Abstract
Osteochondral lesion (OLT) of the ankle joint is an injury involving the chondral layer and the subchondral bone, usually traumatic in etiology. OLT treatment is debated and no clear guidelines exist. Reparative procedures are effective in small-size lesions, but a fibrocartilage layer with low biomechanical properties is generated. Regenerative techniques, supplying a layer of hyaline cartilage, are welcomed. Open-field autologous chondrocytes implantation (ACI) was the first regenerative technique relying on cells to be adopted, but it was rich in technical drawbacks. Arthroscopic ACI was developed thanks to scaffold introduction and a specific instrumentation. The technique was simplified, and the clinical and MRI results were comparable with open-field ACI. Bone marrow-derived cells transplantation (BMDCT) was then developed to overcome the two-step surgery, the high costs, and the laboratoristic phase. BMDCT is based on autologous mesenchymal stem cells, more useful in case of large bony defects and even degenerated joint environment. The clinical, MRI, and histological outcomes were good at midterm follow-up. Regenerative techniques are reliable procedures: Nevertheless, more biological studies are needed to understand the applicability and the possible improvements of these procedures.
| Original language | English |
|---|---|
| Title of host publication | Cartilage Lesions of the Ankle |
| Publisher | Springer Berlin Heidelberg |
| Pages | 17-26 |
| Number of pages | 10 |
| ISBN (Print) | 9783662463321, 9783662463314 |
| DOIs | |
| Publication status | Published - Jan 1 2015 |
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Keywords
- Ankle
- Bone marrow-derived cells
- Chondrocytes
- Osteochondral lesions
- Regenerative technique
ASJC Scopus subject areas
- Medicine(all)
Cite this
Evolution of surgical treatment of cartilaginous lesions. / Giannini, S.; Cavallo, M.; Castagnini, F.
Cartilage Lesions of the Ankle. Springer Berlin Heidelberg, 2015. p. 17-26.Research output: Chapter in Book/Report/Conference proceeding › Chapter
}
TY - CHAP
T1 - Evolution of surgical treatment of cartilaginous lesions
AU - Giannini, S.
AU - Cavallo, M.
AU - Castagnini, F.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Osteochondral lesion (OLT) of the ankle joint is an injury involving the chondral layer and the subchondral bone, usually traumatic in etiology. OLT treatment is debated and no clear guidelines exist. Reparative procedures are effective in small-size lesions, but a fibrocartilage layer with low biomechanical properties is generated. Regenerative techniques, supplying a layer of hyaline cartilage, are welcomed. Open-field autologous chondrocytes implantation (ACI) was the first regenerative technique relying on cells to be adopted, but it was rich in technical drawbacks. Arthroscopic ACI was developed thanks to scaffold introduction and a specific instrumentation. The technique was simplified, and the clinical and MRI results were comparable with open-field ACI. Bone marrow-derived cells transplantation (BMDCT) was then developed to overcome the two-step surgery, the high costs, and the laboratoristic phase. BMDCT is based on autologous mesenchymal stem cells, more useful in case of large bony defects and even degenerated joint environment. The clinical, MRI, and histological outcomes were good at midterm follow-up. Regenerative techniques are reliable procedures: Nevertheless, more biological studies are needed to understand the applicability and the possible improvements of these procedures.
AB - Osteochondral lesion (OLT) of the ankle joint is an injury involving the chondral layer and the subchondral bone, usually traumatic in etiology. OLT treatment is debated and no clear guidelines exist. Reparative procedures are effective in small-size lesions, but a fibrocartilage layer with low biomechanical properties is generated. Regenerative techniques, supplying a layer of hyaline cartilage, are welcomed. Open-field autologous chondrocytes implantation (ACI) was the first regenerative technique relying on cells to be adopted, but it was rich in technical drawbacks. Arthroscopic ACI was developed thanks to scaffold introduction and a specific instrumentation. The technique was simplified, and the clinical and MRI results were comparable with open-field ACI. Bone marrow-derived cells transplantation (BMDCT) was then developed to overcome the two-step surgery, the high costs, and the laboratoristic phase. BMDCT is based on autologous mesenchymal stem cells, more useful in case of large bony defects and even degenerated joint environment. The clinical, MRI, and histological outcomes were good at midterm follow-up. Regenerative techniques are reliable procedures: Nevertheless, more biological studies are needed to understand the applicability and the possible improvements of these procedures.
KW - Ankle
KW - Bone marrow-derived cells
KW - Chondrocytes
KW - Osteochondral lesions
KW - Regenerative technique
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UR - http://www.scopus.com/inward/citedby.url?scp=84956782757&partnerID=8YFLogxK
U2 - 10.1007/978-3-662-46332-1_3
DO - 10.1007/978-3-662-46332-1_3
M3 - Chapter
AN - SCOPUS:84956782757
SN - 9783662463321
SN - 9783662463314
SP - 17
EP - 26
BT - Cartilage Lesions of the Ankle
PB - Springer Berlin Heidelberg
ER -