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Articular
Cartilage Injury
& Treatment Options
Articular
Cartilage
The
knee joint is made up of three bones, ( the femur, also known
as the thigh bone, in the knee joint it has two major prominces,
called the condyles. The tibia which meets the femur in the
knee joint has two areas on which the two femoral condyles
ride during motion, this are called the tibial plateaus. The
Patella (knee Cap) rides in a shallow groove over the front
part of the femur called the trochlea
Articular Cartilage is the durable white tissue that covers
the ends of these bones in the knee Joint. This glistening
white substance has somewhat the consistency of firm rubber.
With normal joint fluid, the surface is more slippery than
water on ice. This allows the normal smooth and easy joint
motion, it softensthe impact during loading much like a shock
absorber. If the cartilage is damaged,the ability to heal
itself is very poor, and continued wear can result in, impaired
joint function leading to disability and eventually progressing
to a full blown osteoarthritis. Cartilage damage is like a
hole in the road, the more activity that takes place, the
greater the chance of the hole getting bigger. The key is
to repair it before it gets to the point of no return. Please
refer to the section titled: Treatment Algorithm to get a
better understanding of how Dr. Gersoff treats the broad spectrum
of cartilage damage.
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Treatment
Options
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Algorithm
Chart - The natural history
of a cartilage lesions is not fully understood, today we still
don't know if a focal lesion will automatically progress if
untreated, historically the factors that have been taken into
consideration are related to the size and depth of the lesions
after controlling for weight, activity, alignment, and instability.
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.ppt file
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| Arthroscopic
Debridement - An
arthroscopic debridement can be described as a clean-up procedure
that removes loose fragments and reduces enzymes that can cause
irritation to the surrounding tissue.
| .doc file |
| Bone
Marrow Stimulation Techniques - There
are a number of techniques designed to penetrate into the subchondral
bone to allow for the body's own bone marrow cells to potentially
heal the cartilage defect.
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| Osteochondral
Allografts - Osteochondral
allografts represent a means of substituting damaged or lost
cartilage with healthy cartilage and bone from a cadaver.
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| Autologous
Chondrocyte Implantation (ACI) - Autologous
Chondrocyte Implantation (ACI) involves the implanting of the
patients own cultured cartilage cells to repair the cartilage
defect.
| .doc file |
| High
Tibial Osteotomy (HTO) - In
patients with osteoarthritis you have arthritic damage to the
cartilage in the inner aspect of the knee, known as the medial
compartment, there usually is some type of alignment deformity,
called a varus deformity or bowleg.
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| Osteochondral
Autografts - Osteochondral
autograft transfers is a technique that involves replacing damaged
joint cartilage with structurally normal cartilage.
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| Nutraceuticals
- Articular
cartilage, the synovial fluid and the underlying subchondral
bone all work together to act as a shock absorber, allowing
for the joint to function in a normal fashion.
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PRESENTATIONS
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Dr.
Gersoff has presented internationally on a variety of topics
related to Meniscal Transplantation and Articular Cartilage
Repair.
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Combining
Autologous Chondrocyte Implantation and a Meniscal Transplant
to Treat the Young Complex Knee
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