By Tom Minas MD MS
A Primer in Cartilage fix and Joint maintenance of the Knee provides the whole diversity of therapies for a altering, more and more more youthful sufferer inhabitants. Dr. Thomas Minas demonstrates each one technique-from non-surgical to mini-incision overall knee arthroplasty to the hot advancements in tissue biologics-through a step by step process. This hugely visible, multimedia reference courses you in determining the most sensible therapy path for every sufferer. Get in basic terms the knowledge you wish via a technique-focused strategy and the constant form of a unmarried writer, Dr. Thomas Minas-a best expert in cartilage fix. essentially see the nuances and significant issues of every approach with surgical pictures and artists' renderings of key events within the working room. decide upon the simplest therapy path for every sufferer via wide insurance of recommendations from non-surgical to mini-incision overall knee arthroplasty. Read more...
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Additional info for A Primer in Cartilage Repair and Joint Preservation of the Knee
Figure 4–1 Empowerment of the patient. Copyright 2005 by Randy Glasbergen. high sense of vitality and an optimistic outlook with strong social supports has demonstrated a good clinical outcome with almost any surgical procedure. We reviewed our clinical outcome data using the Medical Outcomes Study 36-Item Health Survey (SF-36)1 and noted that vitality and social supports played strong into a positive clinical outcome with regard to physical pain relief and well-being (presented at the International Cartilage Repair Society 2002).
Return to ADL and sports as tolerated High-demand patient Arthroscopic chondroplasty Arthroscopic debridement and MSTY Measurable symptomatic19 improvement may last up to 5 years Up to 75%41 success with ADL8, 50% success with return to sport Yes Success? No§ ACI or OCG (autograft) YMST Marrow stimulation technique • Drilling • Abrasion • Microfracture Recommendations My preferred treatment algorithm is outlined in the following section (Table 4–2). I do not treat asymptomatic chondral defects at this time because of the possibility of worsening the patient’s condition.
Several authors have conducted studies comparing different repair techniques, such as microfracture, mosaicplasty, and ACI, with conflicting results. These studies 42 PART 1 DECISION MAKING are often compromised by the nature of the procedures they were designed to investigate; for example, ACI as a cell-based therapy is dependent on a sophisticated cell culturing process. The cell culturing process requires phenotypic validation, cell viability assessment, and sterility process validation according to the FDA, GLP (Good Laboratory Practices), and GMP (Good Manufacturing Practices) to ensure sterile, safe, phenotypically stable cell implantation; however, not all authors use standardized and approved laboratory facilities.
A Primer in Cartilage Repair and Joint Preservation of the Knee by Tom Minas MD MS