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Clinical Relevance of Chondral Lesions in the Treatment of the ACL-Deficient Knee: Microfracture Technique

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The ACL-Deficient Knee

Abstract

Anterior cruciate ligament (ACL) injuries and chondral defects are commonly associated. These chondral injuries can occur simultaneously with the ACL injury or remotely as a secondary injury from instability in the ACL-deficient knee. The literature does not provide clear direction in the management of this combination of injuries. If a chondral injury is encountered at the time of ACL treatment, we recommend that it be treated either concurrently or separately in a staged procedure. Despite a number of procedures described in the literature for chondral defects, our procedure of choice is microfracture. Microfracture is an economical, straightforward technique with a proven track record. The steps of the procedure and the associated rehabilitation process are critically related to one another, and all steps must be followed as described. The goal is to provide the optimal environment for the body’s own progenitor cells to make the reparative tissue in the defect. Over a course of 30 years, our experience with microfracture has developed and evolved through both basic science and clinical research. We have shown excellent results in treating patients with microfracture when the technique and rehabilitation are followed rigorously.

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Authors and Affiliations

  1. The Steadman Clinic, Orthopaedic Sports Medicine, 181 West Meadow Drive, Suite 400, Vail, CO, 81657, USA

    Mark R. Geyer M.D. & J. Richard Steadman M.D.

  2. Steadman Philippon Research Institute, 108 South Frontage Road West, Suite 303, Vail, CO, 81657, USA

    William G. Rodkey DVM

Authors
  1. Mark R. Geyer M.D.
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  2. William G. Rodkey DVM
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  3. J. Richard Steadman M.D.
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Correspondence to William G. Rodkey DVM .

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Editors and Affiliations

  1. Depto. Cirugia Ortopédica, Hospital Arnau de Vilanova, c/San Clemente 12, Valencia, 46015, Spain

    Vicente Sanchis-Alfonso

  2. , Orthopaedic Surgery, Hospital de Sant Pau, St Antoni m Claret 167, Barcelona, 08025, Spain

    Joan Carles Monllau

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Geyer, M.R., Rodkey, W.G., Steadman, J.R. (2013). Clinical Relevance of Chondral Lesions in the Treatment of the ACL-Deficient Knee: Microfracture Technique. In: Sanchis-Alfonso, V., Monllau, J. (eds) The ACL-Deficient Knee. Springer, London. https://doi.org/10.1007/978-1-4471-4270-6_23

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  • DOI: https://doi.org/10.1007/978-1-4471-4270-6_23

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4269-0

  • Online ISBN: 978-1-4471-4270-6

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