Due to its multifaceted nature and high rates for revision procedures, failed cartilage repair represents a challenging problem in patients. Prior to performing a revision procedure, it is essential to identify the non-modifiable and modifiable risk factors that accelerate the degradation of primary cartilage repair tissue. Comorbidities can include a patient's activity status, malalignment, or instability. Since MRI findings may underestimate the true size of a cartilage lesion, data should also be collected from past operative reports and staging arthroscopies. This should be combined with a comprehensive physical exam to assess ligamentous integrity and proper limb alignment in order to optimize the intra-articular environment. When performing osteochondral allograft transplantation for large osteochondral defects, there are a number of important technical strategies and repair options to choose from in order to optimize graft incorporation. For patients who have failed a prior MST and show cystic or osteophytic changes on MRI, it is likely wise to favor OCA. However, in their absence the surgeon may proceed with either OCA or ACI.
CITATION STYLE
Riff, A. J., & Gomoll, A. H. (2019). Revision cartilage treatment. In Joint Preservation of the Knee: A Clinical Casebook (pp. 201–216). Springer International Publishing. https://doi.org/10.1007/978-3-030-01491-9_13
Mendeley helps you to discover research relevant for your work.