Abstract
Symptomatic isolated, small (< 2 cm2) and well demarcated chondral lesion of the femoral condyles and trochlea (ICRS grade 3 or 4) with intact subchondral plate and subjective complaints. This procedure is less recommended at the patella and tibia.
Specific contraindications: osteoarthritis, osteochondral defects, osteonecrosis.
Induction of regenerative cartilage tissue formation through releasing mesenchymal stem cells after penetration of the subchondral lamella. In case of autologous matrix induced chondrogenesis (AMIC), a collagen membrane is additionally sutured to the edges of the defect aiming to stabilize the formed blood clot.
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Symptom specific history: pain character, duration of complaint, limitation of movement, trauma, sporting and functional demands.
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Symptom specific examination: tenderness, pain on motion, range of motion, crepitation, lower limb alignment, instability.
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Conventional X-ray of the knee in 3 views (AP, lateral and tangential patella) for evaluation of osteonecrosis, cysts and arthritic changes.
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Standing long-leg AP radiographs to asses malalignment with subsequent overloading.
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MRI (with intra-articular/intravenous contrast agent injection) to assess the extent of the cartilage damage, associated subchondral reactions, osteoarthritic changes and the presence of loose bodies, special radiological studies could be helpful (e. g. MRI T2-Mapping)
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CT with intraarticular contrast agent injection, when MRI is not possible e. g. presence of metallic implants
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References
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Berninger, M., Vogt, S. (2015). Chondral and Osteochondral Lesions. In: Imhoff, A., Feucht, M. (eds) Surgical Atlas of Sports Orthopaedics and Sports Traumatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-43776-6_18
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DOI: https://doi.org/10.1007/978-3-662-43776-6_18
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