Cartilage transplantation for knee joint trauma, ligament & patellofemoral injury. 7

Cartilage transplantation for knee joint trauma, ligament & patellofemoral injury. 7

Cartilage transplantation for knee joint trauma, ligament & patellofemoral injury. 7

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What knee problems can cartilage transplantation solve? What knee joint injury problems are less amenable to cartilage transplantation? Good question. And there are three big knee trauma areas where cartilage transplantation can be applied. One knee problem, as we were commenting on before, is a patellofemoral injury. Although it is pretty much frequent, it is the less thankful problem to treat cartilage transplantation. Patellofemoral injury is not only difficult for cartilage transplantation. But it is difficult to do any kind of treatment in patellofemoral syndrome because it has a very complex biomechanical behavior. That’s one area for cartilage transplantation in the knee. The other knee problem area is more commonly seen in young patients. This problem affects the femoral condyles. Femoral condyles are these two things. You see, one condyle here, one condyle here. This is usually seen in very young patients with osteochondritis. Osteochondritis is a knee condition that is very typically seen in young patients. Osteochondritis can be seen due to trauma or due to a previous excessive meniscal resection. It can also be seen because of misalignment of a knee joint. There is an overload in that knee compartment. So it’s very frequent to see osteochondral problems in the condyles. In those areas, fresh osteochondral allograft transplantation provides the best outcome. This is considered the gold standard of cartilage transplantation in the knee. Again, when we see a small knee joint injury, we don’t propose cartilage transplantation. We don’t think that osteochondral transplantation is the best alternative. But the knee joint trauma could be big enough, more than two square centimeters in size. Fresh cartilage transplantation then is the gold standard of treatment. Clinical outcomes, as I said before, are the best among all the different cartilage transplantation methods that are available. And then here is the third indication for cartilage transplantation in the knee. It is for the tibial plateau transplantation. This is the tibia, we call this a tibial plateau. Usually, this knee problem is more commonly seen after a tibial plateau fracture. Sometimes the tibial plateau fracture couldn’t have been perfectly reduced. This sometimes causes a kind of depression and irregularity in the knee joint. In those cases, we will also provide this kind of treatment [cartilage transplantation]. There are three categories of knee problems where we offer this kind of treatment [osteochondral transplantation]. Patellofemoral joint problems result in the least good outcomes. Cartilage transplant for a medial and lateral femoral condyle problems provides the best result of all. And the third is tibial plateau transplantations. In most of these cases, when we do cartilage transplantation, we also have to treat different problems. For example, anterior cruciate ligament reconstruction, posterior cruciate ligament reconstructions, lateral ligament reconstructions, meniscal transplantation. We are very experienced in meniscal transplantation. We have transplanted more than 300 meniscal grafts in the last 20 years. And finally, we also do knee joint realignment. As I said before, proper joint alignment is mandatory for a well-aligned lower limb to protect what we are transplanting.

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