Significant articular cartilage incongruity often causes mechanical joint dysfunction and eventual cartilage deterioration, resulting in osteoarthritis. Articular cartilage lesions are common and have been reported in 63% of over 31,000 arthroscopic procedures in one series.1 Although 20% have been… The purpose of this article is to give an overview of the treatment options available for osteochondral defects in the knee and to propose a treatment algorithm based on the senior author's (WGC) experience. A preliminary report. Commonly, multiple cylinders have to be transplanted to fill larger defects. Treatment of osteochondral injuries and osteochondritis dissecans (OCD) is quite controversial and has received recent attention in the literature. For small-sized defects with intact cartilage, our treatment of choice is Retrograde Drilling of the lesion and filling it with a special bone cement. 18 Acute Osteochondral Defects in the Knee JOHN G. COSTOUROS, MARC R. SAFRAN, AND GREGORY B. MALETIS Despite surgical and technologic advancements, the treatment of osteochondral defects continues to challenge orthopaedic surgeons. https://doi.org/10.1016/S0278-5919(05)70309-4. The transplantation of autologous hyaline cartilage plugs results in a hyaline cartilage base with fibrocartilage “grout.”40 Mosaicplasty is designed for the treatment of focal chondral and osteochondral defects of the knee in patients under 45 years of age. Treatment options to restore joint congruity vary widely from nonoperative closed treatment to arthroscopic drilling, with or without fixation, to tissue transplantation or reconstructive procedures. We use cookies to help provide and enhance our service and tailor content and ads. 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 non-surgical treatment. Background: Mosaicplasty and fresh osteochondral allograft transplantation (OCA) are popular cartilage restoration techniques that involve the single-stage implantation of viable, mature hyaline cartilage-bone dowels into chondral lesions of the knee. Trauma, osteochondritis dissecans, osteonecrosis, osteochondroses, and hereditary epiphyseal abnormalities can cause osteochondral lesions in the knee joint.25, 61, 62, 72 When an osteochondral defect persists in a weightbearing portion of the knee joint, degenerative arthritis of that compartment can result. Pathology ranges from the young child with open physes and an OCD lesion, to the middle-aged athlete with an osteochondral fracture secondary to trauma. METHODS: A literature... Read Summary Treatment options to restore joint congruity vary widely from nonoperative closed treatment to arthroscopic drilling, with or without fixation, to tissue transplantation or reconstructive procedures. 2009;7(2 Pt 1):245-7. For instance, if the anterior cruciate ligament were to rupture, the tibia can slide forward (subluxate) and impact the femoral condyle (a so-called kissing contusion). Am J Sports Med (2014). Treatment of osteochondral defects in the knee with MaioRegen Mr Andrew Edwards. Chondral and osteochondral defects in the PF compartment are often encountered in clinical practice on advanced imaging studies and/or during arthroscopy. A. Autologous chondrocyte transplantation (ACT or ACI) to treat cartilaginous defects of the knee is considered medically necessary when all of the following criteria are met: 1. By continuing you agree to the use of cookies. The advantage of this treatment is that the patient's own cartilage is used to repair the damaged area. The defect has been unsuccessful 2 Sports Traumatol Arthrosc 5 ( 4 ):262–267 Terminology replaced normal! Treatment of osteochondral articular cartilage in the literature B.V. or its licensors or contributors surface of Esska... 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