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Hollis G Potter - One of the best experts on this subject based on the ideXlab platform.

  • magnetic resonance imaging of the wrist bone and Cartilage Injury
    Journal of Magnetic Resonance Imaging, 2013
    Co-Authors: Catherine L Hayter, Hollis G Potter, Stephanie Gold
    Abstract:

    Magnetic resonance imaging (MRI) is particularly useful for imaging the wrist due to its superior soft tissue contrast and ability to detect subtle bone marrow changes and occult fractures. A high field (1.5T or greater) strength, dedicated wrist coil, and high in-plane and through-plane resolution must be utilized to successfully visualize the relatively thin Cartilage of the wrist. MRI can be used to detect occult carpal bone fractures, identify complications following scaphoid fractures, and assess for avascular necrosis in the setting in Kienbock's and Preiser's disease. MRI is useful to identify secondary soft tissue and chondral pathology in impaction/impingement syndromes. The use of an intermediate-echo time fast spin echo sequence allows for accurate assessment of articular Cartilage, allowing evaluation of chondral wear in the setting of primary osteoarthritis and posttraumatic degenerative arthrosis. MRI is the most sensitive imaging modality for the detection of early inflammatory arthropathies and can detect synovitis, bone marrow edema, and early erosions in the setting of negative radiographs.

  • Cartilage Injury after acute isolated anterior cruciate ligament tear immediate and longitudinal effect with clinical mri follow up
    American Journal of Sports Medicine, 2012
    Co-Authors: Hollis G Potter, Sapna K Jain, Brandon R Black, Sebastian Fung, Stephen Lyman
    Abstract:

    Background: Anterior cruciate ligament (ACL) tears have been implicated in the development of osteoarthritis. Limited data exist on longitudinal follow-up of isolated ACL Injury.Hypotheses: All isolated ACL tears are associated with some degree of Cartilage Injury that will deteriorate over time. There is a threshold of magnetic resonance imaging (MRI)–detectable Cartilage Injury that will correlate with adverse change in subjective patient-reported outcome measures.Study Design: Cohort study, Level of evidence, 2.Methods: The authors conducted a prospective, observational analysis of 42 knees in 40 patients with acute, isolated ACL Injury (14 treated nonoperatively, 28 by reconstruction) with imaging at the time of Injury and yearly follow-up for a maximum of 11 years. Morphologic MRI and quantitative T2 mapping was performed with validated outcome measures.Results: All patients sustained chondral damage at initial Injury. The adjusted risk of Cartilage loss doubled from year 1 for the lateral compartmen...

  • an autologous Cartilage tissue implant neocart for treatment of grade iii chondral Injury to the distal femur prospective clinical safety trial at 2 years
    American Journal of Sports Medicine, 2009
    Co-Authors: Dennis C Crawford, Chelsea M Heveran, Dilworth W Cannon, Li Foong Foo, Hollis G Potter
    Abstract:

    BackgroundThe healing potential of damaged articular Cartilage is limited. The NeoCart is a tissue-engineered collagen matrix seeded with autogenous chondrocytes designed for the repair of hyaline articular Cartilage.HypothesisThe NeoCart implant is well tolerated in the human knee.Study DesignCase series; Level of evidence, 4.MethodsEight patients (treatment group) with full-thickness Cartilage Injury were treated with the NeoCart and evaluated prospectively. Autogenous chondrocytes provided by arthroscopic biopsy were seeded into a 3-dimensional type I collagen scaffold. The seeded scaffold was subjected to a tissue-engineering protocol including treatment with a bioreactor. Implantation of the prepared Cartilage tissue patch was performed via miniarthrotomy and secured with a collagen bioadhesive. Evaluations through 24 months postoperatively included the subjective International Knee Documentation Committee questionnaire, visual analog scale, range of motion, and Cartilage-sensitive magnetic resonance...

Graeme P Whyte - One of the best experts on this subject based on the ideXlab platform.

  • biologic inlay osteochondral reconstruction arthroscopic one step osteochondral lesion repair in the knee using morselized bone grafting and hyaluronic acid based scaffold embedded with bone marrow aspirate concentrate
    Arthroscopy techniques, 2017
    Co-Authors: Boguslaw Sadlik, Alberto Gobbi, Mariusz Puszkarz, Wojciech Klon, Graeme P Whyte
    Abstract:

    Cartilage Injury of the knee that is associated with significant subchondral bone loss can result in great morbidity, and treatment options that provide durable repair are limited. Osteochondral autograft and allograft reconstruction of these lesions has been used extensively; however, these techniques often require a more invasive surgical exposure, and restoring the natural articular surface radius of curvature can be challenging, particularly in larger lesions. Cell-based repair of these lesions, using autologous chondrocytes in conjunction with bone grafting, has been used with success, although this procedure requires the patient to undergo 2 operations, and access is often restricted due to the high associated costs. Comparable medium-term clinical outcomes have been shown with scaffold-associated mesenchymal stem cell grafting, and this cell-based procedure may also be performed arthroscopically to minimize patient morbidity. In cases of Cartilage Injury associated with bone loss, this procedure has great potential to repair osteochondral Injury when used in conjunction with bone grafting. We present the one-step arthroscopic technique of biologic inlay osteochondral reconstruction in the knee, using an autologous bone graft and a hyaluronic acid-based scaffold embedded with bone marrow aspirate concentrate, to treat full-thickness Cartilage lesions associated with significant subchondral bone loss.

  • one stage Cartilage repair using a hyaluronic acid based scaffold with activated bone marrow derived mesenchymal stem cells compared with microfracture five year follow up
    American Journal of Sports Medicine, 2016
    Co-Authors: Alberto Gobbi, Graeme P Whyte
    Abstract:

    Background:Articular Cartilage Injury is frequently encountered, yet treatment options capable of providing durable Cartilage repair are limited.Purpose:To investigate the medium-term clinical outcomes of Cartilage repair using a 1-stage technique of a hyaluronic acid–based scaffold with activated bone marrow aspirate concentrate (HA-BMAC) and compare results with those of microfracture. A secondary aim of this study was to identify specific patient demographic factors and Cartilage lesion characteristics that are associated with superior outcomes.Study Design:Cohort study; Level of evidence, 2.Methods:Fifty physically active patients (mean age, 45 years) with grade IV Cartilage Injury of the knee (lesion size, 1.5-24 cm2) were treated with HA-BMAC or microfracture and were observed prospectively for 5 years. Patients were placed into the HA-BMAC group if the health insurance policy of the treating institution supported this option; otherwise, they were placed into the microfracture group. Objective and s...

A C Hall - One of the best experts on this subject based on the ideXlab platform.

  • chondroprotection in models of Cartilage Injury by raising the temperature and osmolarity of irrigation solutions
    Cartilage, 2018
    Co-Authors: N M Eltawil, Saima Ahmed, Luke H Chan, Hamish A R W Simpson, A C Hall
    Abstract:

    ObjectivesDuring arthroscopic or open joint surgery, articular Cartilage may be subjected to mechanical insults by accident or design. These may lead to chondrocyte death, Cartilage breakdown and p...

  • iatrogenic articular Cartilage Injury the elephant in the operating theatre the surgeons role in chondroprotection
    Journal of Bone and Joint Surgery-british Volume, 2017
    Co-Authors: A K Amin, A H R W Simpson, A C Hall
    Abstract:

    Arthroscopy of the synovial joint is the most frequently performed orthopaedic procedure in the developed world.[1][1] A variety of soft-tissue and articular pathologies relating to the hip,[2][2] knee, ankle, shoulder, elbow and wrist joints can be treated arthroscopically.[1][1] While advances in

  • the use of hyperosmotic saline for chondroprotection implications for orthopaedic surgery and Cartilage repair
    Osteoarthritis and Cartilage, 2015
    Co-Authors: N M Eltawil, A H R W Simpson, Sarah E. M. Howie, Anish K Amin, A C Hall
    Abstract:

    Summary Objective Articular Cartilage may experience iatrogenic Injury during routine orthopaedic/arthroscopic procedures. This could cause chondrocyte death, leading to Cartilage degeneration and posttraumatic osteoarthritis. In an in vitro Cartilage Injury model, chondrocyte death was reduced by increasing the osmolarity of normal saline (NS), the most commonly-used irrigation solution. Here, we studied the effect of hyperosmolar saline (HS) on chondrocyte viability and Cartilage repair in an in vivo Injury model. Design Cartilage Injury was induced by a single scalpel cut along the patellar groove of 8 week old rats in the absence of irrigation or with either NS (300 mOsm) or HS (600 mOsm). The percentage of cell death (PCD) within the injured area was assessed using confocal microscopy. Repair from Injury was evaluated by histology/immunostaining, and inflammatory response by histology, cytokine array analysis and ELISA (enzyme-linked immunosorbent assay). Results The PCD in saline-irrigated joints was increased compared to non-irrigated (NI) joints [PCD = 20.8% (95%CI; 14.5, 27.1); PCD = 9.14% (95%CI; 6.3, 11.9); P  = 0.0017]. However, hyperosmotic saline reduced chondrocyte death compared to NS (PCD = 10.4% (95%CI; 8.5, 12.3) P  = 0.0024). Repair score, type II collagen and aggrecan levels, and Injury width, were significantly improved with hyperosmotic compared to NS. Mild synovitis and similar changes in serum cytokine profile occurred in all operated joints irrespective of experimental group. Conclusions Hyperosmotic saline significantly reduced the chondrocyte death associated with scalpel-induced Injury and enhanced Cartilage repair. This irrigation solution might be useful as a simple chondroprotective strategy and may also reduce unintentional Cartilage Injury during articular reconstructive surgery and promote integrative Cartilage repair, thereby reducing the risk of posttraumatic osteoarthritis.

  • the use of hyperosmotic saline for chondroprotection implications for orthopaedic surgery and Cartilage repair
    Osteoarthritis and Cartilage, 2015
    Co-Authors: N M Eltawil, A H R W Simpson, Sarah E. M. Howie, Anish K Amin, A C Hall
    Abstract:

    Summary Objective Articular Cartilage may experience iatrogenic Injury during routine orthopaedic/arthroscopic procedures. This could cause chondrocyte death, leading to Cartilage degeneration and posttraumatic osteoarthritis. In an in vitro Cartilage Injury model, chondrocyte death was reduced by increasing the osmolarity of normal saline (NS), the most commonly-used irrigation solution. Here, we studied the effect of hyperosmolar saline (HS) on chondrocyte viability and Cartilage repair in an in vivo Injury model. Design Cartilage Injury was induced by a single scalpel cut along the patellar groove of 8 week old rats in the absence of irrigation or with either NS (300 mOsm) or HS (600 mOsm). The percentage of cell death (PCD) within the injured area was assessed using confocal microscopy. Repair from Injury was evaluated by histology/immunostaining, and inflammatory response by histology, cytokine array analysis and ELISA (enzyme-linked immunosorbent assay). Results The PCD in saline-irrigated joints was increased compared to non-irrigated (NI) joints [PCD = 20.8% (95%CI; 14.5, 27.1); PCD = 9.14% (95%CI; 6.3, 11.9); P  = 0.0017]. However, hyperosmotic saline reduced chondrocyte death compared to NS (PCD = 10.4% (95%CI; 8.5, 12.3) P  = 0.0024). Repair score, type II collagen and aggrecan levels, and Injury width, were significantly improved with hyperosmotic compared to NS. Mild synovitis and similar changes in serum cytokine profile occurred in all operated joints irrespective of experimental group. Conclusions Hyperosmotic saline significantly reduced the chondrocyte death associated with scalpel-induced Injury and enhanced Cartilage repair. This irrigation solution might be useful as a simple chondroprotective strategy and may also reduce unintentional Cartilage Injury during articular reconstructive surgery and promote integrative Cartilage repair, thereby reducing the risk of posttraumatic osteoarthritis.

Alberto Gobbi - One of the best experts on this subject based on the ideXlab platform.

  • biologic inlay osteochondral reconstruction arthroscopic one step osteochondral lesion repair in the knee using morselized bone grafting and hyaluronic acid based scaffold embedded with bone marrow aspirate concentrate
    Arthroscopy techniques, 2017
    Co-Authors: Boguslaw Sadlik, Alberto Gobbi, Mariusz Puszkarz, Wojciech Klon, Graeme P Whyte
    Abstract:

    Cartilage Injury of the knee that is associated with significant subchondral bone loss can result in great morbidity, and treatment options that provide durable repair are limited. Osteochondral autograft and allograft reconstruction of these lesions has been used extensively; however, these techniques often require a more invasive surgical exposure, and restoring the natural articular surface radius of curvature can be challenging, particularly in larger lesions. Cell-based repair of these lesions, using autologous chondrocytes in conjunction with bone grafting, has been used with success, although this procedure requires the patient to undergo 2 operations, and access is often restricted due to the high associated costs. Comparable medium-term clinical outcomes have been shown with scaffold-associated mesenchymal stem cell grafting, and this cell-based procedure may also be performed arthroscopically to minimize patient morbidity. In cases of Cartilage Injury associated with bone loss, this procedure has great potential to repair osteochondral Injury when used in conjunction with bone grafting. We present the one-step arthroscopic technique of biologic inlay osteochondral reconstruction in the knee, using an autologous bone graft and a hyaluronic acid-based scaffold embedded with bone marrow aspirate concentrate, to treat full-thickness Cartilage lesions associated with significant subchondral bone loss.

  • one stage Cartilage repair using a hyaluronic acid based scaffold with activated bone marrow derived mesenchymal stem cells compared with microfracture five year follow up
    American Journal of Sports Medicine, 2016
    Co-Authors: Alberto Gobbi, Graeme P Whyte
    Abstract:

    Background:Articular Cartilage Injury is frequently encountered, yet treatment options capable of providing durable Cartilage repair are limited.Purpose:To investigate the medium-term clinical outcomes of Cartilage repair using a 1-stage technique of a hyaluronic acid–based scaffold with activated bone marrow aspirate concentrate (HA-BMAC) and compare results with those of microfracture. A secondary aim of this study was to identify specific patient demographic factors and Cartilage lesion characteristics that are associated with superior outcomes.Study Design:Cohort study; Level of evidence, 2.Methods:Fifty physically active patients (mean age, 45 years) with grade IV Cartilage Injury of the knee (lesion size, 1.5-24 cm2) were treated with HA-BMAC or microfracture and were observed prospectively for 5 years. Patients were placed into the HA-BMAC group if the health insurance policy of the treating institution supported this option; otherwise, they were placed into the microfracture group. Objective and s...

Eugene J M A Thonar - One of the best experts on this subject based on the ideXlab platform.

  • the use of intra articular na hyaluronate as a potential chondroprotective device in experimentally induced acute articular Cartilage Injury and repair in rabbits
    Journal of Orthopaedic Research, 2003
    Co-Authors: James M. Williams, Vineeta Rayan, Rick D Sumner, Eugene J M A Thonar
    Abstract:

    Abstract Objective: This study examined if viscosupplementation from intra-articular administration of a commercially available form of hyaluronan (HA) could promote the restoration of proteoglycan (PG) depletion induced by chymopapain and then if the repair could be maintained once HA treatment was discontinued. Methods: Animals received Cartilage Injury with intra-articular chymopapain (2.0 mg) followed by weekly treatment with intra-articular HA. HA treated animals were compared to injured animals with no treatment, contralateral untreated joints and joints from normal controls. The effect of intra-articular HA alone on articular Cartilage was also examined. Results: Serum keratan sulfate levels confirmed degradation of the Cartilage PGs in the chymopapain-injected knees. Intra-articular chymopapain resulted in marked loss of PGs. There were no significant differences among the control groups (untreated control, HA/800 treatment only). HA treatment did not affect the loss of PGs caused by chymopapain after 42 days. However, in animals receiving chymopapain Injury followed by weekly HA treatment for 42 days and then 42 days of free cage activity without HA, Cartilage PG contents were significantly increased. Intra-articular HA alone had no effect on the articular Cartilage. Conclusion: The results in the present study suggest a potential protective effect of HA on chymopapain-induced acute articular Cartilage Injury in rabbits that, in time, permits damaged Cartilage to resynthesize matrix PGs after the HA treatment is discontinued.

  • repair of articular Cartilage Injury following intra articular chymopapain induced matrix proteoglycan loss
    Journal of Orthopaedic Research, 1993
    Co-Authors: James M. Williams, Dennis R Ongchi, Eugene J M A Thonar
    Abstract:

    The intra-articular injection of 0.02, 0.2, or 2.0 mg of chymopapain (CP) into the knee of adolescent rabbits caused the loss of more than 50% of the proteoglycans (PGs) in the cartilaginous tissues within the joint. Sequential measurements of Cartilage-derived keratan sulfate epitope in serum and analyses of articular Cartilage slices 2 days after the injection revealed that 0.02 mg of CP was nearly as effective as higher doses (0.2 or 2.0 mg of CP) in causing the depletion. The degradation and depletion of PGs in articular Cartilage were shown to be localized to the joint and did not affect articular Cartilage in the contralateral knee joint (no injection) or other cartilaginous tissues in the body. On day 9, partial replenishment of the articular Cartilage PGs had occurred, irrespective of the dose used, and the articular surface within the joint remained intact. However, by day 21, articular Cartilage in joints injected with 2.0 mg of CP had begun to show progressive degenerative changes, and these changes became more severe with time. In contrast, joints injected with 0.2 mg of CP continued to repair successfully by the reestablishment of a matrix that retained its integrity and appeared to remain functional for at least 6 months. These results suggest that the model may prove useful for the study of the repair processes that follow matrix Injury and severe depletion of PGs from the articular Cartilage matrix.