Email this article Treatment outcomes of patients with knee hyaline cartilage damages using osteoperforative methods
- Authors: Chebotarev S.V.1, Khominets V.V.1, Zemlyanoy D.A.2, Kalyuzhnaya L.I.1, Grankin A.S.1, Fedorov R.A.1
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Affiliations:
- Kirov Military Medical Academy
- Saint Petersburg State Pediatric Medical University
- Issue: Vol 9, No 4 (2021)
- Pages: 397-406
- Section: Original Study Article
- URL: https://ogarev-online.ru/turner/article/view/64290
- DOI: https://doi.org/10.17816/PTORS64290
- ID: 64290
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Abstract
BACKGROUND: The treatment of traumatic and degenerative cartilage damage is one of the largest areas in orthopedic practice, and the therapy success remains limited.
AIM: To analyze the results of surgical treatment of patients with traumatic and degenerative injuries of the knee joint hyaline cartilage using debridement and osteoperforative techniques, taking into account the time from the surgical intervention.
MATERIALS AND METHODS: A statistical analysis was conducted on the treatment outcomes of servicemen with traumatic and degenerative damage in the knee joint articular hyaline cartilage. Patients underwent surgical treatment using osteoperforative techniques (abrasive chondroplasty, tunneling, and microfracturing) at the Clinic of Military Traumatology and Orthopedics of the S.M. Kirov Military Medical Academy from 2009 to 2019. The study relied on the data obtained from questioning the patients using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and LKSS questionnaires.
RESULTS: The result analyses using the KOOS and LKSS scales revealed significantly higher good results in the observed group in the postoperative period from 1 to 4 years than in the groups from 4 to 8 and more than 8 years (p = 0.004). No significant differences were determined in the treatment outcomes of the groups with resection and different osteoperforative methods.
CONCLUSIONS: Treatment methods for hyaline cartilage defects, such as resection and osteoperforative, are technically simple with good treatment outcomes in patients with articular cartilage injuries from 1 to 4 years postoperative. Treatment outcome deterioration was noted in 4–8 years postoperative, regardless of the treatment method used, which is more significant in patients in >8 years postoperative.
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##article.viewOnOriginalSite##About the authors
Sergei V. Chebotarev
Kirov Military Medical Academy
Email: sergeichebotarev90@gmail.com
ORCID iD: 0000-0003-3710-1983
SPIN-code: 4817-5650
MD, residency student, Сaptain of the medical service
Russian Federation, 6 Akademika Lebedeva str., Saint Petersburg, 194044Vladimir V. Khominets
Kirov Military Medical Academy
Email: khominets_62@mail.ru
ORCID iD: 0000-0002-7693-3072
SPIN-code: 5174-4433
MD, PhD, D.Sc., Professor, Colonel of the medical service
Russian Federation, 6 Akademika Lebedeva str., Saint Petersburg, 194044Dmitry A. Zemlyanoy
Saint Petersburg State Pediatric Medical University
Email: zemlianoj@mail.ru
ORCID iD: 0000-0003-4716-809X
SPIN-code: 3871-7531
Dmitry A. Zemlyanoy, MD, PhD
Russian Federation, Saint PetersburgLidiya I. Kalyuzhnaya
Kirov Military Medical Academy
Email: terrestra@mail.ru
MD, PhD, D.Sc., Senior Researcher
Russian Federation, 6 Akademika Lebedeva str., Saint Petersburg, 194044Aleksej S. Grankin
Kirov Military Medical Academy
Email: aleksey-grankin@yandex.ru
ORCID iD: 0000-0002-4565-9066
SPIN-code: 1122-8388
MD, PhD, Major of the medical service
Russian Federation, 6 Akademika Lebedeva str., Saint Petersburg, 194044Roman A. Fedorov
Kirov Military Medical Academy
Author for correspondence.
Email: roman.doc83@yandex.ru
MD, PhD, Lieutenant colonel of the medical service
Russian Federation, 6 Akademika Lebedeva str., Saint Petersburg, 194044References
- Newman AP. Articular cartilage repair. Am J Sports Med. 1998;26(2):309−324. doi: 10.1177/03635465980260022701
- Volova LT, Kotelnikov GP, Rossinskaya VV, et al. Features of the regeneration of hyaline cartilage tissue after plasty of articular surface defects with combined grafts. Journal of Ural Medical Academic Science. 2014;5:70−72. (In Russ.)
- Pearsall AW, Madanagopal SG, Tucker JA, et al. The evaluation of refrigerated and frozen osteochondral allografts in the knee. Surgical Science. 2011;2(05):232. doi: 10.4236/ss.2011.25
- Medvedeva EV, Grebenik EA, Gornostaeva SN, et al. Repair of damaged articular cartilage: current approaches and future directions. Int J Mol Sci. 2018;19(8):2366. doi: 10.3390/ijms19082366
- Mundi R, Bedi A, Chow L, et al. Cartilage restoration of the knee: a systematic review and meta-analysis of level 1 studies. Am J Sports Med. 2016;44(7):1888−1895. doi: 10.1177/0363546515589167
- Devitt BM, Bell SW, Webster KE, et al. Surgical treatments of cartilage defects of the knee: systematic review of randomised controlled trials. Knee. 2017;24(3):508−517. doi: 10.1016/j.knee.2016.12.002
- Goyal D, Keyhani S, Lee EH, et al. Evidence-based status of microfracture technique: a systematic review of level I and II studies. Arthroscopy. 2013;29(9):1579−1588. doi: 10.1016/j.arthro.2013.05.027
- Gracitelli GC, Moraes VY, Franciozi CE, et al. Surgical interventions (microfracture, drilling, mosaicplasty, and allograft transplantation) for treating isolated cartilage defects of the knee in adults. Cochrane Database Syst Rev. 2016;9. doi: 10.1002/14651858.CD010675.pub2
- Orth P, Gao L, Madry H. Microfracture for cartilage repair in the knee: a systematic review of the contemporary literature. Knee Surg Sports Traumatol Arthrosc. 2020;28(3):670−706. doi: 10.1007/s00167-019-05359-9
- Zanasi S, Marcacci M, Brittberg M. Basic science, clinical repair and reconstruction of articular cartilage defects: Current status and prospects. Timeo Editore SRL. 2006.
- Roos EM, Roos HP, Lohmander LS, et al. Knee Injury and Osteoarthritis Outcome Score (KOOS) — development of a self-administered outcome measure. J Orthop Sports Phys Ther. 1998;28(2):88−96. doi: 10.2519/jospt.1998.28.2.88
- Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985;(198):43–49. doi: 10.1097/00003086-198509000-00007
- Rebrova OY. Statistical analysis of medical data. Application of the software package STATISTICA. Health. Medical sciences. Research Methods. Mathematical research methods. Statistical methods in medicine. Moscow: Media Sphere; 2006. (In Russ.)
- Lamplot JD, Schafer KA, Matava MJ. Treatment of failed articular cartilage reconstructive procedures of the knee: a systematic review. Orthop J Sports Med. 2018;6(3). doi: 10.1177/2325967118761871
- Richter DL, Schenck Jr RC, Wascher DC, et al. Knee articular cartilage repair and restoration techniques: a review of the literature. Sports Health. 2016;8(2):153−160. doi: 10.1177/1941738115611350
- Gobbi A, Karnatzikos G, Kumar A. Long-term results after microfracture treatment for full-thickness knee chondral lesions in athletes. Knee Surg Sports Traumatol Arthrosc. 2014;22(9):1986−1996. DOI: 10.1007%2Fs00167-013-2676-8
- Kulyaba TA, Bantser SA, Trachuk PA, et al. The effectiveness of various surgical techniques in the treatment of local injuries of the knee joint cartilage (literature review). Traumatology and Orthopedics of Russia. 2020;26(3):170−181. (In Russ.)
- Mithoefer K, McAdams T, Williams RJ, et al. Clinical efficacy of the microfracture technique for articular cartilage repair in the knee: an evidence-based systematic analysis. Am J Sports Med. 2009;37(10):2053−2063. doi: 10.1177/0363546508328414
- Kreuz PC, Erggelet C, Steinwachs MR, et al. Is microfracture of chondral defects in the knee associated with different results in patients aged 40 years or younger? Arthroscopy. 2006;22(11):1180−1186. doi: 10.1016/j.arthro.2006.06.020
- Trishkin DV, Kriukov EV, Chuprina AP, et al. The evolution of the concept of medical care providing to the wounded and injured with injuries of the musculoskeletal system. Military medical journal. 2020;341(2):4−11. (In Russ.)
- Kalyuzhnaya LI, Khominets VV, Chebotarev SV, et al. Application of biomaterial from the human umbilical cord to restore damage to articular cartilage. Preventive and clinical medicine. 2019;4:45−52. (In Russ.)
- Kalyuzhnaya LI, Chebotarev SV. Human umbilical cord hydrogel in the treatment of joint cartilage defects in an experiment. Izvestija Rossijskoj Voenno-medicinskoj akademii. 2020;39(S3−1):37−40. (In Russ.)
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