Principles of Cartilage Repair

About this book

Cartilage defects affect patients of all age groups. Surgeons, teamdoctors, general practitioners and physiotherapists alike are expected to provide adequate care.

Only individual treatment plans combining a well balanced choice of various options will be successful. Background knowledge, operative and non-operative therapies are described in concise chapters:

* Articular cartilage biology
* Diagnostics
* Surgical techniques
* Symptomatic and alternative medications
* Physiotherapy

Diagnostic findings and surgical procedures are generously illustrated by aquarelles and colour photographs. Recommendations for additional reading, description of important clinical scoring systems and a listing of analytic tools are added for further information.

Table of contents

Introduction
Articular Cartilage Biology
_ Chondrocytes
_ Collagen
_ Proteoglycans
_ The subchondral bone plate

Etiology of Articular Cartilage Lesions
_ Trauma
_ Malalignments
_ Meniscus
_ Instability
_ Osteochondrosis dissecans (OD)
_ Osteoarthritis
_ Rheumatoid arthritis
_ Genetic factors
_ Obesity
_ Cartilage tumors
_ Microtrauma

Diagnostics
_ Clinical examination
_ Radiography
_ Magnetic resonance tomography
_ Classification of articular cartilage lesions and criteria for choosing appropriate therapy
– Localization
– Concomitant injuries
– Defect size/Containment
– Radiography/MRT .

Conservative Treatment
Conservative Treatment of Articular Cartilage Defects
_ Drug treatment
– Non-steroidal anti-inflammatory drugs (NSAID)
– Neuraceuticals
_ Physical therapy
– Physiotherapy
– Bandages and orthosis for the treatment of gonarthrosis
– Electrotherapy
– Pulsed signal therapy
– Ultrasound
– Magnetic fields
– Extracorporeal shock wave therapy

Operative Treatment
Operative Treatment of Articular Cartilage Defects
_ Refixation of detached cartilage fragments
_ Joint lavage/cartilage shaving/débridement
_ Bone marrow stimulation techniques (drilling, abrasion, microfracture)
_ Augmented microfracture techniques
_ Osteochondral transplantation
_ Autologous chondrocyte transplantation (ACT)
_ Autologous chondrocyte transplantation (ACT) – New procedures
_ Correctional osteotomies
_ Implantation of non-resorbable cartilage replacements

Additional Reading
Appendix
_ Scores for the evaluation of therapy results after treatment of articular cartilage defects (selection)

Important Analytic Methods
_ Histology
_ Immunohistochemistry
_ Polymerase chain reaction (PCR)

Subject Index