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Small Femoral Cartilage Defect: Primary/Bone Loss

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Joint Preservation of the Knee

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Abstract

Femoral cartilage defects are a prevalent cause of pain and dysfunction among orthopedic patients. Multiple treatment options are currently available such as arthroscopic debridement and chondroplasty, microfracture with and without realignment procedures, and osteochondral autograft transfer. Each of these treatments is geared toward specific patient and lesion characteristics. The most important elements in the decision-making process are the size of the chondral lesion and the presence or absence of osseous involvement. This chapter reviews the current treatment options and recommendations for the use of each.

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References

  1. Gomoll AH, Yoshioka H, Watanabe A, Dunn JC, Minas T. Preoperative measurement of cartilage defects by MRI underestimates lesion size. Cartilage. 2011;2(4):389–93. https://doi.org/10.1177/1947603510397534.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Flanigan DC, Carey JL, Brophy RH, et al. Interrater and intrarater reliability of arthroscopic measurements of articular cartilage defects in the knee. J Bone Jt Surg. 2017;99(12):979–88. https://doi.org/10.2106/JBJS.16.01132.

    Article  Google Scholar 

  3. Chilelli BJ, Cole BJ, Farr J, Lattermann C, Gomoll AH. The four most common types of knee cartilage damage encountered in practice: how and why orthopaedic surgeons manage them. Instr Course Lect. 2017;66:507–30. Available at: http://www.ncbi.nlm.nih.gov/pubmed/28594526.

    PubMed  Google Scholar 

  4. Levy AS, Lohnes J, Sculley S, LeCroy M, Garrett W. Chondral delamination of the knee in soccer players. Am J Sports Med. 1996;24(5):634–9. https://doi.org/10.1177/036354659602400512.

    Article  CAS  PubMed  Google Scholar 

  5. Barber FA, Iwasko NG. Treatment of grade III femoral chondral lesions: mechanical chondroplasty versus monopolar radiofrequency probe. Arthroscopy. 2006;22(12):1312–7. https://doi.org/10.1016/j.arthro.2006.06.008.

    Article  PubMed  Google Scholar 

  6. Spahn G, Klinger HM, Mückley T, Hofmann GO. Four-year results from a randomized controlled study of knee chondroplasty with concomitant medial meniscectomy: mechanical debridement versus radiofrequency chondroplasty. Arthrosc J Arthrosc Relat Surg. 2010;26(9):S73–80. https://doi.org/10.1016/j.arthro.2010.02.030.

    Article  Google Scholar 

  7. Spahn G, Hofmann GO, von Engelhardt LV. Mechanical debridement versus radiofrequency in knee chondroplasty with concomitant medial meniscectomy: 10-year results from a randomized controlled study. Knee Surg Sport Traumatol Arthrosc. 2016;24(5):1560–8. https://doi.org/10.1007/s00167-015-3810-6.

    Article  Google Scholar 

  8. Steadman JR, Briggs KK, Rodrigo JJ, Kocher MS, Gill TJ, Rodkey WG. Outcomes of microfracture for traumatic chondral defects of the knee: Average 11-year follow-up. Arthroscopy. 2003;19(5):477–84. https://doi.org/10.1053/jars.2003.50112.

    Article  PubMed  Google Scholar 

  9. Gobbi A, Nunag P, Malinowski K. Treatment of full thickness chondral lesions of the knee with microfracture in a group of athletes. Knee Surg Sports Traumatol Arthrosc. 2005;13(3):213–21. https://doi.org/10.1007/s00167-004-0499-3.

    Article  PubMed  Google Scholar 

  10. Gobbi A, Karnatzikos G, Kumar A. Long-term results after microfracture treatment for full-thickness knee chondral lesions in athletes. Knee Surg Sport Traumatol Arthrosc. 2014;22(9):1986–96. https://doi.org/10.1007/s00167-013-2676-8.

    Article  Google Scholar 

  11. Mithoefer K, Mcadams T, Williams RJ, Kreuz PC, Mandelbaum BR. Clinical efficacy of the microfracture technique for articular cartilage repair in the knee: an evidence-based systematic analysis. Am J Sports Med. 2009;37(10):2053–63. https://doi.org/10.1177/0363546508328414.

    Article  PubMed  Google Scholar 

  12. Goyal D, Keyhani S, Lee EH, Hui JH. Evidence-based status of microfracture technique: a systematic review of level I and II studies. Arthrosc J Arthrosc Relat Surg. 2013;29(9):1579–88. https://doi.org/10.1016/j.arthro.2013.05.027.

    Article  Google Scholar 

  13. Arshi A, Fabricant PD, Go DE, Williams RJ, McAllister DR, Jones KJ. Can biologic augmentation improve clinical outcomes following microfracture for symptomatic cartilage defects of the knee? A systematic review. Cartilage. 2017; https://doi.org/10.1177/1947603517746722.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Lynch TS, Patel RM, Benedick A, Amin NH, Jones MH, Miniaci A. Systematic review of autogenous osteochondral transplant outcomes. Arthroscopy. 2015;31(4):746–54. https://doi.org/10.1016/j.arthro.2014.11.018.

    Article  PubMed  Google Scholar 

  15. Assenmacher AT, Pareek A, Reardon PJ, Macalena JA, Stuart MJ, Krych AJ. Long-term outcomes after osteochondral allograft: a systematic review at long-term follow-up of 12.3 years. Arthroscopy. 2016;32(10):2160–8. https://doi.org/10.1016/j.arthro.2016.04.020.

    Article  PubMed  Google Scholar 

  16. Pareek A, Reardon PJ, Macalena JA, et al. Osteochondral autograft transfer versus microfracture in the knee: a meta-analysis of prospective comparative studies at midterm. Arthroscopy. 2016;32(10):2118–30. https://doi.org/10.1016/j.arthro.2016.05.038.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Christian Lattermann

  2. Steadman Philippon Clinic, Vail, CO, USA

    Burak Altintas

Authors
  1. Christian Lattermann
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  2. Burak Altintas
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Correspondence to Christian Lattermann .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Adam B. Yanke

  2. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Brian J. Cole

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Lattermann, C., Altintas, B. (2019). Small Femoral Cartilage Defect: Primary/Bone Loss. In: Yanke, A., Cole, B. (eds) Joint Preservation of the Knee. Springer, Cham. https://doi.org/10.1007/978-3-030-01491-9_7

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  • DOI: https://doi.org/10.1007/978-3-030-01491-9_7

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-01490-2

  • Online ISBN: 978-3-030-01491-9

  • eBook Packages: MedicineMedicine (R0)

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