The subchondral bone in articular cartilage repair: current problems in the surgical management

被引：280

作者：

Gomoll, Andreas H. ^{[1
]}

Madry, Henning ^{[2
,3
]}

Knutsen, Gunnar ^{[5
]}

van Dijk, Niek ^{[4
]}

Seil, Romain ^{[6
]}

Brittberg, Mats ^{[7
]}

Kon, Elizaveta ^{[8
]}

机构：

[1] Harvard Univ, Sch Med, Brigham & Womens Hosp, Dept Orthopaed Surg, Chestnut Hill, MA 02467 USA

[2] Univ Saarland, Inst Expt Orthopaed, D-66421 Homburg, Germany

[3] Univ Saarland, Med Ctr, Dept Orthopaed Surg, D-66421 Homburg, Germany

[4] Univ Amsterdam, Acad Med Ctr, Dept Orthopaed Surg, NL-1100 Amsterdam, Netherlands

[5] Univ Tromso, Univ Hosp N Norway, Dept Orthopaed Surg, N-9038 Tromso, Norway

[6] Ctr Hosp Luxembourg, Clin Eich 78, Ctr Appareil Locomoteur Med Sport & Prevent, Serv Chirurg Orthoped, L-1460 Luxembourg, Luxembourg

[7] Univ Gothenburg, Kungsbacka Hosp, Cartilage Res Unit, Dept Orthopaed, S-43480 Kungsbacka, Sweden

[8] Ist Ortoped Rizzoli, Lab Biomeccan, I-40136 Bologna, Italy

来源：

KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY | 2010年 / 18卷 / 04期

关键词：

Cartilage repair; Autologous chondrocyte implantation; Microfracture; Subchondral bone; AUTOLOGOUS CHONDROCYTE IMPLANTATION; FRESH OSTEOCHONDRAL ALLOGRAFTS; THICKNESS CHONDRAL DEFECTS; MEDIAL MENISCECTOMY; MARROW STIMULATION; MINERAL DENSITY; FEMORAL CONDYLE; PROXIMAL TIBIA; MENISCAL TEARS; HUMAN KNEE;

D O I：

10.1007/s00167-010-1072-x

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

As the understanding of interactions between articular cartilage and subchondral bone continues to evolve, increased attention is being directed at treatment options for the entire osteochondral unit, rather than focusing on the articular surface only. It is becoming apparent that without support from an intact subchondral bed, any treatment of the surface chondral lesion is likely to fail. This article reviews issues affecting the entire osteochondral unit, such as subchondral changes after marrow-stimulation techniques and meniscectomy or large osteochondral defects created by prosthetic resurfacing techniques. Also discussed are surgical techniques designed to address these issues, including the use of osteochondral allografts, autologous bone grafting, next generation cell-based implants, as well as strategies after failed subchondral repair and problems specific to the ankle joint. Lastly, since this area remains in constant evolution, the requirements for prospective studies needed to evaluate these emerging technologies will be reviewed.

引用

页码：434 / 447

页数：14

共 85 条

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