Clinical Aspects: An Orthopedic Surgeon’s Perspective

Abstract

Improvements in musculoskeletal imaging in the past decade have allowed orthopedic surgeons to make great advances in the diagnosis and management of soft tissue pathologies in the musculoskeletal system. As the technology for MRI has enhanced the resolution for visualizing cartilage and other soft tissues, this has improved the orthopedic surgeons’ ­ability to plan preoperatively the treatment of cartilage lesions, and, in selected circumstances, to also monitor the subsequent postoperative course for efficacy. In particular, articular damage of the knee joint is one of the most common reasons for both younger and older patients to seek an orthopedic consultation. While MRIs are helpful in diagnosing focal cartilage defects, diffuse cartilage damage in the ­setting of osteoarthritis often does not require advanced imaging modalities such as an MRI for diagnosis and treatment. In most cases, plain radiography in the weight-bearing setting provides adequate information to the orthopedic surgeon for both the conservative and surgical management of osteoarthritis. As osteoarthritis has been covered extensively in the previous chapter, this chapter will focus on chondral lesions in the knee of a younger, more active population as a model for how orthopedic surgeons approach many of the pathologies that affect cartilage.