The American journal of sports medicine
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Randomized Controlled Trial
Treatment of symptomatic cartilage defects of the knee: characterized chondrocyte implantation results in better clinical outcome at 36 months in a randomized trial compared to microfracture.
Damaged articular cartilage has limited capacity for self-repair. Autologous chondrocyte implantation using a characterized cell therapy product results in significantly better early structural repair as compared with microfracture in patients with symptomatic joint surface defects of the femoral condyles of the knee. ⋯ Characterized chondrocyte implantation for the treatment of articular cartilage defects of the femoral condyles of the knee results in significantly better clinical outcome at 36 months in a randomized trial compared with MF. Time to treatment and chondrocyte quality were shown to affect outcome.
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Tissue engineering has become available for cartilage repair in clinical practice. ⋯ Hyalograft C autograft provides clinical improvement in healthy young patients with single cartilage defects. Less complicated surgery and lower morbidity are considered advantages of the technique. The results of treatment with Hyalograft C as a salvage procedure or in patients with osteoarthritis are poor.
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Comparative Study
Assessment of differences between the modified Cincinnati and International Knee Documentation Committee patient outcome scores: a prospective study.
Functional outcome questionnaires have become a common part of patient follow-up in the orthopaedic community. The modified Cincinnati Knee Rating System and the International Knee Documentation Committee (IKDC) subjective scale were designed to provide clinicians with information regarding a patient's functional and clinical status after knee surgery. ⋯ The modified Cincinnati Knee Rating System and the IKDC subjective rating questionnaires reported by patient population provide similar results. The practitioner who is not performing a population-based study but following individual patients for recovery will find that the individual questionnaires may offer different functional limitations. Individual differences were lost in the population means, with the approximate balance of positive and negative score differences masking the individual patient differences.
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Osteochondral lesions are frequently seen in athletes after ankle injuries. At this time, osteochondral autologous transplantation (OATS, mosaicplasty) is the only surgical treatment that replaces the entire osteochondral unit in symptomatic lesions. ⋯ Indications for mosaicplasty with a plug transfer from the knee to the talus must be considered carefully, as at midterm, moderate outcome and considerable donor-site morbidity may be found.
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Anterior cruciate ligament ruptures, especially to young female athletes, are a cause of major concern in the sports medicine fraternity. The major structural constituents of ligaments are collagens, specifically types I and V. Recently, the gene that encodes for the alpha1 chain of type I collagen (COL1A1) has been shown to be associated with an increased risk of cruciate ligament ruptures. The COL5A1 gene, which encodes for the alpha1 chain of type V collagen, has been shown to be associated with Achilles tendon injuries. ⋯ This is the first study to show that there is a specific genetic risk factor associated with risk of anterior cruciate ligament ruptures in female athletes.