Purpose: The purpose of this study was to compare bone marrow stimulation using micro-computed tomography (micro-CT) analysis of an abrasion arthroplasty technique, drilling k-wire technique, traditional microfacture awl, or a microdrill instrument for subchondral bone defects.
Methods: Eleven cadaveric distal femoral specimens were obtained and divided into 3 common areas of osteochondral defect: trochlea and weightbearing portions of the medial and lateral femoral condyles. Each area of interest was then denuded of cartilage using a PoweRasp and divided into quadrants. Each quadrant was assigned either a 1.6 mm Kirschner wire (k-wire), 1.25 mm microfracture awl, 1.5 mm fluted microdrill, PowerPick, or a curette (abrasion arthroplasty) to create 4 channels into the subchondral bone sing the same instrument. Subchondral bone and adjacent tissue areas were then evaluated using micro-CT to analyze adjacent bone destruction and extension into the bone marrow.
Results: Overall, there was a significantly decreased area of bone destruction or compression using the microdrill (0.030 mm) as compared to the microfracture awl (0.072 mm) and k-wire (0.062 mm) ( < .05). Within the trochlea and the medial femoral condyle, there was significantly decreased bony compression with the microdrill as compared to the awl and k-wire ( < .05); however, when stratified, this was not significant among the lateral femoral condylar samples ( = .08).
Conclusion: Bone marrow stimulation causes bony compression that may negatively impact subchondral bone and trabecular alignment. It is important to understand which tools used for bone marrow stimulation cause the least amount of damage to the subchondral bone.
Clinical Relevance: This study demonstrates the decreased subchondral bony defects seen with the microdrill versus the traditional microfracture awl indicating that when performing bone marrow stimulation, the microdrill may be a less harmful tool to the subchondral bone.
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http://dx.doi.org/10.1016/j.asmr.2023.100786 | DOI Listing |
Arthrosc Tech
December 2024
Department of Orthopedics and Traumatology, Ankara Yıldırım Beyazıt University, Ankara Bilkent City Hospital, Ankara, Turkey.
Mosaicplasty is a relatively challenging procedure used in the management of focal osteochondral lesions of the joints. Donor-site morbidity is still the main concern after mosaicplasty because it entails the harvesting of an osteochondral autograft from an otherwise healthy region to be impacted later on the weight-bearing damaged site. We describe a possible alternative to conventional mosaicplasty with subchondral bone support harvested from the iliac crest as an osteoperiosteal autograft and covered with a minced cartilage layer.
View Article and Find Full Text PDFVet Radiol Ultrasound
January 2025
Ospedale Veterinario "I Portoni Rossi", Anicura Italy, Diagnostic Imaging Department (Mattei, Specchi), Surgical Department (Pratesi), Neuroradiology Department (Bernardini), Bologna, Italy.
Cranial cruciate ligament (CCL) disease causes variable stifle instability assessed by specific clinical tests. Radiographs are performed to measure the tibial plateau angle (TPA) for planning tibial plateau leveling osteotomy (TPLO) surgery. Concomitant damage to other intra-articular structures, for which clinical detection is unreliable, may occur and potentially affect the surgical outcome.
View Article and Find Full Text PDFAm J Sports Med
January 2025
Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, USA.
Background: Treatment of stable osteochondritis dissecans (OCD) lesions of the knee in young patients poses the challenge of abstaining from competitive sports for months. Outcomes relevant to this patient population additionally include successful return to sport (RTS), return to the same level of sport, and the time needed to achieve both.
Purpose: To evaluate the adolescent population for RTS outcomes after treatment of stable OCD lesions of the knee and to compare RTS outcomes between patients treated nonoperatively and those who required surgery.
Biomedicines
December 2024
Department of Maxillofacial Surgery, Medical University of Gdansk, 17 Mariana Smoluchowskiego Street, 80-214 Gdansk, Poland.
Background: The accurate diagnosis of degenerative joint diseases (DJDs) of the temporomandibular joint (TMJ) presents a significant clinical challenge due to their progressive nature and the complexity of associated structural changes. These conditions, characterized by cartilage degradation, subchondral bone remodeling, and eventual joint dysfunction, necessitate reliable and efficient imaging techniques for early detection and effective management. Cone-beam computed tomography (CBCT) is widely regarded as the gold standard for evaluating osseous changes in the TMJ, offering detailed visualization of bony structures.
View Article and Find Full Text PDFBiomedicines
December 2024
Medical School, Max Planck University Center (UniMAX), Indaiatuba 13343-060, SP, Brazil.
Knee osteoarthritis (OA) is a chronic articular disease characterized by the progressive degeneration of cartilage and bone tissue, leading to the appearance of subchondral cysts, osteophyte formation, and synovial inflammation. Conventional treatments consist of non-steroidal anti-inflammatory drugs (NSAIDs), analgesics, and glucocorticoids. However, the prolonged use of these drugs causes adverse effects.
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