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Management of Chondral Injuries Following Fractures Around the Knee

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Knee Fractures

Part of the book series: Strategies in Fracture Treatments ((SFT))

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Abstract

Fractures around the knee joint are able to impair the articular cartilage in various manners. Chondral injuries directly related to knee fractures with an intraarticular involvement (e.g., multifragmentary cartilaginous defect areas, osteochondral fragments, or osteochondral steps) are cartilage lesions, which are diagnosed and need to be treated in the course of the osteosynthesis.

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References

  1. Niemeyer P, Andereya S, Angele P, Ateschrang A, Aurich M, Baumann M, et al. Autologous chondrocyte implantation (ACI) for cartilage defects of the knee: a guideline by the working group “Tissue Regeneration” of the German Society of Orthopaedic Surgery and Traumatology (DGOU). Zeitschrift fur Orthopadie und Unfallchirurgie. 2013;151(1):38–47. Epub 2013/02/21. Stellenwert der autologen Chondrozytentransplantation (ACT) in der Behandlung von Knorpelschaden des Kniegelenks – Empfehlungen der AG Klinische Geweberegeneration der DGOU.

    Google Scholar 

  2. Kuhle J, Sudkamp NP, Niemeyer P. Osteochondral fractures at the knee joint. Der Unfallchirurg. 2015;118(7):621–32; quiz 33–4. Epub 2015/07/08. Osteochondrale Frakturen am Kniegelenk.

    Google Scholar 

  3. Pape D, Filardo G, Kon E, van Dijk CN, Madry H. Disease-specific clinical problems associated with the subchondral bone. Knee Surg Sports Traumatol Arthrosc. 2010;18(4):448–462. Epub 2010/02/13.

    Google Scholar 

  4. Brophy RH, Zeltser D, Wright RW, Flanigan D. Anterior cruciate ligament reconstruction and concomitant articular cartilage injury: incidence and treatment. Arthroscopy. 2010;26(1):112–120. Epub 2010/02/02.

    Google Scholar 

  5. Nomura E, Inoue M, Kurimura M. Chondral and osteochondral injuries associated with acute patellar dislocation. Arthroscopy. 2003;19(7):717–721. Epub 2003/09/11.

    Google Scholar 

  6. Kuhle J, Angele P, Balcarek P, Eichinger M, Feucht M, Haasper C, et al. Treatment of osteochondral fractures of the knee: a meta-analysis of available scientific evidence. Int Orthop. 2013;37(12):2385–2394. Epub 2013/09/12.

    Google Scholar 

  7. Adachi N, Motoyama M, Deie M, Ishikawa M, Arihiro K, Ochi M. Histological evaluation of internally-fixed osteochondral lesions of the knee. J Bone Joint Surg. 2009;91(6):823–829. Epub 2009/06/02.

    Google Scholar 

  8. Savarese A, Lunghi E. Traumatic dislocations of the patella: problems related to treatment. La Chirurgia degli organi di movimento. 1990;75(1):51–57. Epub 1990/01/01.

    Google Scholar 

  9. Paar O, Boszotta H. Avulsion fractures of the knee and upper ankle joint. Classification and therapy. Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen. 1991;62(2):121–5. Epub 1991/02/01. Abscherfrakturen am Knie- und oberen Sprunggelenk. Klassifikation und Therapie.

    Google Scholar 

  10. Chotel F, Knorr G, Simian E, Dubrana F, Versier G. Knee osteochondral fractures in skeletally immature patients: French multicenter study. Orthop Traumatol Surg Res. 2011;97(8 Suppl):S154–S159. Epub 2011/11/02.

    Google Scholar 

  11. Mayer G, Seidlein H. Chondral and osteochondral fractures of the knee joint--treatment and results. Arch Orthop Trauma Surg. 1988;107(3):154–157. Epub 1988/01/01.

    Google Scholar 

  12. Kaplonyi G, Zimmerman I, Frenyo AD, Farkas T, Nemes G. The use of fibrin adhesive in the repair of chondral and osteochondral injuries. Injury. 1988;19(4):267–272. Epub 1988/07/01.

    Google Scholar 

  13. Fuchs M, Vosshenrich R, Dumont C, Sturmer KM. Refixation of osteochondral fragments using absorbable implants. First results of a retrospective study. Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen. 2003;74(6):554–61. Epub 2003/07/29. Refixation osteochondraler Fragmente mit resorbierbaren Implantaten. Erste Ergebnisse einer retrospektiven Studie.

    Google Scholar 

  14. Wachowski MM, Floerkemeier T, Balcarek P, Walde TA, Schuttrumpf JP, Frosch S, et al. Mid-term clinical and MRI results after refixation of osteochondral fractures with resorbable implants. Zeitschrift fur Orthopadie und Unfallchirurgie. 2011;149(1):61–7. Epub 2011/01/25. Mittelfristige klinische und kernspintomografische Ergebnisse nach Refixation osteochondraler Fragmente mit resorbierbaren Implantaten.

    Google Scholar 

  15. Wouters DB, Burgerhof JG, de Hosson JT, Bos RR. Fixation of osteochondral fragments in the human knee using Meniscus Arrows. Knee Surg Sports Traumatol Arthrosc. 2011;19(2):183–188. Epub 2010/05/14.

    Google Scholar 

  16. Matsusue Y, Nakamura T, Suzuki S, Iwasaki R. Biodegradable pin fixation of osteochondral fragments of the knee. Clin Orthop Relat Res. 1996(322):166–173. Epub 1996/01/01.

    Google Scholar 

  17. Zellner J, Krutsch W, Pfeifer CG, Koch M, Nerlich M, Angele P. Autologous chondrocyte implantation for cartilage repair: current perspectives. Orthop Res Rev. 2015;7:149–58.

    Google Scholar 

  18. Mithoefer K, McAdams T, Williams RJ, Kreuz PC, Mandelbaum BR. Clinical efficacy of the microfracture technique for articular cartilage repair in the knee: an evidence-based systematic analysis. Am J Sports Med. 2009;37:2053–63.

    Article  Google Scholar 

  19. Marcacci M, Filardo G, Kon E. Treatment of cartilage lesions: what works and why? Injury. 2013;44(Suppl 1):S11–5.

    Article  Google Scholar 

  20. Fortier LA, Cole BJ, McIlwraith CW. Science and animal models of marrow stimulation for cartilage repair. J Knee Surg. 2012;25:3–8.

    Article  Google Scholar 

  21. Steadman JR, Rodkey WG, Rodrigo JJ. Microfracture: surgical technique and rehabilitation to treat chondral defects. Clin Orthop Relat Res. 2001:S362–9.

    Google Scholar 

  22. Kon E, Filardo G, Berruto M, Benazzo F, Zanon G, Della Villa S, et al. Articular cartilage treatment in high-level male soccer players: a prospective comparative study of arthroscopic second-generation autologous chondrocyte implantation versus microfracture. Am J Sports Med. 2011;39:2549–57.

    Article  Google Scholar 

  23. Kreuz PC, Erggelet C, Steinwachs MR, Krause SJ, Lahm A, Niemeyer P, et al. Is microfracture of chondral defects in the knee associated with different results in patients aged 40 years or younger? Arthroscopy. 2006;22:1180–6.

    Article  Google Scholar 

  24. Gille J, Schuseil E, Wimmer J, Gellissen J, Schulz AP, Behrens P. Mid-term results of autologous matrix-induced chondrogenesis for treatment of focal cartilage defects in the knee. Knee Surg Sports Traumatol Arthrosc. 2010;18:1456–64.

    Article  CAS  Google Scholar 

  25. Kusano T, Jakob RP, Gautier E, Magnussen RA, Hoogewoud H, Jacobi M. Treatment of isolated chondral and osteochondral defects in the knee by autologous matrix-induced chondrogenesis (AMIC). Knee Surg Sports Traumatol Arthrosc. 2012;20:2109–15.

    Article  Google Scholar 

  26. Stanish WD, McCormack R, Forriol F, Mohtadi N, Pelet S, Desnoyers J, et al. Novel scaffold-based BST-CarGel treatment results in superior cartilage repair compared with microfracture in a randomized controlled trial. J Bone Joint Surg Am. 2013;95:1640–50.

    Article  Google Scholar 

  27. Hangody L, Dobos J, Balo E, Panics G, Hangody LR, Berkes I. Clinical experiences with autologous osteochondral mosaicplasty in an athletic population: a 17-year prospective multicenter study. Am J Sports Med. 2010;38:1125–33.

    Article  Google Scholar 

  28. Gudas R, Gudaite A, Pocius A, Gudiene A, Cekanauskas E, Monastyreckiene E, et al. Ten-year follow-up of a prospective, randomized clinical study of mosaic osteochondral autologous transplantation versus microfracture for the treatment of osteochondral defects in the knee joint of athletes. Am J Sports Med. 2012;40:2499–508.

    Article  Google Scholar 

  29. Niemeyer P, Albrecht D, Andereya S, Angele P, Ateschrang A, Aurich M, et al. Autologous chondrocyte implantation (ACI) for cartilage defects of the knee: a guideline by the working group “Clinical Tissue Regeneration” of the German Society of Orthopaedics and Trauma (DGOU). Knee. 2016;23:426–35.

    Article  CAS  Google Scholar 

  30. Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L. Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med. 1994;331:889–95.

    Article  CAS  Google Scholar 

  31. Harris JD, Siston RA, Brophy RH, Lattermann C, Carey JL, Flanigan DC. Failures, re-operations, and complications after autologous chondrocyte implantation--a systematic review. Osteoarthritis Cartilage. 2011;19:779–91.

    Article  CAS  Google Scholar 

  32. Vavken P, Samartzis D. Effectiveness of autologous chondrocyte implantation in cartilage repair of the knee: a systematic review of controlled trials. Osteoarthritis Cartilage. 2010;18:857–63.

    Article  CAS  Google Scholar 

  33. Basad E, Ishaque B, Bachmann G, Sturz H, Steinmeyer J. Matrix-induced autologous chondrocyte implantation versus microfracture in the treatment of cartilage defects of the knee: a 2-year randomised study. Knee Surg Sports Traumatol Arthrosc. 2010;18:519–27.

    Article  Google Scholar 

  34. Crawford DC, DeBerardino TM, Williams RJ 3rd. NeoCart, an autologous cartilage tissue implant, compared with microfracture for treatment of distal femoral cartilage lesions: an FDA phase-II prospective, randomized clinical trial after two years. J Bone Joint Surg Am. 2012;94:979–89.

    Article  Google Scholar 

  35. Bentley G, Biant LC, Vijayan S, Macmull S, Skinner JA, Carrington RW. Minimum ten-year results of a prospective randomised study of autologous chondrocyte implantation versus mosaicplasty for symptomatic articular cartilage lesions of the knee. J Bone Joint Surg Br. 2012;94:504–9.

    Article  CAS  Google Scholar 

  36. Angele P, Fritz J, Albrecht D, Koh J, Zellner J. Defect type, localization and marker gene expression determines early adverse events of matrix-associated autologous chondrocyte implantation. Injury. 2015;46(Suppl 4):S2–9.

    Article  Google Scholar 

  37. Vanlauwe J, Saris DB, Victor J, Almqvist KF, Bellemans J, Luyten FP, et al. Five-year outcome of characterized chondrocyte implantation versus microfracture for symptomatic cartilage defects of the knee: early treatment matters. Am J Sports Med. 2011;39:2566–74.

    Article  Google Scholar 

  38. Niemeyer P, Koestler W, Sudkamp NP. Problems and complications of surgical techniques for treatment of full-thickness cartilage defects. Zeitschrift fur Orthopadie und Unfallchirurgie. 2011;149:45–51.

    Article  CAS  Google Scholar 

  39. Nejadnik H, Hui JH, Feng Choong EP, Tai BC, Lee EH. Autologous bone marrow-derived mesenchymal stem cells versus autologous chondrocyte implantation: an observational cohort study. Am J Sports Med. 2010;38:1110–6.

    Article  Google Scholar 

  40. Farr J, Tabet SK, Margerrison E, Cole BJ. Clinical, radiographic, and histological outcomes after cartilage repair with particulated juvenile articular cartilage: a 2-year prospective study. Am J Sports Med. 2014;42:1417–25.

    Article  Google Scholar 

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Zellner, J., Koch, M., Weber, J., Angele, P. (2021). Management of Chondral Injuries Following Fractures Around the Knee. In: Hanschen, M., Biberthaler, P., Waddell, J.P. (eds) Knee Fractures . Strategies in Fracture Treatments. Springer, Cham. https://doi.org/10.1007/978-3-030-81776-3_22

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  • DOI: https://doi.org/10.1007/978-3-030-81776-3_22

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