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Utilizsing Mosaicplasty For Cartilage Resurfacing
Osteochondral defects are a significant clinical challenge for the orthopedic surgeon. Patients often experience swelling, clicking, pain and at times a feeling of instability. Although some low-demand can be adequately managed with non-operative treatments, active, young patients or older patients with a higher activity level often benefit from surgical intervention for symptomatic lesions.Several surgical therapies exist to treat symptomatic cartilage injuries. Osteochondral autograft transplantation (OAT), or mosaicplasty, is an effective treatment for cartilage lesions ranging from 1-5cm2. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - August 4, 2014 Category: Orthopaedics Authors: Zachary Thielen, Brian T. Feeley Source Type: research

The Current State of Cartilage Restoration
The treatment of cartilage injuries in the knee is an evolving field. Although this pathology is exceedingly difficult to address, within the past decade there have been numerous advances in the field. These range from innovative techniques to refinement and validation of classic procedures. The growth in knowledge of this field has allowed for advancement in surgical treatment. Yet, the influx of new literature and procedures in cartilage restoration makes for a daunting task when surgeons attempt to stay up to date on the topic. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - August 4, 2014 Category: Orthopaedics Authors: Alan L. Zhang, C. Benjamin Tags: OTO Editorial Source Type: research

Autologous Osteochondral Transplantation for Osteochondral Lesions of the Talus
Autologous osteochondral transplantation is used in the management of osteochondral lesions of the talus that are not responsive or amenable to arthroscopic debridement or bone marrow stimulation. Therefore, the technique is indicated for large (>100-150mm2) or cystic lesions. Technical success of the procedure is predicated on the ability to achieve perpendicular access to the lesion. Several methods exist to achieve this, including alterations in foot positioning with medial or lateral arthrotomy, as well as malleolar or tibial osteotomy. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - July 8, 2014 Category: Orthopaedics Authors: Keir A. Ross, Justin Robbins, Mark E. Easley, John G. Kennedy Source Type: research

Autologous Chondrocyte Implantation for Treatment of Osteochondral Lesions of the Talus
Autologous chondrocyte implantation (ACI) technology and techniques are a rapidly evolving field. There are currently 3 generations of chondrocyte implantation techniques for osteochondral defects. First-generation and some second-generation ACI techniques are in use in the United States, whereas third-generation chondrocyte implantation methods are in the early phases of human clinical trials. ACI is reserved for patients who have failed marrow stimulation. Caveats to this may be the larger osteochondral lesion of the talus (>1.5cm2) or the presence of significant subchondral cyst (>8mm), where ACI with “sandwich” bon...
Source: Operative Techniques in Orthopaedics - July 8, 2014 Category: Orthopaedics Authors: Nicholas J. Larsen, Martin Sullivan, Richard D. Ferkel Source Type: research

Autologous Matrix-Induced Chondrogenesis and Generational Development of Autologous Chondrocyte Implantation
The treatment of osteochondral defects of the talus is still controversial. Matrix-guided treatment options for covering of the defect with a scaffold have gained increasing popularity. Cellular-based autologous chondrocyte implantation (ACI) has undergone a generational development overcoming the surgical drawbacks related to the use of the periosteal flap over time. As ACI is associated with high costs and limited in availability, autologous matrix-induced chondrogenesis, a single-step procedure combining microfracturing of the subchondral bone to release bone marrow mesenchymal stem cells in combination with the coverag...
Source: Operative Techniques in Orthopaedics - July 8, 2014 Category: Orthopaedics Authors: Hajo Thermann, Christoph Becher, Francesca Vannini, Sandro Giannini Source Type: research

Arthroscopic Approaches to the Ankle Joint
This chapter reviews anterior and posterior arthroscopic approaches to the ankle and subtalar joints. The specific anatomy relevant to arthroscopy is reviewed including the major tendon, vascular, nerve and ligament structures along with the bony anatomy of the joints. A step by step discussion of portal placement, portal establishment, and diagnostic arthroscopy of the joints is presented, first for anterior approaches and then for posterior approaches. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - July 8, 2014 Category: Orthopaedics Authors: Kevin D. Martin, James W. Stone, Annunziato Amendola Source Type: research

Autologous Osteochondral Transplantation
Autologous osteochondral transplantation (AOT) is utilized in the management of osteochondral lesions of the talus (OLT) that are not responsive or amenable to arthroscopic debridement or bone marrow stimulation. Therefore, the technique is indicated for large (>100-150mm2) or cystic lesions. Technical success of the procedure is predicated on the ability to achieve perpendicular access to the lesion. Several methods exist to achieve this, including alterations in foot positioning with medial or lateral arthrotomy, as well as malleolar or tibial osteotomy. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - July 8, 2014 Category: Orthopaedics Authors: Keir A. Ross, Justin Robbins, Mark E. Easley, John G. Kennedy Source Type: research

Autologous chondrocyte implantation for the treatment of osteochondral lesions
Autologous chondrocyte implantation(ACI) technology and techniques are a rapidly evolving field. There are currently three generations of chondrocyte implantation techniques for osteochondral defects. First-generation and some second generation ACI techniques are in use in the United States while third-generation chondrocyte implantation methods are in the early phases of human clinical trials. ACI is reserved for patients who have failed marrow stimulation. Caveats to this may be the larger OLT (>1.5cm²) or the presence of significant subchondral cyst (>8mm), where ACI with “sandwich” bone grafting is more likely to ...
Source: Operative Techniques in Orthopaedics - July 8, 2014 Category: Orthopaedics Authors: Nicholas Larsen, Martin Sullivan, Richard D. Ferkel Source Type: research

Autologous matrix induced Chondrogenesis and generational development of autologous chondrocyte implantation
The treatment of osteochondral defects of the talus is still controversial. Matrix guided treatment options for covering of the defect with a scaffold have gained increasing popularity. Cellular-based Autologous Chondrocyte Implantation (ACI) has undergone a generational development overcoming the surgical drawbacks related to the use of the periosteal flap over time. Since ACI is associated with high costs and limited in availability, Autologous Matrix Induced Chondrogenesis (AMIC), a single- step procedure combining microfracturing of the subchondral bone to release bone marrow mesenchymal stem cells in combination with ...
Source: Operative Techniques in Orthopaedics - July 8, 2014 Category: Orthopaedics Authors: Hajo Thermann, Christoph Becher, Francesca Vannini, Sandro Giannini Source Type: research

Arthroscopic Approaches to the Ankle Joint
In the early days of arthroscopy the ankle joint was deemed unsuitable for arthroscopic procedures due to its unique anatomy of complex curved articular surfaces constrained by tight ligament structures1. Improvements in optics, miniaturization of arthroscopes, and the development of techniques for joint distraction contributed to improved arthroscopic visualization of the ankle joint and expanding applications of arthroscopy for surgical procedures. . The first series on ankle arthroscopy demonstrating intra-articular pathology was published in a textbook chapter in 19772. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - July 8, 2014 Category: Orthopaedics Authors: Kevin D. Martin, James W. Stone, Annunziato Amendola Source Type: research