Current and Novel Approaches to Treating Chondral Lesions

Wright, Timothy M.; Maher, Suzanne A.
February 2009
Journal of Bone & Joint Surgery, American Volume;Feb2009 Supplement 1, Vol. 91-A Issue S1, p120
Academic Journal
Total joint arthroplasty remains the most effective treatment to relieve pain and restore function in damaged and diseased joints; however, less invasive, more functional solutions are necessary for young, active patients who have chondral defects and are at the early stages of disease. Unfortunately, attempts at providing such a method have provided variable and often unsatisfactory outcomes. Unicondylar knee replacement, for example, is associated with a markedly higher rate of revision when compared with total knee arthroplasty, and there is a distinct probability of disease progression in the remaining joint compartments. Small metallic caps intended for filling the cartilage defects are commercially available, but the clinical follow-up of patients who have undergone this treatment is short. Although not yet in clinical use, synthetic polymeric implant scaffolds, with and without cell-seeding, are also under development. The biomechanical requirements for treating chondral lesions, like those of total knee arthroplasty, are wear and fixation. A lesion-filling implant must carry large joint loads without damaging the opposing tissue. Integration with surrounding cartilage and subchondral bone would enhance load-sharing and load transfer. The challenge of meeting these requirements is difficult, but new forms of computational models and in vitro tests can aid in establishing performance and in rapidly screening possible solutions.


Related Articles

  • HIP AND KNEE SURGERY UNICOMPARTMENTAL KNEE RESURFACING WHEN LESS IS MORE. Haddad, Fares; Wardle, Nic // Pulse;2/16/2006, Vol. 66 Issue 7, p44 

    The article focuses on the advantages and disadvantages of partial knee resurfacing. The author assesses the health history of the patient with a three-year history of gradually worsening pain on the inside of his right knee. Unicompartmental knee arthritis is characterized by degeneration of...

  • Passive Anterior-Posterior Knee Stability After Unconstrained Unicompartmental Arthroplasty. Imran, Ahmed // Proceedings of the World Congress on Engineering 2011 Volume I;2011, p1276 

    These Passive anterior-posterior (A-P) stability of the knee, measured in terms of joint laxity, is considered important for good clinical outcome following knee arthroplasty. In vitro and in vivo studies measured the laxity at selected joint positions in the intact and replaced knees. However,...

  • What is your best indication for reverse arthroplasty and why? Willems, W. Joap // Orthopaedics Today Europe;Jul/Aug2011, Vol. 14 Issue 4, p7 

    The article author explains why cuff tear arthropathy (CTA) and massive cuff tears and revisions are the two most important indications for reverse athroplasty.

  • Atraumatic patellar prosthesis dislocation with patellar tendon injury following a total knee arthroplasty: a case report. Singh, Vinay Kumar; Singh, Pankaj Kumar; Singh, Yashwant; Singh, Alka; Javed, Sadaf; Abdunabi, Murad // Journal of Medical Case Reports;2010, Vol. 4 Issue 1, p1 

    Introduction: Total knee arthroplasty is a well-established procedure with gratifying results. There is no consensus in the literature whether to routinely resurface the patella while performing total knee arthroplasty or not. Although an extremely rare occurrence in clinical practice, patellar...

  • Cementless Humeral Resurfacing Arthroplasty in Active Patients Less Than Fifty-five Years of Age. Bailie, David S.; Llinas, Paulo J.; Ellenbecker, Todd S. // Journal of Bone & Joint Surgery, American Volume;Jan2008, Vol. 90-A Issue 1, p110 

    Background: Cementless humeral resurfacing arthroplasty is a bone-conserving arthroplasty option for patients with glenohumeral arthritis. It has been successful in the older patient population. However, data regarding the results of arthroplasty in younger, more active patients are lacking. We...

  • Psoriatic Arthritis and Arthroplasty. Iofin, Ilya; Levine, Brett; Badlani, Neil; Klein, Gregg R.; Jaffe, William L. // Bulletin of the NYU Hospital for Joint Diseases;2008, Vol. 66 Issue 1, p41 

    Psoriatic arthritis is an inflammatory arthropathy associated with the characteristic dermatologic lesions of psoriasis. The diagnosis of psoriatic arthritis is quite difficult, due to the overlap of patients with osteoarthritis (OA) or rheumatoid arthritis (RA) with concomitant non-associated...

  • Elbow fractures/dislocations call for early treatment and accurate reduction. Rapp, Susan M. // Orthopedics Today;Apr2008, Vol. 28 Issue 4, p56 

    The article reports that recognition is key in dealing with supracondylar elbow fractures and elbow-fracture dislocation, said doctor Emil H. Schemitsch during a presentation at the Annual Advances in Arthritis, Arthroplasty and Trauma meeting. Schemitsch said that rigid fixation of coronoid...

  • Ankylose temporo-mandibulaire : résultats du traitement après résection interruptrice. Béogo, Rasmané; Gandéma, Salif; Coulibaly, Toua Antoine; Traoré, Ibraïma; Guyot, Laurent // Médecine Buccale Chirurgie Buccale;2013, Vol. 19 Issue 3, p191 

    Temporomandibular joint ankylosis treatment is challenging given its risks of recurrence and complications. Material and method: This case series aimed to report the results of the treatment of temporomandibular joint ankylosis by gap arthroplasty in 8 patients in the Stomatology and...

  • Silicone-induced foreign-body reaction after first metatarsophalangeal joint arthroplasty for Jaccoud’s arthropathy. Waguri-Nagaya, Yuko; Yamagami, T.; Tsuchiya, A.; Nozaki, M.; Goto, H.; Kobayashi, M.; Aoyama, M.; Tada, T.; Otsuka, T. // Rheumatology International;Sep2009, Vol. 29 Issue 11, p1367 

    We report a case of Jaccoud’s arthropathy with forefoot plantar callosity. The lesser toe metatarsal heads were resected and Swanson’s double-stemmed flexible-hinge implant arthroplasty of the first metatarsophalangeal joint was performed. An osteolytic defect had formed around the...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics