3 years ago

Berkson Managment Cartilage3 (2) [Compatibility Mode].pdf

Berkson Managment Cartilage3 (2) [Compatibility Mode].pdf


Radiographic Evaluation• Patellar skyline (Merchant)• PA Weightbearing 45 degree flexion• MRI• Arthroscopic evaluationMGH Sports MedicineTypes of Cartilage Repair1) Bone-marrow stimulation– abrasion, drilling, microfracture2) Transplantation of osteochondralgrafts– OATS, mosaicplasty, allografts3) Implantation of autologous cells(chondrocytes)– ACI4) Matrices / scaffolds– +/- cells, +/- growth factorsMGH Sports MedicinePrerequisites for Healing of Articular Cartilage1) Source of cells2) Provision of a matrix3) Removal stressconcentration4) Intact subchondral plate5) Mechanical stimulationMGH Sports Medicine4

Marrow Stimulation Techniques• Goal- initiate bleeding• in the hope of forming fibrocartilagenous scar• Goal blood = Fibrin clot = primitiveundifferentiated mesenchymal stem cellsFibrocartilage• non hyaline repair tissue resultsMGH Sports MedicineMarrow-Stimulating Techniques• Abrasion Arthroplasty– Remove 1-2mm of sclerotic bonedown to vasculature ofsubchondral plate– Fibrin clot fibrocartilage– Debridement vs. Abrasionarthroplasty 1• 33% worse HSS score than beforesurgey– Technique sensitive– Not recommended1 Bert Arthroscopy 1999MGH Sports MedicineMicrofracture• Improvement uponabrasion• Subchondral architectureleft intact except areasbroached with small metalpicks• Fibrin clot = FibrocartilageMicrofractureAAOS ICLS p 47MGH Sports Medicine5

Ali Elhaj (2) [Compatibility Mode].pdf
Harris Group Managing Retrofits.ppt [Compatibility Mode] - NWCCC
Mohamed Hamandi [Compatibility Mode].pdf
Fruit of GRACE2 2 [Compatibility Mode]
Replacement rates - english (2) [Compatibility Mode] - Netspar
ORANGE [Compatibility Mode].pdf - CMAI
Integ50 MedII_KSA3 [Compatibility Mode].pdf
21-IntroductionMetamorphism [Compatibility Mode].pdf
130116 Macro Economics Upate [Compatibility Mode].pdf
AMMS AMRE-JK [Compatibility Mode].pdf -
maxillary_anteriors_2012 [Compatibility Mode].pdf
[Compatibility Mode].pdf
2 - KNGF Guideline PT in COPD [Compatibility Mode].pdf
Fiona Killilea [Compatibility Mode] -
Mackenzie Swallowing (2) [Read-Only] [Compatibility Mode]
24-MetamorphicStableAssemblages [Compatibility Mode].pdf