Purpose: The aim of this study is the mid-term analysis of osteochondral autograft transplantatio... more Purpose: The aim of this study is the mid-term analysis of osteochondral autograft transplantation for the repair of focal femoral defects. Methods: We present clinical data based on arthroscopic and MRI appearances of 18 patients, from 2 to 6 years postoperatively, which illustrate growing concern about the progressive deterioration of articular cartilage surrounding the OAT graft. It seems that the osteochondral autograft transfer (OAT) can restore the height and the shape of articulating surface in osteochondral defects with composite autologous material that contains hyaline articular cartilage and a firm carrier. However, limited availability of autologous osteochondral grafts, dead spaces between circular grafts, the lack of integration of donor and recipient hyaline cartilage, and different thickness and mechanical properties of donor and recipient hyaline cartilage are frequent sources of clinical concern. Results: Typically, the OAT graft itself maintains its mechanical and...
Aims: We present the results of the PFC Sigma knee replacement at a mean follow-up of 2.75 years ... more Aims: We present the results of the PFC Sigma knee replacement at a mean follow-up of 2.75 years (range: 1 to 6 years). Clinician and radiographic evaluation was carried out using the American Knee Society Clinical Rating and Radiographic Scoring Systems. Patient outcome was assessed using the Oxford-12 and SF-12 health-status questionnaires. Methods: A consecutive series of 293 Total Knee Replacements (TKR) in 247 patients was followed prospectively between September 1996 and September 2002. Our series included 138 females and 109 males with a mean age of 73.2 years. We operated on 214 patients with osteoarthritis, 20 with rheumatoid arthritis, 12 with post-traumatic arthritis and on one patient with erosive arthritis. The patella was resurfaced in 36 knees. 11 patients died during the follow-up period. Results: Subjective patient satisfaction score was based on improvement in pain and functional status. It was marked as excellent in 183 knees, good in 75, fair in 26 and poor in 9....
It is well known that the capacity of articular cartilage for repair is limited. There have been ... more It is well known that the capacity of articular cartilage for repair is limited. There have been many attempts to address this problem. However, treatment options are limited and the long-term outcome is uncertain. This article will focus on the osteochondral autograft transplantation (OAT), which is currently the only surgical cartilage repair technique that provides and retains proper hyaline articular cartilage. Osteochondral autograft transplants have been associated with a good rate of success, but further long-term follow-up and biomechanical evaluation are essential. size and depth of osteochondral defects, availability of donor autologous grafts, potential for damaging donor sites, the dead spaces between circular grafts and integration of donor and recipient hyaline cartilage.
Objective: To assess the clinical outcome of patients treated with autologous chondrocyte implant... more Objective: To assess the clinical outcome of patients treated with autologous chondrocyte implantation using ChondroCelect in daily practice. Methods: The study is a cross-sectional analysis of an open-label, noninterventional cohort. The setting was a compassionate use program, involving 43 orthopaedic centers in 7 European countries. The participants were patients treated with ChondroCelect between October 13, 2004 and July 2, 2008. The measurements used were Clinical Global Impression–Improvement and –Efficacy and solicited adverse event reports. Results: Safety data were collected from 334 patients (90.3%), and effectiveness data were from 282 (76.2%) of the 370 patients treated. Mean age at baseline was 33.6 years (range, 12-57 years), 57% were male, and mean body mass index was 25 kg/m2. Mean follow-up was 2.2 years (range, 0.4-4.1 years). A femoral condyle lesion was reported in 66% (288/379) and a patellar lesion in 19% (84/379). Mean lesion size was 3.5 cm2; a collagen memb...
UNLABELLED It is well known that the capacity of articular cartilage for repair is limited. There... more UNLABELLED It is well known that the capacity of articular cartilage for repair is limited. There have been many attempts to address this problem. However, treatment options are limited and the long-term outcome is uncertain. This article will focus on the osteochondral autograft transplantation (OAT), which is currently the only surgical cartilage repair technique that provides and retains proper hyaline articular cartilage. Osteochondral autograft transplants have been associated with a good rate of success, but further long-term follow-up and biomechanical evaluation are essential. LIMITATIONS size and depth of osteochondral defects, availability of donor autologous grafts, potential for damaging donor sites, the dead spaces between circular grafts and integration of donor and recipient hyaline cartilage.
Hambly, Karen and Van Assche, Dieter and Wondrasch, Barbara and Bobic, Vladimir and Marlovits, St... more Hambly, Karen and Van Assche, Dieter and Wondrasch, Barbara and Bobic, Vladimir and Marlovits, Stefan (2006) Current status and prospects for rehabilitation following cell-based cartilage repair. In: Basic science and clinical repair of articular cartilage defects: Current status ...
... Am J Sports Med 1998; 26(1):15-19. (18) Lance E, Deutsch AL, Mink JH. Prior lateral patellar ... more ... Am J Sports Med 1998; 26(1):15-19. (18) Lance E, Deutsch AL, Mink JH. Prior lateral patellar dislocation: MR imaging findings. ... J Bone Joint Surg 1992; 74B:118-21. (74) Joergensen U, Sonne-Holm S, Lauridsen F et al. Long-term follow-up of meniscectomy in athletes. ...
ABSTRACT It is well known that the capacity of articular cartilage for repair is limited. There h... more ABSTRACT It is well known that the capacity of articular cartilage for repair is limited. There have been many attempts to address this problem. However, treatment options are limited and the long-term outcome is uncertain. This article will focus on the osteochondral autograft transplantation (OAT), which is currently the only surgical cartilage repair technique that provides and retains proper hyaline articular cartilage. Osteochondral autograft transplants have been associated with a good rate of success, but further long-term follow-up and biomechanical evaluation are essential. Limitations: size and depth of osteochondral defects, availability of donor autologous grafts, potential for damaging donor sites, the dead spaces between circular grafts and integration of donor and recipient hyaline cartilage. Zum jetzigen Zeitpunkt ist die autologe Knochen-Knorpel-Transplantation die einzige operative Technik, die hyalinen Gelenkknorpel ersetzen und erhalten kann. Autologe Knochen-Knorpel-Transplantate haben bisher eine gute Erfolgsquote, aber es stehen noch Langzeitstudien und biomechanische Untersuchungen aus [1, 2]. Augrund der geringen Anzahl der möglichen Entnahmestellen für die autologen Knochen-Knorpel-Transplantate ist die Verwendung solcher Transplantate auf einige ausgewählte, lokalisierte Bereiche mit Gelenkknorpeldefekten begrenzt. Mittelfristige Ergebnisse bei einer kleinen Reihe von Patienten haben gezeigt, daß die Übertragung von autologen Knochen-Knorpel-Transplantaten für die Behandlung von fokalen Gelenkknorpeldefekten bei ausgewählten Patienten effektiv sein kann.
Magnetic resonance imaging is the optimal modality for assessing articular cartilage because of s... more Magnetic resonance imaging is the optimal modality for assessing articular cartilage because of superior soft tissue contrast, direct visualization of articular cartilage, and multiplanar capability. Despite these advantages, there has been disagreement as to the efficacy of magnetic resonance imaging of articular cartilage. The reason for this controversy is multifactorial but in part is attributable to the lack of the use of optimized pulse sequences for articular cartilage. The current authors will review the current state of the art of magnetic resonance imaging of articular cartilage and cartilage repair procedures, discuss future new directions in imaging strategies and methods being developed to measure cartilage thickness and volume measurements, and propose a magnetic resonance imaging protocol to evaluate cartilage that is achievable on most magnetic resonance scanners, vendor independent, practical (time and cost efficient), and accepted and used by a majority of musculos...
To assess the clinical outcome of patients treated with autologous chondrocyte implantation using... more To assess the clinical outcome of patients treated with autologous chondrocyte implantation using ChondroCelect in daily practice. The study is a cross-sectional analysis of an open-label, noninterventional cohort. The setting was a compassionate use program, involving 43 orthopaedic centers in 7 European countries. The participants were patients treated with ChondroCelect between October 13, 2004 and July 2, 2008. The measurements used were Clinical Global Impression-Improvement and -Efficacy and solicited adverse event reports. Safety data were collected from 334 patients (90.3%), and effectiveness data were from 282 (76.2%) of the 370 patients treated. Mean age at baseline was 33.6 years (range, 12-57 years), 57% were male, and mean body mass index was 25 kg/m(2). Mean follow-up was 2.2 years (range, 0.4-4.1 years). A femoral condyle lesion was reported in 66% (288/379) and a patellar lesion in 19% (84/379). Mean lesion size was 3.5 cm(2); a collagen membrane was used in 92.4% (328/355). A therapeutic effect was reported in 89% (234/264) of patients overall and in 87% (40/46) of patellar lesion patients. Rates of much or very much improved patients were similar in patients with short- (<18 months: 71% [115/163]) and long-term follow-up (>18 months: 68% [70/103]) (P = 0.68) and were independent of lesion size (>4 cm(2): 75.5% [37/49]; ≤4 cm(2): 67.7% [111/164]) (P = 0.38). Adverse events were similar to those reported in the randomized trial with the same product, with more arthrofibrosis, more reduced joint mobility, and more crepitations reported in patellar lesions. Overall, less cartilage hypertrophy was noted, probably due to the use of a biological membrane cover. Implantation of ChondroCelect appeared to result in a positive benefit/risk ratio when used in an unselected heterogenous population, irrespective of the follow-up period, lesion size, and type of lesion treated.
Purpose: The aim of this study is the mid-term analysis of osteochondral autograft transplantatio... more Purpose: The aim of this study is the mid-term analysis of osteochondral autograft transplantation for the repair of focal femoral defects. Methods: We present clinical data based on arthroscopic and MRI appearances of 18 patients, from 2 to 6 years postoperatively, which illustrate growing concern about the progressive deterioration of articular cartilage surrounding the OAT graft. It seems that the osteochondral autograft transfer (OAT) can restore the height and the shape of articulating surface in osteochondral defects with composite autologous material that contains hyaline articular cartilage and a firm carrier. However, limited availability of autologous osteochondral grafts, dead spaces between circular grafts, the lack of integration of donor and recipient hyaline cartilage, and different thickness and mechanical properties of donor and recipient hyaline cartilage are frequent sources of clinical concern. Results: Typically, the OAT graft itself maintains its mechanical and...
Aims: We present the results of the PFC Sigma knee replacement at a mean follow-up of 2.75 years ... more Aims: We present the results of the PFC Sigma knee replacement at a mean follow-up of 2.75 years (range: 1 to 6 years). Clinician and radiographic evaluation was carried out using the American Knee Society Clinical Rating and Radiographic Scoring Systems. Patient outcome was assessed using the Oxford-12 and SF-12 health-status questionnaires. Methods: A consecutive series of 293 Total Knee Replacements (TKR) in 247 patients was followed prospectively between September 1996 and September 2002. Our series included 138 females and 109 males with a mean age of 73.2 years. We operated on 214 patients with osteoarthritis, 20 with rheumatoid arthritis, 12 with post-traumatic arthritis and on one patient with erosive arthritis. The patella was resurfaced in 36 knees. 11 patients died during the follow-up period. Results: Subjective patient satisfaction score was based on improvement in pain and functional status. It was marked as excellent in 183 knees, good in 75, fair in 26 and poor in 9....
It is well known that the capacity of articular cartilage for repair is limited. There have been ... more It is well known that the capacity of articular cartilage for repair is limited. There have been many attempts to address this problem. However, treatment options are limited and the long-term outcome is uncertain. This article will focus on the osteochondral autograft transplantation (OAT), which is currently the only surgical cartilage repair technique that provides and retains proper hyaline articular cartilage. Osteochondral autograft transplants have been associated with a good rate of success, but further long-term follow-up and biomechanical evaluation are essential. size and depth of osteochondral defects, availability of donor autologous grafts, potential for damaging donor sites, the dead spaces between circular grafts and integration of donor and recipient hyaline cartilage.
Objective: To assess the clinical outcome of patients treated with autologous chondrocyte implant... more Objective: To assess the clinical outcome of patients treated with autologous chondrocyte implantation using ChondroCelect in daily practice. Methods: The study is a cross-sectional analysis of an open-label, noninterventional cohort. The setting was a compassionate use program, involving 43 orthopaedic centers in 7 European countries. The participants were patients treated with ChondroCelect between October 13, 2004 and July 2, 2008. The measurements used were Clinical Global Impression–Improvement and –Efficacy and solicited adverse event reports. Results: Safety data were collected from 334 patients (90.3%), and effectiveness data were from 282 (76.2%) of the 370 patients treated. Mean age at baseline was 33.6 years (range, 12-57 years), 57% were male, and mean body mass index was 25 kg/m2. Mean follow-up was 2.2 years (range, 0.4-4.1 years). A femoral condyle lesion was reported in 66% (288/379) and a patellar lesion in 19% (84/379). Mean lesion size was 3.5 cm2; a collagen memb...
UNLABELLED It is well known that the capacity of articular cartilage for repair is limited. There... more UNLABELLED It is well known that the capacity of articular cartilage for repair is limited. There have been many attempts to address this problem. However, treatment options are limited and the long-term outcome is uncertain. This article will focus on the osteochondral autograft transplantation (OAT), which is currently the only surgical cartilage repair technique that provides and retains proper hyaline articular cartilage. Osteochondral autograft transplants have been associated with a good rate of success, but further long-term follow-up and biomechanical evaluation are essential. LIMITATIONS size and depth of osteochondral defects, availability of donor autologous grafts, potential for damaging donor sites, the dead spaces between circular grafts and integration of donor and recipient hyaline cartilage.
Hambly, Karen and Van Assche, Dieter and Wondrasch, Barbara and Bobic, Vladimir and Marlovits, St... more Hambly, Karen and Van Assche, Dieter and Wondrasch, Barbara and Bobic, Vladimir and Marlovits, Stefan (2006) Current status and prospects for rehabilitation following cell-based cartilage repair. In: Basic science and clinical repair of articular cartilage defects: Current status ...
... Am J Sports Med 1998; 26(1):15-19. (18) Lance E, Deutsch AL, Mink JH. Prior lateral patellar ... more ... Am J Sports Med 1998; 26(1):15-19. (18) Lance E, Deutsch AL, Mink JH. Prior lateral patellar dislocation: MR imaging findings. ... J Bone Joint Surg 1992; 74B:118-21. (74) Joergensen U, Sonne-Holm S, Lauridsen F et al. Long-term follow-up of meniscectomy in athletes. ...
ABSTRACT It is well known that the capacity of articular cartilage for repair is limited. There h... more ABSTRACT It is well known that the capacity of articular cartilage for repair is limited. There have been many attempts to address this problem. However, treatment options are limited and the long-term outcome is uncertain. This article will focus on the osteochondral autograft transplantation (OAT), which is currently the only surgical cartilage repair technique that provides and retains proper hyaline articular cartilage. Osteochondral autograft transplants have been associated with a good rate of success, but further long-term follow-up and biomechanical evaluation are essential. Limitations: size and depth of osteochondral defects, availability of donor autologous grafts, potential for damaging donor sites, the dead spaces between circular grafts and integration of donor and recipient hyaline cartilage. Zum jetzigen Zeitpunkt ist die autologe Knochen-Knorpel-Transplantation die einzige operative Technik, die hyalinen Gelenkknorpel ersetzen und erhalten kann. Autologe Knochen-Knorpel-Transplantate haben bisher eine gute Erfolgsquote, aber es stehen noch Langzeitstudien und biomechanische Untersuchungen aus [1, 2]. Augrund der geringen Anzahl der möglichen Entnahmestellen für die autologen Knochen-Knorpel-Transplantate ist die Verwendung solcher Transplantate auf einige ausgewählte, lokalisierte Bereiche mit Gelenkknorpeldefekten begrenzt. Mittelfristige Ergebnisse bei einer kleinen Reihe von Patienten haben gezeigt, daß die Übertragung von autologen Knochen-Knorpel-Transplantaten für die Behandlung von fokalen Gelenkknorpeldefekten bei ausgewählten Patienten effektiv sein kann.
Magnetic resonance imaging is the optimal modality for assessing articular cartilage because of s... more Magnetic resonance imaging is the optimal modality for assessing articular cartilage because of superior soft tissue contrast, direct visualization of articular cartilage, and multiplanar capability. Despite these advantages, there has been disagreement as to the efficacy of magnetic resonance imaging of articular cartilage. The reason for this controversy is multifactorial but in part is attributable to the lack of the use of optimized pulse sequences for articular cartilage. The current authors will review the current state of the art of magnetic resonance imaging of articular cartilage and cartilage repair procedures, discuss future new directions in imaging strategies and methods being developed to measure cartilage thickness and volume measurements, and propose a magnetic resonance imaging protocol to evaluate cartilage that is achievable on most magnetic resonance scanners, vendor independent, practical (time and cost efficient), and accepted and used by a majority of musculos...
To assess the clinical outcome of patients treated with autologous chondrocyte implantation using... more To assess the clinical outcome of patients treated with autologous chondrocyte implantation using ChondroCelect in daily practice. The study is a cross-sectional analysis of an open-label, noninterventional cohort. The setting was a compassionate use program, involving 43 orthopaedic centers in 7 European countries. The participants were patients treated with ChondroCelect between October 13, 2004 and July 2, 2008. The measurements used were Clinical Global Impression-Improvement and -Efficacy and solicited adverse event reports. Safety data were collected from 334 patients (90.3%), and effectiveness data were from 282 (76.2%) of the 370 patients treated. Mean age at baseline was 33.6 years (range, 12-57 years), 57% were male, and mean body mass index was 25 kg/m(2). Mean follow-up was 2.2 years (range, 0.4-4.1 years). A femoral condyle lesion was reported in 66% (288/379) and a patellar lesion in 19% (84/379). Mean lesion size was 3.5 cm(2); a collagen membrane was used in 92.4% (328/355). A therapeutic effect was reported in 89% (234/264) of patients overall and in 87% (40/46) of patellar lesion patients. Rates of much or very much improved patients were similar in patients with short- (<18 months: 71% [115/163]) and long-term follow-up (>18 months: 68% [70/103]) (P = 0.68) and were independent of lesion size (>4 cm(2): 75.5% [37/49]; ≤4 cm(2): 67.7% [111/164]) (P = 0.38). Adverse events were similar to those reported in the randomized trial with the same product, with more arthrofibrosis, more reduced joint mobility, and more crepitations reported in patellar lesions. Overall, less cartilage hypertrophy was noted, probably due to the use of a biological membrane cover. Implantation of ChondroCelect appeared to result in a positive benefit/risk ratio when used in an unselected heterogenous population, irrespective of the follow-up period, lesion size, and type of lesion treated.
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