Abstract
Full-thickness defects of articular cartilage have limited to no spontaneous repair potential and can compromise patients through symptoms such as activity-related pain and swelling. Various techniques have been developed toaddress these defects, including palliative procedures such as debridement and reparative procedures such as marrow stimulation techniques (MST). Marrow stimulation techniques result in changes to the subchondral bone, including osseous overgrowth and intralesional osteophytes. Defects that had prior treatment affecting the subchondral bone have a three to seven times higher failure rate after ACI procedure when compared with non-treated defects.
In this chapter we are going to discuss the role of previous bone marrow stimulation on subsequent cartilage repair and discuss possible surgical techniques to address the altered subchondral bone in order to restore the osteochondral functional unit.
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References
Buckwalter JA. Articular cartilage: injuries and potential for healing. J Orthop Sports Phys Ther. 1998;28:192–202.
Sterett WI, Steadman JR, Huang MJ, Matheny LM, Briggs KK. Chondral resurfacing and high tibial osteotomy in the varus knee: survivorship analysis. Am J Sports Med. 2010;38:1420–4.
Steadman JR, Briggs KK, Rodrigo JJ, Kocher MS, Gill TJ, Rodkey WG. Outcomes of microfracture for traumatic chondral defects of the knee: average 11-year follow-up. Arthroscopy. 2003;19:477–84.
Frisbie DD, Oxford JT, Southwood L, et al. Early events in cartilage repair after subchondral bone microfracture. Clin Orthop Relat Res. 2003;(407):215–27.
Steadman JR, Rodkey WG, Rodrigo JJ. Microfracture: surgical technique and rehabilitation to treat chondral defects. Clin Orthop Relat Res. 2001;(391 Suppl):S362-9.
Mithoefer K, McAdams T, Williams RJ, Kreuz PC, Mandelbaum BR. Clinical efficacy of the microfracture technique for articular cartilage repair in the knee: an evidence-based systematic analysis. Am J Sports Med. 2009;37:2053–63.
Gudas R, Kalesinskas RJ, Kimtys V, et al. A prospective randomized clinical study of mosaic osteochondral autologous transplantation versus microfracture for the treatment of osteochondral defects in the knee joint in young athletes. Arthroscopy. 2005;21:1066–75.
Kreuz PC, Steinwachs MR, Erggelet C, et al. Results after microfracture of full-thickness chondral defects in different compartments in the knee. Osteoarthritis Cartilage. 2006;14:1119–25.
Pestka JM, Bode G, Salzmann G, Sudkamp NP, Niemeyer P. Clinical outcome of autologous chondrocyte implantation for failed microfracture treatment of full-thickness cartilage defects of the knee joint. Am J Sports Med. 2012;40:325–31.
Vanlauwe J, Saris DB, Victor J, Almqvist KF, Bellemans J, Luyten FP. Five-year outcome of characterized chondrocyte implantation versus microfracture for symptomatic cartilage defects of the knee: early treatment matters. Am J Sports Med. 2011;39:2566–74.
Kon E, Filardo G, Berruto M, et al. Articular cartilage treatment in high-level male soccer players: a prospective comparative study of arthroscopic second-generation autologous chondrocyte implantation versus microfracture. Am J Sports Med. 2011;39:2549–57.
Mithoefer K, Hambly K, Della Villa S, Silvers H, Mandelbaum BR. Return to sports participation after articular cartilage repair in the knee: scientific evidence. Am J Sports Med. 2009;37 Suppl 1:167S–76.
Mithoefer K, Williams 3rd RJ, Warren RF, et al. The microfracture technique for the treatment of articular cartilage lesions in the knee. A prospective cohort study. J Bone Joint Surg Am. 2005;87:1911–20.
Saris DB, Vanlauwe J, Victor J, et al. Treatment of symptomatic cartilage defects of the knee: characterized chondrocyte implantation results in better clinical outcome at 36 months in a randomized trial compared to microfracture. Am J Sports Med. 2009;37 Suppl 1:10S–9.
Kesemenli CC, Memisoglu K, Muezzinoglu US. Bone marrow edema seen in MRI of osteoarthritic knees is a microfracture. Med Hypotheses. 2009;72:754–5.
Peterson L, Minas T, Brittberg M, Lindahl A. Treatment of osteochondritis dissecans of the knee with autologous chondrocyte transplantation: results at two to ten years. J Bone Joint Surg Am. 2003;85-A Suppl 2:17–24.
Miller JD, McCreadie BR, Hankenson KD, Goldstein S. Bone: form and function. In: Einhorn TA, O'Keefe RJ, Buckwalter JA, editors. Orthopaedic basic science foundations of clinical practice. 3rd ed. Doody Enterprises;2007.
Goldring MB, Goldring SR. Articular cartilage and subchondral bone in the pathogenesis of osteoarthritis. Ann N Y Acad Sci. 2010;1192:230–7.
Burr DB, Radin EL. Microfractures and microcracks in subchondral bone: are they relevant to osteoarthrosis? Rheum Dis Clin North Am. 2003;29:675–85.
Gomoll AH, Madry H, Knutsen G, et al. The subchondral bone in articular cartilage repair: current problems in the surgical management. Knee Surg Sports Traumatol Arthrosc. 2010;18:434–47.
Frisbie DD, Morisset S, Ho CP, Rodkey WG, Steadman JR, McIlwraith CW. Effects of calcified cartilage on healing of chondral defects treated with microfracture in horses. Am J Sports Med. 2006;34:1824–31.
Wei HW, Sun SS, Jao SH, Yeh CR, Cheng CK. The influence of mechanical properties of subchondral plate, femoral head and neck on dynamic stress distribution of the articular cartilage. Med Eng Phys. 2005;27:295–304.
Brown TD, Radin EL, Martin RB, Burr DB. Finite element studies of some juxtarticular stress changes due to localized subchondral stiffening. J Biomech. 1984;17:11–24.
Schneider E, Lo GH, Sloane G, et al. Magnetic resonance imaging evaluation of weight-bearing subchondral trabecular bone in the knee. Skeletal Radiol. 2011;40:95–103.
Roemer FW, Frobell R, Hunter DJ, et al. MRI-detected subchondral bone marrow signal alterations of the knee joint: terminology, imaging appearance, relevance and radiological differential diagnosis. Osteoarthritis Cartilage. 2009;17:1115–31.
Welsch GH, Zak L, Mamisch TC, Resinger C, Marlovits S, Trattnig S. Three-dimensional magnetic resonance observation of cartilage repair tissue (MOCART) score assessed with an isotropic three-dimensional true fast imaging with steady-state precession sequence at 3.0 Tesla. Invest Radiol. 2009;44:603–12.
Hayter C, Potter H. Magnetic resonance imaging of cartilage repair techniques. J Knee Surg. 2011;24:225–40.
Potter HG, le Chong R, Sneag DB. Magnetic resonance imaging of cartilage repair. Sports Med Arthrosc. 2008;16:236–45.
Steadman JR, Rodkey WG, Briggs KK. Microfracture to treat full-thickness chondral defects: surgical technique, rehabilitation, and outcomes. J Knee Surg. 2002;15:170–6.
Kon E, Delcogliano M, Filardo G, Montaperto C, Marcacci M. Second generation issues in cartilage repair. Sports Med Arthrosc. 2008;16:221–9.
Gomoll AH, Probst C, Sodha S, Minas T. Collagen membrane as cover for autologous chondrocyte implantation. Letter to the editor. Am J Sports Med. 2010;38:NP4.
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Demange, M.K., Minas, T., Gomoll, A.H. (2014). Autologous Chondrocyte Implantation After Previous Treatment with Marrow Stimulation Techniques. In: Emans, P., Peterson, L. (eds) Developing Insights in Cartilage Repair. Springer, London. https://doi.org/10.1007/978-1-4471-5385-6_12
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DOI: https://doi.org/10.1007/978-1-4471-5385-6_12
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