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

被引：0
作者：
Andreas H. Gomoll
Henning Madry
Gunnar Knutsen
Niek van Dijk
Romain Seil
Mats Brittberg
Elizaveta Kon
机构：
[1] Harvard Medical School,Department of Orthopaedic Surgery, Brigham and Women’s Hospital
[2] Saarland University Medical Center,Institute for Experimental Orthopaedics, Saarland University and Department of Orthopaedic Surgery
[3] University of Amsterdam,Department of Orthopaedic Surgery, Academic Medical Center
[4] University of Tromsø,Department of Orthopaedic Surgery
[5] University Hospital North Norway,Service de Chirurgie Orthopédique, Centre de L’ Appareil Locomoteur de Médecine du Sport et de Prévention
[6] Centre Hospitalier de Luxembourg-Clinique d’Eich 78,Department of Orthopaedics, Kungsbacka Hospital, Cartilage Research Unit
[7] University of Gothenburg,Laboratorio di Biomeccanica
[8] Istituti Ortopedici Rizzoli,undefined
来源：
Knee Surgery, Sports Traumatology, Arthroscopy | 2010年 / 18卷
关键词：
Cartilage repair; Autologous chondrocyte implantation; Microfracture; Subchondral bone;
D O I：
暂无
中图分类号：
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
收藏
页码：434 / 447
页数：13
相关论文
共 360 条
  • [1] Ahn H(2009)An evidence-based approach to the adoption of new technology J Bone Joint Surg Am 91 95-98
  • [2] Bhandari M(1986)An analysis of the stresses in a thin layer of articular cartilage in a synovial joint Eng Med 15 55-61
  • [3] Schemitsch EH(1998)Impact-induced fissuring of articular cartilage: an investigation of failure criteria J Biomech Eng 120 181-187
  • [4] Armstrong CG(1986)Meniscal tears: the effect of meniscectomy and of repair on intraarticular contact areas and stress in the human knee. A preliminary report Am J Sports Med 14 270-275
  • [5] Atkinson TS(2003)The clinical importance of meniscal tears demonstrated by magnetic resonance imaging in osteoarthritis of the knee J Bone Joint Surg Am 85A 4-9
  • [6] Haut RC(2009)Do steroids, conventional non-steroidal anti-inflammatory drugs and selective Cox-2 inhibitors adversely affect fracture healing? J Musculoskelet Neuronal Interact 9 44-52
  • [7] Altiero NJ(2006)Yet more evidence that osteoarthritis is not a cartilage disease Ann Rheum Dis 65 1261-1264
  • [8] Baratz ME(2008)Autologous chondrocyte implantation–technique and long-term follow-up Injury 39 S40-S49
  • [9] Fu FH(1994)Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation N Engl J Med 331 889-895
  • [10] Mengato R(2008)Mega-OATS technique–autologous osteochondral transplantation as a salvage procedure for large osteochondral defects of the femoral condyle Oper Orthop Traumatol 20 188-198
12345678910