Tag Archive for: Chondral

Anupama Patil, Aniket Jadhav

Volume 4 | Issue 1 | Jan – April 2019 | Page 4-8

Author: Anupama Patil[1], Aniket Jadhav[1]

STAR imaging and research centre, Joshi Hospital Campus Opposite Kamla Nehru Park, Erandwane, Pune, Maharashtra.

Address of Correspondence
Dr Anupama Patil
STAR imaging and research centre, Joshi Hospital Campus Opposite Kamla Nehru Park, Erandwane, Pune, Maharashtra 411004
Email: anupama.patil2003@gmail.com


Chondral injuries can occur in an isolated manner or, more commonly, in association with osseous or soft tissue injuries. Accurate pre-knowledge of the chondral injury and associated injuries help the orthopedic surgeon in planning appropriate treatment procedures. Advances in various treatment techniques for chondral defects places paramount importance on the identification, and quantification of these injuries. Through this article, we present a review of literature regarding Magnetic resonance imaging assessment of chondral injuries, also addressing the scan parameters used, advances in imaging for cartilage, role of Magnetic resonance imaging in postoperative follow-up, comparison of accuracy of Magnetic resonance imaging with arthroscopy as well as the roles of ultrasonography and computed tomography in evaluation of articular cartilage.
Magnetic resonance imaging has an indispensable role in the pre-arthroscopic work-up and post-arthroscopic follow-up of chondral injuries. It gives an accurate knowledge of chondral defects/ injuries, staging of lesions, evaluating subchondral bone, assessing adjacent cartilage, identifying loose bodies in remote recesses likely to be missed on arthroscopy, and identifying another ligament/meniscal tears. It is also useful in assessing the donor and recipient sites in
The post-arthroscopic workup following cartilage repair. Ultrasound arthroscopy is a new quantitative intra-operative imaging modality, still not widely used. Computed tomography doesn’t image the cartilage directly but plays an important ancillary role in the evaluation of subchondral bone and identification of location and size of loose bodies.


1. Michel D. Crema, Frank W. Roemer et al.Articular cartilage in the knee: current MR imaging techniques and applications in clinical practice and research.Radiographics.2011;31(1):37-62.
2. Tallal C. Mamisch, Siegfried Trattnig et al. Musculoskeletal Imaging : Quantitative T2 Mapping of Knee Cartilage Differentiation of Healthy Control Cartilage and Cartilage Repair Tissue in the Knee with Unloading—Initial Results.Radiology.2010;254(3):818-26.
3. Garry E. Gold, Christina A. Chen et al. Recent Advances in MRI of Articular Cartilage.American Journal of Roentgenology.2009;193:628-38 .
4. Yon Sun Choi, Hollis G. Potter, Tong Jin Chun. MR imaging of Cartilage Repair in the Knee and Ankle. Radiographics.2008;28(4):1043-59.
5. Christiaan JA van Bergen, Rogier Gerards et al. Diagnosing, planning and evaluating osteochondral ankle defects with imaging modalities.World J Orthop.2015;6(11):944–53.
6. Pekko Penttilä, Jukka Liukkonen et al.Diagnosis of Knee Osteochondral Lesions With Ultrasound Imaging.Arthrosc Tech.2015;4(5):e429–e433.
7. Kira D. Novakofski, Sarah L. Pownder et al. High-Resolution Methods for Diagnosing Cartilage Damage In Vivo. Cartilage. 2016; 7(1): 39–51.
8. Bhawan K Paunipagar, DD Rasalkar et al.Imaging of articular cartilage.Indian J Radiol Imaging.2014;24(3):237-48.
9. Irmak Durur-Subasi, Afak Durur-Karakaya et al.Osteochondral Lesions of Major Joints.Eurasian J Med.2015;47:138-44.
10. Marcelo Bordalo Rodrigues, Gilberto Luís Camanho.MRI EVALUATION OF KNEE CARTILAGE. Rev Bras Ortop.2010;45(4):340-6.
11. Candace L. White, Nancy A. Chauvin et al.MRI of Native Knee Cartilage Delamination Injuries.American Journal of Roentgenology.2017;209(5):W317-W321.
12. Richard Kijowski.Clinical Cartilage Imaging of the Knee and Hip Joints.Americal Journal of Roentgenology.2010;195:618-28.
13. Richard Kijowski, Donna G. Blankenbaker et al. Comparison of 1.5- and 3.0-T MR Imaging for Evaluating the Articular Cartilage of the Knee Joint.Radiology.2009;250(3):839-848.

How to Cite this article: Patil A, Jadhav A. Imaging for Cartilage injuries. Asian Journal Arthroscopy. Jan-April 2019;4(1):4-8 .

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Endoscopic Plantar Fasciotomy with Gastrocnemius Recession for Chronic Plantar Fasciitis

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


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.


1. Brattstroem H. Shape of the intercondylar groove normally and in recurrent dislocation of patella. A clinical and x-ray-anatomical investigation. Acta Orthop ScandSuppl 1964;68Suppl 68:1-148.
2. Goldthwait JE. V. Permanent dislocation of the patella. The report of a case of twenty years’ duration, successfully treated by transplantation of the patella tendons with the tubercle of the tibia. Ann Surg 1899;29:62-8.
3. Hauser ED. Total tendon transplant for slipping patella: A new operation for recurrent dislocation of the patella 1938. ClinOrthopRelat Res 2006;452:7-16.
4. Roux C. Luxation habituelle de la rotule. Traitementopératoire/[Recurrent dislocation of the patella. Operative treatment]. Rev Chir 1888;8:682-9.
5. Dejour D, Byn P, Ntagiopoulos PG. The lyon’s sulcus-deepening trochleoplasty in previous unsuccessful patellofemoral surgery. IntOrthop 2013;37:433-9.
6. Dejour H, Walch G, Nove-Josserand L, Guier C. Factors of patellar instability: An anatomic radiographic study. Knee Surg Sports TraumatolArthrosc 1994;2:19-26.
7. Trillat A, Dejour H, Couette A. Diagnostic et traitement des subluxation récidivantes de la rotule/[Diagnosis and treatment of recurrent dislocations of the patella]. Rev ChirOrthopReparatriceAppar Mot 1964;50:813-24.
8. Campbell WC, Edmonson AS, Crenshaw AH. Campbell’s Operative Orthopaedics. 6th ed. St. Louis: Mosby; 1980.
9. Hawkins RJ, Bell RH, Anisette G. Acute patellar dislocations. The natural history. Am J Sports Med 1986;14:117-20.
10. Macnab I. Recurrent dislocation of the patella. J Bone Joint Surg [Am] 1952;34:957-67.
11. Arendt EA, Donell ST, Sillanpää PJ, Feller JA. The management of lateral patellar dislocation: State of the art. J ISAKOS 2017;2:205-12.
12. Tensho K, Akaoka Y, Shimodaira H, Takanashi S, Ikegami S, Kato H, et al. What components comprise the measurement of the tibial tuberosity-trochlear groove distance in a patellar dislocation population? J Bone Joint Surg Am 2015;97:1441-8.
13. Seitlinger G, Scheurecker G, Högler R, Labey L, Innocenti B, Hofmann S, et al. Tibial tubercle-posterior cruciate ligament distance: A new measurement to define the position of the tibial tubercle in patients with patellar dislocation. Am J Sports Med 2012;40:1119-25.
14. Heidenreich MJ, Camp CL, Dahm DL, Stuart MJ, Levy BA, Krych AJ, et al. The contribution of the tibial tubercle to patellar instability: Analysis of tibial tubercle-trochlear groove (TT-TG) and tibial tubercle-posterior cruciate ligament (TT-PCL) distances. Knee Surg Sports TraumatolArthrosc 2017;25:2347-51.
15. Arendt EA, England K, Agel J, Tompkins MA. An analysis of knee anatomic imaging factors associated with primary lateral patellar dislocations. Knee Surg Sports TraumatolArthrosc 2017;25:3099-107.
16. Askenberger M, Janarv PM, Finnbogason T, Arendt EA. Morphology and anatomic patellar instability risk factors in first-time traumatic lateral patellar dislocations: A Prospective magnetic resonance imaging study in skeletally immature children. Am J Sports Med 2017;45:50-8.
17. Matsushita T, Kuroda R, Oka S, Matsumoto T, Takayama K, Kurosaka M, et al. Clinical outcomes of medial patellofemoral ligament reconstruction in patients with an increased tibial tuberosity-trochlear groove distance. Knee Surg Sports TraumatolArthrosc 2014;22:2438-44.
18. Fulkerson JP. Anteromedialization of the tibial tuberosity for patellofemoral malalignment. ClinOrthopRelat Res 1983;177:176-81.
19. Blumensaat C. Die lageabweichungen und verrenkungen der kniescheibe/[The positional deviation and dislocation of the kneecap]. In: Payr E, Kirschner M, editors. Ergebnisse der Chirurgie und Orthopädie. Einunddreissigster Band. Berlin: Springer-Verlag; 1938. p. 149-223.
20. Brattström H. Patella alta in non-dislocating knee joints. ActaOrthopScand 1970;41:578-88.
21. Geenen E, Molenaers G, Martens M. Patella alta in patellofemoral instability. ActaOrthopBelg 1989;55:387-93.
22. Lancourt JE, Cristini JA. Patella alta and patella infera. Their etiological role in patellar dislocation, chondromalacia, and apophysitis of the tibial tubercle. J Bone Joint Surg Am 1975;57:1112-5.
23. Insall J, Salvati E. Patella position in the normal knee joint. Radiology 1971;101:101-4.
24. Grelsamer RP, Meadows S. The modified insall-salvati ratio for assessment of patellar height. ClinOrthopRelat Res 1992;282:170-6.
25. Caton J, Deschamps G, Chambat P, Lerat JL, Dejour H. Patella infera. Apropos of 128 cases. Rev ChirOrthopReparatriceAppar Mot 1982;68:317-25.
26. Caton J. Method of measuring the height of the patella. ActaOrthopBelg 1989;55:385-6.
27. Blackburne JS, Peel TE. A new method of measuring patellar height. J Bone Joint Surg Br 1977;59:241-2.
28. Biedert RM, Albrecht S. The patellotrochlear index: A new index for assessing patellar height. Knee Surg Sports TraumatolArthrosc 2006;14:707-12.
29. Bernageau J, Goutallier D, Debeyre J, Ferrané J. Nouvelle technique d’exploration de l’articulationfémoro-patellaire: Incidences axiales quadriceps décontractés et quadriceps contractés. [New exploration technique of the patellofemoral joint. Relaxed axial quadriceps and contracted quadriceps]. Rev ChirOrthopReparatriceAppar Mot 1975;61Suppl 2:286-90.
30. Charles MD, Haloman S, Chen L, Ward SR, Fithian D, Afra R, et al. Magnetic resonance imaging-based topographical differences between control and recurrent patellofemoral instability patients. Am J Sports Med 2013;41:374-84.
31. Caton JH, Dejour D. Tibial tubercle osteotomy in patello-femoral instability and in patellar height abnormality. IntOrthop 2010;34:305-9.
32. Amis AA, Firer P, Mountney J, Senavongse W, Thomas NP. Anatomy and biomechanics of the medial patellofemoral ligament. Knee 2003;10:215-20.
33. Ellera Gomes JL. Medial patellofemoral ligament reconstruction for recurrent dislocation of the patella: A preliminary report. Arthroscopy 1992;8:335-40.

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 .

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