Juvenile osteochondritis dissecans: is it a growth disturbance of the secondary physis of the epiphysis? The next generation ACI-c (collagen-covered) technique was developed to reduce the reoperation rate because of hypertrophy of the periosteal patch used to cover the defect. Author information: (1)Sport Medicine and Knee Research Center, Milad Hospital, Tehran, Iran. What are the options for treating a chondral defect of the knee caused by sports trauma? Within the ankle, these lesions often occur on the talus, which is the bone that joins the foot and the leg together. In conclusion, treatment of early knee osteoarthritis and chondral lesions is still a challenging problem. Before the development of modern bioengineering techniques, orthopedists were restricted to procedures that aimed to palliate the effects of chondral lesions or attempted to stimulate a healing response initiated from the subchondral bone resulting in the formation of fibrocartilage to fill the defect. 2013;41(3):528-34. Yoshimura I, Kanazawa K, Takeyama A, et al. Treatment strategies for osteochondral defects (OCDs) of the ankle have substantially increased over the last decade. An osteochondral lesion may also be known as an osteochondral defect. This joint permits much of the up (dorsiflexion) and down (plantarflexion) motion of the foot and ankle. Osteochondral autografting is limited by the amount of cartilage that can be harvested without violating the weight-bearing articular surface.8 The main advantage lies in its autogenicity, avoidance of disease transmission, immediate graft availability through harvesting of the patient’s own tissue, and decreased cost of this single-stage procedure. 1 The knee joint is perhaps one of the busiest joints in the body as it bears most of the body weight when standing. Table 96-1 provides an overview of cartilage repair studies. Surgical Treatment Options for Osteochondritis Dissecans of the Knee Cecilia Pascual Garrido, MD, Allison G. McNickle, MS, and Brian J. Cole, MD* Osteochondritis dissecans of the knee is identified with increasing frequency in the young adult patient. Currently, to our knowledge, there are no data regarding which MRI features may predict improved outcomes in these patients. Marrow stimulation techniques (MST), such as abrasion arthroplasty, drilling, and microfracture, attempt to induce a reparative response by perforation of the subchondral bone after radical debridement of damaged cartilage and removal of the tide mark “calcified” zone to enhance the integration of repair tissue. This special focus section will discuss the diagnosis and treatment options for traumatic osteochondral knee injuries, including the subset secondary to juvenile OCD lesions. Damage to the articular cartilage comprises a spectrum of disease entities ranging from single, focal chondral defects to more advanced degenerative disease. Should Patella Be Resurfaced in Total Knee Replacement? ACI, autologous chondrocyte implantation; ACI-c collagen-covered autologous chondrocyte implantation; BMI, body mass index; MACI, membrane-associated autologous chondrocyte implantation. The surgeon removes a circular plug of healthy cartilage from an outside donor. Treatment options for diffuse PVNS can be arthroscopic excision, open synovectomy, combined arthroscopic and open synovectomy, with or without adjuvant radiotherapy. Depth: the depth of a defect is a consideration in selection of treatment, and if there is underlying bone loss beneath the cartilage defect then this may need to be restored. TOM. Much of this bone is covered with cartilage. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. What Is the Best Treatment for End-Stage Hallux Rigidus? Microfracture treatment results in better outcomes in younger patients (<30–40 years old). Regardless, each osteochondritis dissecans lesion must be followed until osseous integration is confirmed by imaging -otherwise, progression of disease to osteoarthritis is likely.” Osteochondral allograft transplantation uses cartilage from outside the patient, usually from a cadaver. Because of the relatively high cost of ACI and the knee morbidity seen in OATS, we conclude that BMS is the treatment of choice for primary osteochondral talar lesions. Am J Sports Med. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. Articular cartilage is a avascular, aneural and alymphatic tissue that covers the articular ends of bones. Although wearing a brace or cast may ease the discomfort of an osteochondral lesion, they are usually not enough to remedy the problem permanently, except in children, who can respond well to … CONCLUSION: Osteochondral allograft transplantation is a useful salvage treatment option for reciprocal bipolar cartilage lesions of the knee. TREATMENT OPTIONS FOR JUVENILE OSTEOCHONDRAL KNEE DEFECTS D Crisan 1,2, D Vermesan 1,2, R Prejbeanu 1,2, S Nitescu 2, C Bogdan 2 Abstract Articular cartilage is a avascular, aneural and alymphatic tissue that covers the articular ends of bones. Therapy The conservative treatment of OCLs of the talus is limited for stages I and II only. Initial treatment and self care. Treatment may include activity modification, drilling, fixation, or osteochondral replacement of osteochondritis dissecans lesions in the knee. This was achieved by substitution of periosteum with a collagen membrane, frequently consisting of a porcine type-I/III collagen bilayer membrane. The resultant blood clot, and the primitive mesenchymal cells contained within, may differentiate into a fibrocartilaginous repair tissue that fills the defect. Treatment. Five surgical procedures to manage OCD lesions in the knee. If you've injured your joint and your symptoms are not too severe – for example, you're still able to put weight on and move the joint – you can often look after yourself using PRICE therapy. The field of cartilage repair is a recent development within orthopedic surgery with techniques that continue to evolve. 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