Age-related surgical management of chondral and osteochondral lesions

Tiago Lazzaretti Fernandes , Joao P.C. SantAnna , Mario Sergio Boff , Caio Gomes Tabet , Betina B. Hinckel , Seth L. Sherman , Christian Lattermann
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引用次数: 0

Abstract

Introduction

Cartilage lesions and osteoarthritis are very prevalent and imply a significant clinical and economic burden.

Objectives

To review treatments for cartilage lesions in a time life sequence and its particularities.

Methods

We performed a broad PUBMED database review with a sensitive systematized strategy without restriction to article date or type.

Results

This review brings us to the aspects of chondral and osteochondral lesions throughout the different age groups of patients. Focusing mainly on surgical treatment, we present here the most widely used techniques. To facilitate discussion, patients have been divided into 3 groups: children and adolescents with open physes, adults until the fifth decade, and adult patients over the fifth decade. For open physes patients, their capacity for healing is of important consideration in both conservative and operative management. In those with closed physes, most patients are treated surgically. While marrow stimulation is the most common cartilage treatment procedure, there is a growing use of other techniques such as osteochondral autograft transplantation and osteochondral allograft transplantation. Patients over 50 years old commonly present with more severe chondral lesions, which influences the treatment decision-making process.

Conclusion

When attempting to optimize cartilage restoration in these 3 groups, it is important to weigh the physiologic age, the extent of the cartilage lesion, and the stage of the degenerative and osteoarthritic processes.

与年龄有关的软骨和骨软骨病变的手术治疗
方法我们采用灵敏的系统化策略对 PUBMED 数据库进行了广泛的综述,对文章的日期和类型没有限制。我们主要关注手术治疗,在此介绍最广泛使用的技术。为了便于讨论,我们将患者分为三组:开放性髋关节病变的儿童和青少年、五岁前的成人和五岁以上的成人患者。对于开放性髋臼患者,其愈合能力是保守治疗和手术治疗的重要考虑因素。对于闭合性腓骨,大多数患者都要接受手术治疗。虽然骨髓刺激是最常见的软骨治疗方法,但骨软骨自体移植物移植和骨软骨异体移植物移植等其他技术的应用也在不断增加。50岁以上的患者通常软骨病变更严重,这影响了治疗决策过程。结论在试图优化这3类患者的软骨修复时,必须权衡生理年龄、软骨病变的程度以及退行性和骨关节炎过程的阶段。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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