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Decision Making in Cartilage Repair Procedures

  • Chapter
Cartilage Repair Strategies

Abstract

The treatment of isolated articular cartilage lesions remains a difficult clinical problem. Cartilage has a poor intrinsic capacity for repair. Untreated lesions persist indefinitely and can predispose affected joints to pain and dysfunction. Fortunately, the treatment options for these lesions continue to evolve and expand. However, a validated approach to the treatment of such lesions remains elusive. Decision making in these circumstances is highly variable between practitioners. We describe an approach to the patient with a symptomatic articular cartilage lesion. Consideration of certain parameters, including lesion size, lesion location, patient demand, body mass index, limb alignment, and treatment history should be considered when selecting a surgical approach. In addition, surgeons should understand the physiology of the cartilage repair method employed and how this relates to the postoperative rehabilitation program. Cartilage repair strategies are classified into the following: enhancement intrinsic repair response, cell-based, scaffold-based, cell plus scaffold-based, and whole tissue transplantation. A treatment algorithm based on lesion size, patient demand, and treatment (primary vs secondary) is presented.

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Authors and Affiliations

  1. Weill Medical College of Cornell University, New York, NY

    Riley J. Williams III MD (Associate Professor of Orthopaedic Surgery, Attending Orthopaedic Surgeon, Director)

  2. Hospital for Special Surgery, Institute for Cartilage Repair, New York, NY

    Riley J. Williams III MD (Associate Professor of Orthopaedic Surgery, Attending Orthopaedic Surgeon, Director)

  3. Resident, Orthopedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY

    Robert H. Brophy MD

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  1. Riley J. Williams III MD
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Editors and Affiliations

  1. Weill Medical College of Cornell University, USA

    Riley J. Williams III MD (Associate Professor of Orthopaedic Surgery, Attending Orthopaedic Surgeon Director) (Associate Professor of Orthopaedic Surgery, Attending Orthopaedic Surgeon Director)

  2. Institute for Cartilage Repair, Hospital for Special Surgery, New York, NY

    Riley J. Williams III MD (Associate Professor of Orthopaedic Surgery, Attending Orthopaedic Surgeon Director) (Associate Professor of Orthopaedic Surgery, Attending Orthopaedic Surgeon Director)

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Williams, R.J., Brophy, R.H. (2007). Decision Making in Cartilage Repair Procedures. In: Williams, R.J. (eds) Cartilage Repair Strategies. Humana Press. https://doi.org/10.1007/978-1-59745-343-1_4

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  • DOI: https://doi.org/10.1007/978-1-59745-343-1_4

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-629-0

  • Online ISBN: 978-1-59745-343-1

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