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The Mosaicplasty / OAT procedure: Technique, Pearls and Pitfalls

Rajkumar Amaravathi, Renato Andrade, Ricardo Bastos, João Espregueira-Mendes

Volume 4 | Issue 1 | Jan – April 2019 | Page 15-22


Author: Rajkumar Amaravathi [1], Renato Andrade [2,3,4], Ricardo Bastos [2,3,5,6], João Espregueira-Mendes [2]

[1] Department Of Orthopedics, Division of Arthroscopy and Sports Surgery, St. John’s Medical College and Hospital, Bangalore 560034,India
[2] Clínica do Dragão, Espregueira-Mendes Sports Centre – FIFA Medical Centre of Excellence, Porto, Portugal.
[3] Dom Henrique Research Centre, Porto, Portugal.
[4] Faculty of Sports, University of Porto, Porto, Portugal.
[5] Fluminense Federal University, Niteroi, Brazil.
[6] ICVS/3B’s-PT Government Associate Laboratory, Guimarães, Portugal.
[7] School of Medicine, Minho University, Braga, Portugal.

Address of Correspondence
Dr João Espregueira-Mendes,
M.D., Ph.D.; Clínica do Dragão, Espregueira-Mendes Sports Centre – FIFA Medical Centre of Excellence,
Estádio do Dragão, Entrada Nascente, Piso -3, 4350-415, Porto, Portugal.
Email: espregueira@dhresearchcentre.com


Abstract

Osteochondral autologous transplantation is a surgical procedure that involves the transplant of the autologous cartilage from the non-weight bearing areas of the knee to the articular defect. It has the advantage of being a single stage procedure, repairs the subchondral bone, provides hyaline cartilage and allows a fast return to play. It is indicated for small and medium-sized defects, but the mosaicplasty technique allows treating defects up to 9 cm2. A major disadvantage of this technique is the donor site morbidity associated with the graft harvesting. To overcome this drawback, we harvest the autografts from the upper tibio-fibular joint with low or none donor site morbidity. Osteochondral autologous transplantation and mosaicplasty procedures remain an excellent option for small to medium osteochondral injuries resulting in long-term good to excellent clinical and imaging outcomes.Osteochondral autologous transplantation is a surgical procedure that involves the transplant of the autologous cartilage from the non-weight bearing areas of the knee to the articular defect. It has the advantage of being a single stage procedure, repairs the subchondral bone, provides hyaline cartilage and allows a fast return to play. It is indicated for small and medium-sized defects, but the mosaicplasty technique allows treating defects up to 9 cm2. A major disadvantage of this technique is the donor site morbidity associated with graft harvesting. To overcome this drawback, we harvest the autografts from the upper tibio-fibular joint with low or none donor site morbidity. Osteochondral autologous transplantation and mosaicplasty procedures remain an excellent option for small to medium osteochondral injuries resulting in long-term good to excellent clinical and imaging outcomes.


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How to Cite this article: Rajkumar Amaravathi R, Andrade R, Bastos R, Espregueira-Mendes J. The Mosaicplasty / OAT procedure: Technique, Pearls and Pitfalls. Asian Journal Arthroscopy. Jan-April 2019;4(1):15-22 .


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Endoscopic Plantar Fasciotomy with Gastrocnemius Recession for Chronic Plantar Fasciitis

Management of Patellar Chondral Defects

Kelsey L. Wise, Jeffrey A. Macalena

Volume 3 | Issue 1 | Jan – Apr 2018 | Page 30-35


Author: Kelsey L Wise [1], Jeffrey A Macalena [1]

[1] Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue South, Suite R200, Minneapolis, MN 55454.

Address of Correspondence
Dr. Jeffrey A. Macalena,
Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue South, Suite R200, Minneapolis, MN 55454.
E-mail: maca0049@umn.edu


Abstract

Patellar cartilage has a poor capacity for healing because of the avascular and hypocellular nature of articular cartilage. Surgical options for cartilage defects are varied and include repair, regeneration, and reconstruction. Open reduction internal fixation of chondral defects should be attempted when a large chondral fragment with bone is present. This is frequently seen following patellar dislocation, patellar fracture, or in the setting of osteochondritis dissecans lesions. Cartilage regeneration options include microfracture and a bone marrow-stimulating technique that involves penetration of the subchondral bone. This technique is best for small, isolated defects. Augmentation to microfracture with biologically active adjuncts is becoming more widely available and is thought to enhance stem cell production and tissue regeneration. Cartilage reconstruction options such as autologous chondrocyte implantation area cell-based therapy that develops hyaline-like cartilage, as opposed to the fibrocartilage of microfracture, and has the added advantage of ease in contouring to patellar anatomy. Short-term data suggest improvement of clinical outcomes for most patellar cartilage techniques; however, long-term studies are needed to assess the durability and clinical outcomes of these evolving procedures.
Keywords: Patellar, Chondral, Cartilage.


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How to Cite this article:. Wise KL, Macalena JA. Management of Patellar Chondral Defects. Asian Journal of Arthroscopy Jan – April 2018;3(1):30-35 .


(Abstract)      (Full Text HTML)      (Download PDF)