Comparing Results of Cartilage Repair Techniques
The authors of this study take on a big task of comparing results for different surgical methods of repairing cartilage injuries. All of the operations were performed on athletes. The goal was to return them to play at a pre-injury level.
Four major types of repair methods for articular cartilage are reviewed. A description is given for each one. Advantages and disadvantages are discussed. And the latest results in research are reported. These four methods include:
Microfracture is the use of an awl or pick to place tiny holes through the cartilage into the first layer of bone. Bleeding occurs and stimulates healing. Graft implantation or transplantation is the use of the same cells harvested from another site and transferred to the area of injury. Autograft refers to the use of the patient's own cells. Allograft are cells that come from a donor.
After sorting through all the studies and comparing one type of treatment to another, there are a few important points. First, all four treatment methods have been successful. But not all four kinds have been used in athletes, so more studies are needed in that area.
Smaller lesions seem to do better with microfracture and osteochondral autograft transplantation. Larger lesions and especially degenerative problems respond best to autologous chondrocyte implantation. Implantation provides repair at the cellular level.
Younger patients seem to have better results with cartilage repair compared to older patients. The sooner the surgery is done, the better. Waiting more than 12 months may mean less optimal results.
The authors conclude that despite all of these repair techniques, none are able to reproduce the strength and function of natural knees. Repair tissue gives the knee durability. But it doesn't allow the knee to withstand the demands of normal knee function. Hopefully, further research combining technology, science, and surgery will yield better results in the future.
Michael E. Trice. Articular Cartilage Surgery for the Athlete. In Current Orthopedic Practice. May/June 2008. Vol. 19. No. 3. Pp. 299-307.
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