Background: Bone marrow lesions (BMLs) have been found on magnetic resonance imaging in patients with meniscal tears.
Purpose: We sought to determine the prevalence and location of BMLs, the association between BMLs and chondral lesions, and the association between BMLs and pain in patients without radiographic evidence of degenerative joint disease who underwent arthroscopic partial meniscectomy (APM).
Study Design: Cohort study; Level of evidence, 2.
Methods: We performed a secondary analysis of the Chondral Lesions And Meniscus Procedures (ChAMP) randomized controlled trial. BMLs were assessed on preoperative magnetic resonance imaging, and chondral lesions were documented at the time of surgery. Pain was assessed preoperatively and at 1 year after APM using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Knee injury and Osteoarthritis Outcome Score (KOOS). The chi-square test was used to examine the association between BMLs and chondral lesions, and the test was used to examine the association between BMLs and pain.
Results: Of 241 patients, 58.9% had ≥1 BMLs, and most were located on the medial tibial plateau (MTP; 74.6%) and/or medial femoral condyle (MFC; 28.9%). Most MTP BMLs were submeniscal (56%), and most MFC BMLs extended beyond the meniscus (73%). There were more MFC chondral lesions for patients with any MFC BMLs ( = .01) and submeniscal MFC BMLs ( = .02) versus those without BMLs, and there was no association between BMLs and chondral lesions on the MTP. There was also no association between BMLs and preoperative or postoperative pain scores.
Conclusion: In patients without radiographic evidence of degenerative joint disease who underwent APM, BMLs were found in 58.9% of knees and were primarily located in the medial compartment. There was a borderline statistically significant association between BMLs and chondral lesions for the MFC; however, BMLs were not associated with pain scores preoperatively or at 1 year after surgery.
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http://dx.doi.org/10.1177/2325967119830381 | DOI Listing |
Osteochondral and chondral injuries of the patellofemoral joint are common in active patients, and effective management requires a thorough physical and imaging evaluation, a detailed understanding of the unique anatomic and biomechanical joint properties contributing to these injuries, and an appropriate selection of treatment modality. Diagnosis of patellofemoral chondral injuries can be challenging, and differentiating between various causes of anterior knee pain is crucial to successful outcomes. Once identified, nonsurgical treatments including physical therapy, bracing, and injections are a mainstay of initial management.
View Article and Find Full Text PDFIn Vivo
December 2024
Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan.
Background/aim: Costal cartilage fractures are associated with poor prognosis in patients with blunt chest trauma. A Computer-Aided Detection (CAD) system for detecting rib fractures has been used in practice, but it is unclear whether this system recognizes costal cartilage fractures. This study investigated whether the CAD system for rib fracture can detect costal cartilage fractures.
View Article and Find Full Text PDFIndian J Orthop
January 2025
Ortho One Orthopaedic Specialty Centre, Coimbatore, India.
Introduction: Interspace defects after osteochondral autograft transfer (OATS) are filled only with fibrocartilage. Attempts have been made to address these issues in OATS with procedures like mega OATS and Hexagonal Osteochondral Graft System. We have described the functional outcomes of a hybrid technique combining a regeneration and a restoration modality to address the interspace defect in OATS.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
December 2024
Sporthopaedicum, Berlin, Germany.
Purpose: Sulcus-deepening trochleoplasty (TP) effectively treats patellofemoral (PF) instability (PFI) caused by high-grade trochlear dysplasia (TD), but current evidence is based on small case series. We hypothesised, that TP would result in significant functional improvements and a low re-dislocation rate but would not accelerate the progression of PF cartilage deterioration.
Methods: We retrospectively reviewed all TP cases performed by a single surgeon between 2015 and 2021.
Arthrosc Tech
November 2024
Orthopaedic Department, Faculty of Medicine in Assiut, Al-Azhar University, Cairo, Egypt.
Osteochondral lesions of the talus are chondral lesions affecting the subchondral bone mostly due to acute ankle trauma, including either sprains or fractures. After failure of conservative treatment, operative treatment is necessary, with different surgical techniques described in the literature. We describe a single-step osteochondral autograft transfer to access the medial talar dome lesion that avoids the need for a medial malleolar osteotomy and therefore eliminates morbidity while reducing operative time.
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