Priority of surgical treatment techniques of full cartilage defects of knee joint
DOI:
https://doi.org/10.15587/2313-8416.2015.51246Keywords:
deep forage, chondromalacia, articular cartilage, cartilage defect, medullary canalAbstract
Aim. Surgical treatment of chondromalacia of knee joint cartilage is an actual problem of the modern orthopedics because the means of conservative therapy can be realized at an initial stage only and almost exhausted at the further ones. Imperfections of palliative surgical techniques are the short-term clinical effect and pathogenetic baselessness because surgical procedure is not directed on reparation of cartilaginous tissue. For today there are a lot of transplantation techniques that are used for biological renewal of articular surface with formation of hyaline or at least hyaline-like cartilage. The deep forage of cartilage defect bottom to the medullary canal is a perspective and priority technique.
Methods. The results of treatment of 61 patients with chondromalacia of knee joint of 3-4 degree according to R. Outerbridge are the base of the work. 20 patients of every group underwent microfracturization of cartilage defect bottom and subchondral forage of defect zone. 21 patients underwent the deep forage of defect zone of knee joint according to an offered technique.
Result. The results of treatment with microfracturization, subchondral forage and deep forage of defect zone indicate the more strong clinical effect especially in the last clinical group where good and satisfactory results ratios in the term of observation 18 and 24 month remain stable.
Conclusions. Deep forage of cartilage defects zone is the most adequate reparative technique of the surgical treatment of local knee joint cartilage defects. Owing to this procedure the number of cells of reparative chondrogenesis predecessors is realized
References
Korzh, N. A., Golovaha, M. L., Orljanskij, V. (2013). Povrezhdenie hrjashha kolennogo sustava. Zaporozhe: «Prosvіta», 126.
Herrlin, S. V., Wange, P. O., Lapidus, G., Hållander, M., Werner, S., Weidenhielm, L. (2012). Is arthroscopic surgery beneficial in treating non-traumatic, degenerative medial meniscal tears? A five year follow-up. Knee Surg Sports Traumatol Arthrosc, 21 (2), 358–364. doi: 10.1007/s00167-012-1960-3
Sihvonen, R., Paavola, M., Malmivaara, A., Itälä, A., Joukainen, A., Nurmi, H. et. al. (2013). Arthroscopic Partial Meniscectomy versus Sham Surgery for a Degenerative Meniscal Tear. New England Journal of Medicine, 369 (26), 2515–2524. doi: 10.1056/nejmoa1305189
Anetzberger, H., Mayer, A., Glaser, C., Lorenz, S., Birkenmaier, C., Müller-Gerbl, M. (2012). Meniscectomy leads to early changes in the mineralization distribution of subchondral bone plate. Knee Surg Sports Traumatol Arthrosc, 22 (1), 112–119. doi: 10.1007/s00167-012-2297-7
Zazirnyj, I. M., Jevsjejenko, V. G. (2010). Hirurgichne likuvannja defektiv hrjashha kolinnogo sugloba. Kyiv: Zdorov΄ja, 176.
Jejsmont, O. L., Skakun, P. G., Borisov, A. V. et. al. (2008). Sovremennye vozmozhnosti i perspektivy hirurgicheskogo lechenija povrezhdenij i zabolevanij sustavnogo hrjashha. Medicinskie novosti, 7, 12–19.
Zakirova, A. R. (2010). Artroskopicheskoe lechenie hrjashhevyh defektov kolennogo sustava (klinicheskoe issledovanie. Moscow, 19.
Malanin, D. A., Pisarev, V. B., Chrezov, L. L. et. al (2000). Plastika polnoslojnyh defektov pokrovnogo hrjashha kolennogo sustava cilindricheskimi kostno-hrjashhevymi auto- i allotransplantatami malogo razmera. Vestnik travmatologii i ortopedii im. N. N. Priorova, 2, 16–22.
Grigorovskij, V. V., Strafun, S. S., Kostogryz, O. A. et. al (2012). Patomorfologicheskie izmenenija i ishod travmaticheskogo defekta sustavnoj poverhnosti myshhelka bedrennoj kosti v uslovijah implantacii v jeksperimente autogennyh hondrocitov suspenzii ehvivo. Ortopedija, travmatologija i protezirovanie, 4, 30–39.
Petrenko, A. Ju., Hunov, Ju. A., Ivanov, Je. N. (2011). Stvolovye kletki. Svojstva i perspektivy klinicheskogo primenenija. Lugansk: OOO «Press Jekspress», 368.
Litovchenko, A. V. (2015). Reparatyvna metodyka hirurgichnogo likuvannja defektiv hrjashha kolinnogo sugloba. Mizhnarodnyj medychnyj zhurnal, 21 (2), 52–55.
Ishenin, Ju. M. (2010). Doktrina mehanicheskoj tunnelizacii. Vestnik klinicheskoj mediciny, 3 (2), 51–54.
Eroshkin, S. N. (2012). Vozmozhnosti revaskuljarizirujushhej osteotrepanacii v kompleksnom lechenii gnojnonekroticheskih form sindroma diabeticheskoj stopy. Novosti hirurgii, 5, 57–61.
Brittberg, M., Aglietti, P., Gambardella, R. et. al. International Cartilage Repair Society ICRS. ICRS 2005а. Available at: http://www.cartilage.org
Lysholm, J., Gillquist, J. (1982). Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. The American Journal of Sports Medicine, 10 (3), 150–154. doi: 10.1177/036354658201000306
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Copyright (c) 2015 Андрій Вікторович Літовченко, Микола Іванович Березка, Максим Олегович Гуліда, Євгеній Владиславович Гарячий
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