By Christoph Erggelet, Bert R. Mandelbaum, Eike H. Mrosek, Jason M. Scopp
Cartilage defects impact sufferers of all age teams. Surgeons, teamdoctors, normal practitioners and physiotherapists alike are anticipated to supply sufficient care. simply person cures combining a good balanced collection of quite a few suggestions may be winning. historical past wisdom, operative and non-operative treatments are defined in concise chapters: Articular cartilage biology - Diagnostics - Surgical innovations - Symptomatic and replacement drugs - Physiotherapy. Diagnostic findings and surgeries are generously illustrated via aquarelles and color images. suggestions for added analyzing, description of vital scientific scoring structures and a list of analytic instruments are further for extra details.
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Additional info for Principles of Cartilage Repair
A Debridement of the defect in rectangular shape and drilling of anchor holes in each corner. b Implant prearmed with resorbable sutures in every corner (woven, 2-0) using special knotting techniques. c Insertion of pre-armed implant into the defect. d Principle of transosseous anchoring of the implant by press fit-insertion of knots into holes.
This may be reliably prevented by using bandages. Proprioceptive qualities of bandages are accepted nowadays, however, there is no detailed proof for this phenomenon. Nevertheless, it is beyond doubt that bandages may improve muscular activity patterns around injured joints by means of their propriocep- 33 34 ] Conservative Treatment of Articular Cartilage Defects The following chapter introduces the most important techniques: ] low frequency currents (< 1000 Hz) ] Stanger’s bath ] Iontophoresis: transcutaneous ion transport for increased uptake of positively or negatively charged drug containing gels.
Increased stability is achieved with cannulated pins (smart nails©). ] – – – Advantages Resorbable material Arthroscopic technique Only thin perforation of fragment. Fig. 26. Arthroscopic view after fixation of an osteochondral fragment using resorbable pins (Ethicon). ] Disadvantages – Insufficient compression of fragment to bone possible – Fixation less stable compared to screws. Fixation of osteochondral fragments with screws After reposition, detached fragments may be fixed with small fragment spongiosa (cancellous is the term we use in America) screws.