The American journal of sports medicine
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Chondral lesions in athletically active patients cause considerable morbidity, and treatment with existing cell-based therapies can be challenging. Bone marrow has been shown as a possible source of multipotent stem cells (MSCs) with chondrogenic potential and is easy to harvest during the same surgical procedure. ⋯ The treatment of large chondral defects with MSCs is an effective procedure and can be performed routinely in clinical practice. Moreover, it can be achieved with 1-step surgery, avoiding a previous surgical procedure to harvest cartilage and subsequent chondrocyte cultivation.
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Bioabsorbable anchors may lead to osteolysis and cyst formation. However, the prevalence of these outcomes is not known for rotator cuff repairs. ⋯ Osteolysis and cyst formation are common complications following the use of bioabsorbable anchors in rotator cuff repairs. Considering that adequate absorption of anchors and preservation of bone stock are the reasons for using bioabsorbable anchors, use of these anchors should be reconsidered because of possible interference with revision surgery.
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The medial patellofemoral ligament (MPFL) is the main restraining force against lateral patellar displacement. It is disrupted after patellar subluxation or dislocation. Reconstruction of the MPFL is frequently performed when nonoperative management fails and the patient experiences recurrent patellar dislocation. ⋯ This study demonstrates the importance of restoration of the anatomic insertion point of the MPFL when performing MPFL reconstruction and proposes that this procedure should not be performed in isolation in patients with high-grade trochlear dysplasia.
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Randomized Controlled Trial
Platelet-rich plasma as a treatment for patellar tendinopathy: a double-blind, randomized controlled trial.
Previous studies have shown improvement in patellar tendinopathy symptoms after platelet-rich plasma (PRP) injections, but no randomized controlled trial has compared PRP with dry needling (DN) for this condition. ⋯ A therapeutic regimen of standardized eccentric exercise and ultrasound-guided leukocyte-rich PRP injection with DN accelerates the recovery from patellar tendinopathy relative to exercise and ultrasound-guided DN alone, but the apparent benefit of PRP dissipates over time.
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Comparative Study
Treatment of "patellofemoral" cartilage lesions with matrix-assisted autologous chondrocyte transplantation: a comparison of patellar and trochlear lesions.
Matrix-assisted autologous chondrocyte transplantation (MACT) has been shown to offer good outcomes at midterm follow-up, but results are heterogeneous among different patients and lesion types. Being part of the same joint, both patellar and trochlear cartilage lesions are commonly considered to be affected by the same treatment issues, and therefore, it is common practice to report results obtained treating these lesions together. ⋯ Patient characteristics differ between patellar and trochlear cartilage defects, and moreover, the results obtained are significantly different, with a markedly good outcome in cases with trochlear lesions and less satisfactory results for patients affected by cartilage lesions of the patella. Thus, patellar and trochlear defects should be considered separately when evaluating the outcome of cartilage treatments in this anatomic region.