Abstract：
BACKGROUND:Bone marrow stimulation techniques in cartilage repair such as drilling are limited by the formation of fibrous to hyaline-like repair tissue. It has been suggested such techniques can be enhanced by covering the defect with scaffolds. We present an innovative approach using a polyglycolic acid (PGA)-hyaluronan scaffold with platelet-rich-plasma (PRP) in drilling. QUESTIONS/PURPOSES:We asked whether (1) PRP immersed in a cell-free PGA-hyaluronan scaffold improves patient-reported 1-year outcomes for the Knee injury and Osteoarthritis Score (KOOS), and (2) implantation of the scaffold in combination with bone marrow stimulation leads to the formation of hyaline-like cartilage repair tissue. PATIENTS AND METHODS:We reviewed 52 patients who had arthroscopic implantation of the PGA-hyaluronan scaffold immersed with PRP in articular cartilage defects of the knee pretreated with Pridie drilling. Patients were assessed by KOOS. At 9 months followup, histologic staining was performed in specimens obtained from five patients to assess the repair tissue quality. RESULTS:The KOOS subscores improved for pain (55 to 91), symptoms (57 to 88), activities of daily living (69 to 86), sports and recreation (36 to 70), and quality of life (38 to 73). The histologic evaluation showed a homogeneous hyaline-like cartilage repair tissue. CONCLUSIONS:The cell-free PGA-hyaluronan scaffold combined with PRP leads to cartilage repair and improved patient-reported outcomes (KOOS) during 12 months of followup. Histologic sections showed morphologic features of hyaline-like repair tissue. Long-term followup is needed to determine if the cartilage repair tissue is durable. LEVEL OF EVIDENCE:Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Siclari A,Mascaro G,Gentili C,Cancedda R,Boux Edoi
10.1007/s11999-011-2107-4subject
Has Abstractpub_date
2012-03-01 00:00:00pages
910-9issue
3eissn
0009-921Xissn
1528-1132journal_volume
470pub_type
杂志文章abstract：:An approach to mild, moderate, and severe fixed valgus deformities of the knee is described. The sequential approach to soft-tissue releases in the fixed valgus knee allows the surgeon to regain a neutral alignment in valgus deformities of up to 90 degrees. An additional benefit of the approach is spontaneous correcti...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-11-01 00:00:00
abstract：:The histopathologic changes leading to rotator cuff rupture are gradual and progressive. Incomplete tears can be observed in the articular or bursal surface. These partial lesions are infrequently demonstrated with arthrography or bursography. Although structural variations in cuff integrity can be demonstrated with u...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1990-05-01 00:00:00
abstract：:When inserting screws into a vertebral pedicle, the surgeon usually exposes the back part of the vertebra and uses his or her anatomic knowledge to align the drill in the proper direction. A slight error in direction may result in an important error in the position of the tip of the screw. This is done with no direct ...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章
doi：10.1097/00003086-199704000-00011
更新日期：1997-04-01 00:00:00
abstract：:Bone allografts are commonly used in spinal surgery. Structural allografts placed anteriorly in the spine may be used as interbody grafts or as strut grafts spanning multiple segments. Posterior allografts are used to supplement autologous bone for spinal fusions in patients who lack sufficient host bone and to avoid ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-199603000-00010
更新日期：1996-03-01 00:00:00
abstract：:Seventy-five uncemented porous-coated total hip prostheses were implanted in 64 patients. The results were reviewed after a mean follow-up period of 47 months (range, 40-64 months). The mean preoperative rating was fair, and the mean postoperative rating was excellent. There were six dislocations. Ten patients had mil...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-08-01 00:00:00
abstract：:A retrospective epidemiological study was performed to determine whether postmenopausal osteoporosis is a hereditary condition. Frequency of fractures was calculated in women whose mothers had suffered vertebral fractures after a low-energy trauma three decades earlier. The frequency of fractures was compared to the f...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-03-01 00:00:00
abstract：:Osteoarticular defects present a reparative challenge to orthopaedic surgeons. Osteoarticular allografts provided a promising solution. Unfortunately, many of these allografts failed secondary to articular cartilage degeneration. To determine the role of the extracellular matrix in graft failure, the authors have char...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200101000-00004
更新日期：2001-01-01 00:00:00
abstract：:Heterotopic ossification can impair the functional results of total hip arthroplasty. The causative role of trochanteric osteotomy in heterotopic ossification is uncertain. Postoperative radiographs of 100 total hip arthroplasties were analyzed for incidence of heterotopic ossification. Forty procedures were performed...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-11-01 00:00:00
abstract：:Mechanical evaluation of healing fractures in rabbits suggests that tensile testing both minimizes artifacts and permits direct intrinsic determinations of tissue quality. In healing osteotomies in the rabbit fibula, there is a rapid return of stiffness at 16 days, correlating with callus maturation. The failure mode ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-01-01 00:00:00
abstract：:Severe thoracolumbar kyphosis in Larsen's syndrome is rare. A successful 10-year treatment course, including T2-L4 subfascial rod placement when the patient was 6 years 3 months of age, nine periodic lengthenings, and definitive surgery at age 14 years 4 months is presented. From preoperative to 2-year postoperative d...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200008000-00024
更新日期：2000-08-01 00:00:00
abstract：BACKGROUND:Minor events that occur in the workplace sometimes are evaluated with MRI, which may reveal age-related changes in the symptomatic body part. These age-related changes are often ascribed to the event. However, evidence of similar or worse pathophysiology in the contralateral joint would suggest that the symp...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-017-5401-y
更新日期：2017-10-01 00:00:00
abstract：:Fusion indications in adult degenerative disk disease of the lumbosacral spine include isolated disk resorption, primary and secondary instability, recurrent disk herniation, and pseudarthrosis. Common to these indications are variable proportions of biomechanical insufficiency of the motion segment, instability, defo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1994-03-01 00:00:00
abstract：:The diagnosis of forearm compartment syndrome by clinical findings alone has been difficult and inconsistent. This study was designed to assist in the diagnosis and treatment of forearm compartment syndromes. We evaluated several forearm incisions and determined their effectiveness by measuring compartment pressures u...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-07-01 00:00:00
abstract：:To define radiographic criteria, the radiographs of all patients diagnosed with coxarthrosis during the year 1951 were reviewed. Structural or joint space changes, evident radiographically in one of every seven cases in 1951, persisted at the time of the review in 1962. In the remaining cases, the diagnosis had been b...
journal_title：Clinical orthopaedics and related research
pub_type： 传,古典文章,历史文章,杂志文章
doi：
更新日期：1993-02-01 00:00:00
abstract：:Delay in surgical intervention has been reported to enhance the process of fracture healing. Quantitative observations or experimental osteotomies were made to investigate the mechanical for such enhancement. Eight mongrel dogs with bilateral radial osteotomies were prepared with immediate plate fixation on the right ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-03-01 00:00:00
abstract：BACKGROUND:Leverage of the femoral head against the acetabular rim may lead to posterior hip dislocation during sports activities in hips with femoroacetabular impingement (FAI) deformity. Abnormal concavity of the femoral head and neck junction has been well described in association with posterior hip dislocation. How...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/CORR.0000000000000514
更新日期：2019-05-01 00:00:00
abstract：:Ninety-two patients (103 hips) treated with total hip arthroplasty (THA) were assessed before and after operation to determine nutritional status and any correlation with delayed wound healing. Parameters indicative of nutritional status (serum albumin and serum transferrin) were assessed, along with immunologic and a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-08-01 00:00:00
abstract：:The authors investigated the reliability of the safe area, which previously was defined to prevent injury to the superior gluteal nerve during the lateral approach to the hip, and its relation to body height. The distance between the point of entry of the superior gluteal nerve into the gluteus medius muscle and the g...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000068768.86536.7e
更新日期：2003-07-01 00:00:00
abstract：:Although femoral shaft fractures constitute fewer than 2% of all fractures in children and adolescents, their treatment has produced many pieces of literature and years of controversy. Prevailing opinion has favored nonoperative and operative treatment, and a variety of techniques have been advocated to avoid complica...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000163463.05141.1c
更新日期：2005-05-01 00:00:00
abstract：:Most studies on shoulder arthroplasty include a diverse group of patients presenting to a tertiary care center. Little information is available regarding outcomes in a community setting. We reviewed 98 residents (110 shoulders) of Olmsted County, Minnesota who had shoulder arthroplasties from 1976 to 2000. There were ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000238870.99980.64
更新日期：2007-02-01 00:00:00
abstract：:Tissue biopsy alone is diagnostic in less than 10% of cases of metastatic bone disease with an unknown primary tumor. Accordingly, to delineate the neoplastic process in cases of metastatic bone disease, where the primary tumor cannot be determined with conventional modalities, new tools are attractive. Complementary ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000093060.96273.db
更新日期：2003-10-01 00:00:00
abstract：:Quality of life measures have neglected to include a critical self-assessment component in pediatric sarcoma patients. Our report shows how children rate their own quality of life and how that varies over time after surgery. Using the Pediatric Outcomes Data Collection Instrument, quality of life data was prospectivel...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/BLO.0b013e31804f545d
更新日期：2007-06-01 00:00:00
abstract：:The clinical and metallurgical performance of 12 retrieved Noiles total knee prostheses was investigated. Clinical histories and serial roentgenograms were used in conjunction with the American Society for Testing and Materials (ASTM) standard implant retrieval and analysis techniques to assess device performance. All...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-03-01 00:00:00
abstract：:Eleven hips in eight patients with Ficat Stage II osteonecrosis were treated with core decompression and placement of an electrical stimulating coil in the anterior superior quadrant of the femoral head. The hips were followed two to five years (average, three and one-half years). Five hips required reoperation at an ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-07-01 00:00:00
abstract：:Habitual dislocation of the hip occurred in a nine-year-old girl. The nomenclature of the literature on this disorder and other related conditions is confusing. The following simple classification is therefore proposed: (1) recurrent dislocation (posttraumatic, nonvoluntary); (2) voluntary dislocation (nonhabitual, as...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-05-01 00:00:00
abstract：:This study evaluated the quality and quantity of osseointegration of two thicknesses of hydroxyapatite coating on press-fit, porous-coated titanium implants in a canine hip model. In 12 dogs, titanium press-fit porous-coated prostheses were implanted. The stems had a 50-microm thickness hydroxyapatite coating, 100-mic...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200111000-00058
更新日期：2001-11-01 00:00:00
abstract：:Although many techniques have been devised for the roentgenographic measurement for angular motion in the lumbar spine, all present technical and visual problems. No previously described method has been subjected to a test of accuracy or reliability. A transparent plastic sheet technique provides a reproducible and ac...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-03-01 00:00:00
abstract：:The authors report the results of a prospective randomized clinical trial using continuous passive motion after total knee arthroplasty. One hundred twenty patients were assigned randomly to one treatment group: No continuous passive motion (Group I), continuous passive motion from 0 degrees to 50 degrees and increase...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1097/00003086-200011000-00005
更新日期：2000-11-01 00:00:00
abstract：:Fractures of the femur in two women, ages 17 and 27, were treated with Brooker-Wills nails. While the distal deployment device was inserted into the nail in one patient, the tip of the driver/inserter broke into the proximal end of the distal deployment device. This complicated the extraction of the nail and the dista...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-05-01 00:00:00
abstract：BACKGROUND:Alternative dispute resolution (ADR) refers to techniques used to resolve conflicts without going to the courtroom. As healthcare and malpractice costs continue to rise, there is growing interest in tactics such as early apology, mediation, and arbitration in the medical arena. QUESTIONS/PURPOSES:(1) Why is...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-2206-2
更新日期：2012-05-01 00:00:00
