarez, Moyukh O. Chakrabarti, Patrick J. McGahan, James L. ChenAbstractRadial tears increase tibiofemoral contact pressure and disrupt the ability of the meniscus to withstand hoop stress, leading to earlier-onset osteoarthritis. Repair of radial tears is problematic because they have a lower healing rate and lack a single gold standard technique. However, when a radial tear is proximal to the root, there is an opportunity to convert it into a root tear....
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
Publication date: December 2019Source: Arthroscopy Techniques, Volume 8, Issue 12Author(s): Alberto Gobbi, Katarzyna Herman, Radosław Grabowski, Dawid SzwedowskiAbstractIt is well known that the anterior cruciate ligament (ACL) is the main stabilizer to the anterior tibial translation in the knee. The current gold standard of treatment for such lesions is ACL reconstruction. However, there are notable disadvantages to ACL reconstruction that include loss of proprioception, donor site morbidity, incomplete return to high-demand sports, and the inability to restore normal kinematics of the knee joint. Additionally, in adole...
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
To compare the preoperative and 1- and 2-year postoperative Knee injury and Osteoarthritis Outcome Score (KOOS) subscale scores between isolated anterior cruciate ligament reconstruction (ACLR) and ACLR with additional medial meniscus (MM) and/or lateral meniscus (LM) resection or repair.
Source: Arthroscopy - Journal of Arthroscopic and Related Surgery - Category: Surgery Authors: Source Type: research
To compare the preoperative and 1- and 2-year postoperative Knee Injury and Osteoarthritis Outcome Score (KOOS) subscale scores between isolated anterior cruciate ligament reconstruction (ACLR) and ACLR with additional medial meniscus (MM) and/or lateral meniscus (LM) resection or repair.
Source: Arthroscopy - Journal of Arthroscopic and Related Surgery - Category: Surgery Authors: Tags: Original Article Source Type: research
AbstractPurposeThe purpose of this study was to evaluate the clinical outcomes and meniscus healing after arthroscopic repair of horizontal-cleavage meniscus tears, compared with vertical-longitudinal meniscus tears.MethodsThis was a retrospective review of a consecutive series of 52 meniscal repairs for horizontal-cleavage tears (n = 27) or vertical-longitudinal tears (n = 25); the groups were compared with respect to clinical symptoms and meniscal healing. Arthroscopic meniscal repair was performed using the inside-out technique with a marrow-stimulating technique. Clinical symptoms were evalu...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
Publication date: Available online 16 November 2019Source: Orthopaedics &Traumatology: Surgery &ResearchAuthor(s): Christophe Mathoulin, Mathilde GrasAbstractScapholunate ligament tear is most frequently encountered in the aftermath of trauma in supination and extension of the wrist. It generates chronic instability, leading to osteoarthritis. It may be associated with fracture of the distal epiphysis of the radius or of the scaphoid. These lesions are often difficult to diagnose, especially in early stages. Treatment of chronic scapholunate ligament lesions before onset of osteoarthritis is a challenge for the sur...
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
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