Alexander Zimmerer, Sebastian Gebhardt, Stefan Kinkel, Christian Sobau
{"title":"[治疗髋关节髋臼软骨病变的碎软骨手术]。","authors":"Alexander Zimmerer, Sebastian Gebhardt, Stefan Kinkel, Christian Sobau","doi":"10.1007/s00064-022-00796-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Treatment of acetabular cartilage defects using autologous cartilage fragments.</p><p><strong>Indications: </strong>Acetabular cartilage damage (1-6 cm<sup>2</sup>) associated with femoroacetabular impingement syndrome (FAIS).</p><p><strong>Contraindications: </strong>Advanced osteoarthritis (≥ 2 according to Tönnis) and extensive acetabular cartilage damage > 6 cm<sup>2</sup>. Lack of labral containment due to irreparable labral damage.</p><p><strong>Surgical technique: </strong>Arthroscopic preparation of the acetabular cartilage damage and removal of unstable cartilage fragments using a 4.0 mm shaver, which minces the cartilage fragments. If necessary, additional cartilage harvesting over the CAM morphology requiring resection. Collection of the cartilage fragments using Graftnet<sup>TM</sup> and augmentation with autologous conditioned plasma (ACP). Treatment of associated pathologies such as CAM morphology, pincer morphology, and labral refixation or reconstruction. Implantation of cartilage mass and remodeling into the defect zone. Final sealing with autologous fibrin.</p><p><strong>Postoperative management: </strong>Postoperatively, weight bearing is restricted to 20 kg and range of motion to 90° of flexion for 6 weeks. This is supplemented by passive movement using a continuous passive motion (CPM) device.</p><p><strong>Results: </strong>Since 2021, 13 patients treated with the described method were followed up for at least 6 months. A significant increase in the International Hip Outcome Tool (iHot)-12 and a significant reduction of pain were observed. No severe complications occurred.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":"35 2","pages":"100-109"},"PeriodicalIF":1.0000,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"2","resultStr":"{\"title\":\"[Minced cartilage procedure for the treatment of acetabular cartilage lesions of the hip joint].\",\"authors\":\"Alexander Zimmerer, Sebastian Gebhardt, Stefan Kinkel, Christian Sobau\",\"doi\":\"10.1007/s00064-022-00796-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Treatment of acetabular cartilage defects using autologous cartilage fragments.</p><p><strong>Indications: </strong>Acetabular cartilage damage (1-6 cm<sup>2</sup>) associated with femoroacetabular impingement syndrome (FAIS).</p><p><strong>Contraindications: </strong>Advanced osteoarthritis (≥ 2 according to Tönnis) and extensive acetabular cartilage damage > 6 cm<sup>2</sup>. Lack of labral containment due to irreparable labral damage.</p><p><strong>Surgical technique: </strong>Arthroscopic preparation of the acetabular cartilage damage and removal of unstable cartilage fragments using a 4.0 mm shaver, which minces the cartilage fragments. If necessary, additional cartilage harvesting over the CAM morphology requiring resection. Collection of the cartilage fragments using Graftnet<sup>TM</sup> and augmentation with autologous conditioned plasma (ACP). Treatment of associated pathologies such as CAM morphology, pincer morphology, and labral refixation or reconstruction. Implantation of cartilage mass and remodeling into the defect zone. Final sealing with autologous fibrin.</p><p><strong>Postoperative management: </strong>Postoperatively, weight bearing is restricted to 20 kg and range of motion to 90° of flexion for 6 weeks. This is supplemented by passive movement using a continuous passive motion (CPM) device.</p><p><strong>Results: </strong>Since 2021, 13 patients treated with the described method were followed up for at least 6 months. A significant increase in the International Hip Outcome Tool (iHot)-12 and a significant reduction of pain were observed. No severe complications occurred.</p>\",\"PeriodicalId\":54677,\"journal\":{\"name\":\"Operative Orthopadie Und Traumatologie\",\"volume\":\"35 2\",\"pages\":\"100-109\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2023-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Operative Orthopadie Und Traumatologie\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00064-022-00796-1\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Operative Orthopadie Und Traumatologie","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00064-022-00796-1","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Contraindications: Advanced osteoarthritis (≥ 2 according to Tönnis) and extensive acetabular cartilage damage > 6 cm2. Lack of labral containment due to irreparable labral damage.
Surgical technique: Arthroscopic preparation of the acetabular cartilage damage and removal of unstable cartilage fragments using a 4.0 mm shaver, which minces the cartilage fragments. If necessary, additional cartilage harvesting over the CAM morphology requiring resection. Collection of the cartilage fragments using GraftnetTM and augmentation with autologous conditioned plasma (ACP). Treatment of associated pathologies such as CAM morphology, pincer morphology, and labral refixation or reconstruction. Implantation of cartilage mass and remodeling into the defect zone. Final sealing with autologous fibrin.
Postoperative management: Postoperatively, weight bearing is restricted to 20 kg and range of motion to 90° of flexion for 6 weeks. This is supplemented by passive movement using a continuous passive motion (CPM) device.
Results: Since 2021, 13 patients treated with the described method were followed up for at least 6 months. A significant increase in the International Hip Outcome Tool (iHot)-12 and a significant reduction of pain were observed. No severe complications occurred.
期刊介绍：
Orthopedics and Traumatology is directed toward all orthopedic surgeons, trauma-tologists, hand surgeons, specialists in sports injuries, orthopedics and rheumatology as well as gene-al surgeons who require access to reliable information on current operative methods to ensure the quality of patient advice, preoperative planning, and postoperative care.
The journal presents established and new operative procedures in uniformly structured and extensively illustrated contributions. All aspects are presented step-by-step from indications, contraindications, patient education, and preparation of the operation right through to postoperative care. The advantages and disadvantages, possible complications, deficiencies and risks of the methods as well as significant results with their evaluation criteria are discussed. To allow the reader to assess the outcome, results are detailed and based on internationally recognized scoring systems.
Orthopedics and Traumatology facilitates effective advancement and further education for all those active in both special and conservative fields of orthopedics, traumatology, and general surgery, offers sup-port for therapeutic decision-making, and provides – more than 30 years after its first publication – constantly expanding and up-to-date teaching on operative techniques.
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