By Tom Minas MD MS
A Primer in Cartilage fix and Joint renovation of the Knee offers the complete diversity of therapies for a altering, more and more more youthful sufferer inhabitants. Dr. Thomas Minas demonstrates every one technique-from non-surgical to mini-incision overall knee arthroplasty to the hot advancements in tissue biologics-through a step by step process. Surgical pictures and illustrations and procedural video clips on-line at www.expertconsult.com and on DVD supply specific advice. This hugely visible, multimedia reference courses you in making a choice on the simplest therapy direction for every patient.
- Get basically the data you would like via a technique-focused procedure and the constant form of a unmarried writer, Dr. Thomas Minas-a major expert in cartilage repair.
- Access the absolutely searchable textual content on-line at www.expertconsult.com, besides videos.
- Incorporate tissue biologics into your perform and supply your sufferers with extra options.
- Clearly see the nuances and demanding issues of every process with surgical photos and artists' renderings of key events within the working room.
- Select the easiest remedy direction for every sufferer via wide insurance of thoughts from non-surgical to mini-incision overall knee arthroplasty.
- Master state-of-the-art options via videos-online and on DVD-that reveal each one procedure.
Meet the recent demanding situations of cartilage fix with the newest techniques
Read Online or Download A Primer in Cartilage Repair and Joint Preservation of the Knee: Expert Consult, 1e PDF
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Additional info for A Primer in Cartilage Repair and Joint Preservation of the Knee: Expert Consult, 1e
We perform corrective osteotomy to mechanical neutral, without overcorrection, for defects 44 PART 1 DECISION MAKING Chondral injury Assess background factors* Persistent symptoms (WB pain, catching, effusion) Lesion ≥2cm2† Return to ADL and sports as tolerated Wish to use traditional treatment methods‡ Wish to use ACI as first option Arthroscopic debridement and MST (marrow stimulation techniques) ACI Unknown success rate on these larger lesions Greater than 90% success rate with WB on femoral condyle Yes Success?
Microfracture Most studies show good outcomes in 60% to 80% of patients. Several studies have attempted to define the indications for microfracture with regard to patient and defect characteristics. Kreuz et al demonstrated improved results in patients younger than 40 years with regard to both validated scores and MRI findings of better fill and quality. They also demonstrated a worsening Study Design (Level of Evidence) Follow-up Interval (No. 2 cm2) Patient age: <40 yr, >40 yr All groups improved significantly; younger patients improved more.
9 This finding supports the idea that progression of lesions smaller than 2 cm2 is unlikely and that 2 cm2 may represent a critical defect size. 10–12 A critical size defect is considered a defect that shoulders the subchondral bone well from stimulus, thus lessening the symptoms from subchondral bone nerve stimulation and the abrasive effects of subchondral bone on the opposing articular cartilage and therefore the development of bipolar changes. A larger defect that is poorly shouldered will damage the opposing articular surface, resulting in progressive joint space cartilage loss, will remain symptomatic, and will enlarge quickly because of the excessive force on the edges of the defect.