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Akio Minami - One of the best experts on this subject based on the ideXlab platform.
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autologous osteochondral Mosaicplasty for osteochondritis dissecans of the elbow in teenage athletes
Journal of Bone and Joint Surgery American Volume, 2009Co-Authors: Norimasa Iwasaki, Jyunichi Ishikawa, Tatsuya Masuko, Tadanao Funakoshi, Hiroyuki Kato, Akio MinamiAbstract:BACKGROUND: Although autologous osteochondral Mosaicplasty is widely used as a procedure for osteochondritis dissecans lesions, the effectiveness of this procedure in elbow lesions remains unclear. Our aim was to clarify the surgical efficacy of Mosaicplasty for teenage athletes with advanced lesions of capitellar osteochondritis dissecans. METHODS: From 2001 to 2006, nineteen teenage male patients who were competitive athletes and had advanced lesions of capitellar osteochondritis dissecans underwent mosaicplasties. The mean age of the patients was 14.2 years. The surgical technique involved obtaining small-sized cylindrical osteochondral grafts with a mean diameter of 3.5 mm from the lateral periphery of the femoral condyle at the level of the patellofemoral joint and transplanting the grafts (mean, 3.3 grafts) to prepared osteochondral defects. The patients were evaluated clinically and radiographically at a mean of forty-five months after surgery. RESULTS: Eighteen patients were free from elbow pain, and one had mild pain occasionally. The mean total arc of elbow motion and standard deviation increased significantly from 112° ± 17° preoperatively to 128° ± 12° postoperatively (p < 0.005). The mean clinical score described by Timmerman and Andrews (with a maximum of 200 points) improved significantly from 131 ± 23 points preoperatively to 191 ± 15 points postoperatively (p < 0.0001). All patients except one had an excellent or good clinical result. All donor knees were graded as excellent on the basis of the Lysholm knee scoring system. All patients except two returned to a competitive level of the sport they had previously played. Neither loose-body formation nor secondary osteoarthritic changes were found in any patient. CONCLUSIONS: The current midterm results indicate that Mosaicplasty can provide satisfactory clinical outcomes for teenage athletes with advanced capitellar osteochondritis dissecans lesions. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence. ORIGINAL ABSTRACT CITATION: “Autologous Osteochondral Mosaicplasty for Osteochondritis Dissecans of the Elbow in Teenage Athletes” (2009;91:2359-66).
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donor site evaluation after autologous osteochondral Mosaicplasty for cartilaginous lesions of the elbow joint
American Journal of Sports Medicine, 2007Co-Authors: Norimasa Iwasaki, Hiroyuki Kato, Tamotsu Kamishima, Naoki Suenaga, Akio MinamiAbstract:BackgroundOne significant disadvantage of autologous osteochondral Mosaicplasty (Mosaicplasty) is the harvesting of osteochondral grafts from the normal articular area of the knee joint. However, the effect of harvesting grafts on knee function remains unclear.PurposeTo clarify the functional effects on the donor knee of harvesting osteochondral grafts and to perform magnetic resonance imaging evaluation of donor site repair after Mosaicplasty for capitellar osteochondritis dissecans in young athletes.Study DesignCase series; Level of evidence, 4.MethodsEleven male competitive athletes with advanced lesions of capitellar osteochondritis dissecans underwent mosaicplasties. The surgical technique involves obtaining small-sized cylindrical osteochondral grafts from the lateral periphery of the femoral condyle at the level of the patellofemoral joint and transplanting them to osteochondral defects in the capitellum. Assessment at a mean follow-up of 26 months included local findings of the donor knees, a Lysh...
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autologous osteochondral Mosaicplasty for capitellar osteochondritis dissecans in teenaged patients
American Journal of Sports Medicine, 2006Co-Authors: Norimasa Iwasaki, Jyunichi Ishikawa, Hiroyuki Kato, Satoru Saitoh, Akio MinamiAbstract:BackgroundAutologous osteochondral Mosaicplasty is a new technique to provide hyaline repair for articular defects. Although recent studies have reported the successful treatment of articular defects in the knee and ankle joints with this surgical procedure, little attention has been given to the surgical efficacy of Mosaicplasty in the treatment of osteochondritis dissecans of the humeral capitellum.PurposeTo clarify the clinical outcomes of Mosaicplasty for teenaged patients with advanced lesions of capitellar osteochondritis dissecans.Study DesignCase series; Level of evidence, 4.MethodsEight teenaged patients with advanced lesions of capitellar osteochondritis dissecans underwent mosaicplasties. All patients were baseball players who were affected on the right side, which was also their throwing side. The surgical technique involves obtaining small-sized cylindrical osteochondral grafts from the lateral periphery of the femoral condyles and transplanting them to prepared osteochondral defects. At a me...
Norimasa Iwasaki - One of the best experts on this subject based on the ideXlab platform.
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autologous osteochondral Mosaicplasty for osteochondritis dissecans of the elbow in teenage athletes
Journal of Bone and Joint Surgery American Volume, 2009Co-Authors: Norimasa Iwasaki, Jyunichi Ishikawa, Tatsuya Masuko, Tadanao Funakoshi, Hiroyuki Kato, Akio MinamiAbstract:BACKGROUND: Although autologous osteochondral Mosaicplasty is widely used as a procedure for osteochondritis dissecans lesions, the effectiveness of this procedure in elbow lesions remains unclear. Our aim was to clarify the surgical efficacy of Mosaicplasty for teenage athletes with advanced lesions of capitellar osteochondritis dissecans. METHODS: From 2001 to 2006, nineteen teenage male patients who were competitive athletes and had advanced lesions of capitellar osteochondritis dissecans underwent mosaicplasties. The mean age of the patients was 14.2 years. The surgical technique involved obtaining small-sized cylindrical osteochondral grafts with a mean diameter of 3.5 mm from the lateral periphery of the femoral condyle at the level of the patellofemoral joint and transplanting the grafts (mean, 3.3 grafts) to prepared osteochondral defects. The patients were evaluated clinically and radiographically at a mean of forty-five months after surgery. RESULTS: Eighteen patients were free from elbow pain, and one had mild pain occasionally. The mean total arc of elbow motion and standard deviation increased significantly from 112° ± 17° preoperatively to 128° ± 12° postoperatively (p < 0.005). The mean clinical score described by Timmerman and Andrews (with a maximum of 200 points) improved significantly from 131 ± 23 points preoperatively to 191 ± 15 points postoperatively (p < 0.0001). All patients except one had an excellent or good clinical result. All donor knees were graded as excellent on the basis of the Lysholm knee scoring system. All patients except two returned to a competitive level of the sport they had previously played. Neither loose-body formation nor secondary osteoarthritic changes were found in any patient. CONCLUSIONS: The current midterm results indicate that Mosaicplasty can provide satisfactory clinical outcomes for teenage athletes with advanced capitellar osteochondritis dissecans lesions. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence. ORIGINAL ABSTRACT CITATION: “Autologous Osteochondral Mosaicplasty for Osteochondritis Dissecans of the Elbow in Teenage Athletes” (2009;91:2359-66).
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donor site evaluation after autologous osteochondral Mosaicplasty for cartilaginous lesions of the elbow joint
American Journal of Sports Medicine, 2007Co-Authors: Norimasa Iwasaki, Hiroyuki Kato, Tamotsu Kamishima, Naoki Suenaga, Akio MinamiAbstract:BackgroundOne significant disadvantage of autologous osteochondral Mosaicplasty (Mosaicplasty) is the harvesting of osteochondral grafts from the normal articular area of the knee joint. However, the effect of harvesting grafts on knee function remains unclear.PurposeTo clarify the functional effects on the donor knee of harvesting osteochondral grafts and to perform magnetic resonance imaging evaluation of donor site repair after Mosaicplasty for capitellar osteochondritis dissecans in young athletes.Study DesignCase series; Level of evidence, 4.MethodsEleven male competitive athletes with advanced lesions of capitellar osteochondritis dissecans underwent mosaicplasties. The surgical technique involves obtaining small-sized cylindrical osteochondral grafts from the lateral periphery of the femoral condyle at the level of the patellofemoral joint and transplanting them to osteochondral defects in the capitellum. Assessment at a mean follow-up of 26 months included local findings of the donor knees, a Lysh...
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autologous osteochondral Mosaicplasty for capitellar osteochondritis dissecans in teenaged patients
American Journal of Sports Medicine, 2006Co-Authors: Norimasa Iwasaki, Jyunichi Ishikawa, Hiroyuki Kato, Satoru Saitoh, Akio MinamiAbstract:BackgroundAutologous osteochondral Mosaicplasty is a new technique to provide hyaline repair for articular defects. Although recent studies have reported the successful treatment of articular defects in the knee and ankle joints with this surgical procedure, little attention has been given to the surgical efficacy of Mosaicplasty in the treatment of osteochondritis dissecans of the humeral capitellum.PurposeTo clarify the clinical outcomes of Mosaicplasty for teenaged patients with advanced lesions of capitellar osteochondritis dissecans.Study DesignCase series; Level of evidence, 4.MethodsEight teenaged patients with advanced lesions of capitellar osteochondritis dissecans underwent mosaicplasties. All patients were baseball players who were affected on the right side, which was also their throwing side. The surgical technique involves obtaining small-sized cylindrical osteochondral grafts from the lateral periphery of the femoral condyles and transplanting them to prepared osteochondral defects. At a me...
Maurilio Marcacci - One of the best experts on this subject based on the ideXlab platform.
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comparative evaluation of autologous chondrocyte implantation and Mosaicplasty a multicentered randomized clinical trial
Clinical Journal of Sport Medicine, 2005Co-Authors: Beatrice Dozin, Mara Malpeli, Silvano Calcagno, Ferdinando Priano, Paolo Bruzzi, Luigi Molfetta, Ranieri Cancedda, Maurilio MarcacciAbstract:Objective:To compare the respective performance and effectiveness of autologous chondrocyte implantation (ACI) and Mosaicplasty at resurfacing local full-thickness chondral defects of the knee.Design:Randomized clinical trial.Setting:Multicenter trial at orthopedic clinics and university hospitals c
G Bentley - One of the best experts on this subject based on the ideXlab platform.
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minimum ten year results of a prospective randomised study of autologous chondrocyte implantation versus Mosaicplasty for symptomatic articular cartilage lesions of the knee
Journal of Bone and Joint Surgery-british Volume, 2012Co-Authors: G Bentley, L C Biant, J A Skinner, S Vijayan, S Macmull, R CarringtonAbstract:Autologous chondrocyte implantation (ACI) and Mosaicplasty are methods of treating symptomatic articular cartilage defects in the knee. This study represents the first long-term randomised comparison of the two techniques in 100 patients at a minimum follow-up of ten years. The mean age of the patients at the time of surgery was 31.3 years (16 to 49); the mean duration of symptoms pre-operatively was 7.2 years (9 months to 20 years). The lesions were large with the mean size for the ACI group being 440.9 mm2 (100 to 1050) and the Mosaicplasty group being 399.6 mm2 (100 to 2000). Patients had a mean of 1.5 previous operations (0 to 4) to the articular cartilage defect. Patients were assessed using the modified Cincinnati knee score and the Stanmore-Bentley Functional Rating system. The number of patients whose repair had failed at ten years was ten of 58 (17%) in the ACI group and 23 of 42 (55%) in the Mosaicplasty group (p < 0.001). The functional outcome of those patients with a surviving graft was significantly better in patients who underwent ACI compared with Mosaicplasty (p = 0.02).
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Consultant Orthopaedic Surgeon
2012Co-Authors: S Macmull, G Bentley, J A Skinner, R. W. J. Carrington, Royal National OrthopaedicAbstract:Minimum ten-year results of a prospective randomised study of autologous chondrocyte implantation versus Mosaicplasty for symptomatic articular cartilage lesions of the kneeG. Bentley, L. C. Biant, S. Vijayan
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a prospective randomised comparison of autologous chondrocyte implantation versus Mosaicplasty for osteochondral defects in the knee
Journal of Bone and Joint Surgery-british Volume, 2003Co-Authors: G Bentley, L C Biant, R Carrington, M Akmal, A Goldberg, A Williams, J A Skinner, J PringleAbstract:Autologous chondrocyte implantation (ACI) and Mosaicplasty are both claimed to be successful for the repair of defects of the articular cartilage of the knee but there has been no comparative study of the two methods. A total of 100 patients with a mean age of 31.3 years (16 to 49) and with a symptomatic lesion of the articular cartilage in the knee which was suitable for cartilage repair was randomised to undergo either ACI or Mosaicplasty; 58 patients had ACI and 42 Mosaicplasty. Most lesions were post-traumatic and the mean size of the defect was 4.66 cm2. The mean duration of symptoms was 7.2 years and the mean number of previous operations, excluding arthroscopy, was 1.5. The mean follow-up was 19 months (12 to 26).Functional assessment using the modified Cincinatti and Stanmore scores and objective clinical assessment showed that 88% had excellent or good results after ACI compared with 69% after Mosaicplasty. Arthroscopy at one year demonstrated excellent or good repairs in 82% after ACI and in 34%...
Laszlo Hangody - One of the best experts on this subject based on the ideXlab platform.
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autologous osteochondral Mosaicplasty for the treatment of full thickness defects of weight bearing joints ten years of experimental and clinical experience
Journal of Bone and Joint Surgery American Volume, 2003Co-Authors: Laszlo Hangody, Peter FulesAbstract:Background: The successful treatment of chondral and osteochondral defects of the weight-bearing surfaces is a challenge for orthopaedic surgeons. Autologous osteochondral transplantation is one method that can be used to create hyaline or hyaline-like repair in the defect area. This paper describes the results after ten years of clinical experience with autologous osteochondral Mosaicplasty. Methods: Clinical scores, imaging techniques, arthroscopy, histological examination of biopsy samples, and cartilage stiffness measurements were used to evaluate the clinical outcomes and quality of the transplanted cartilage in 831 patients undergoing Mosaicplasty. Results: According to these investigations, good-to-excellent results were achieved in 92% of the patients treated with femoral condylar implantations, 87% of those treated with tibial resurfacing, 79% of those treated with patellar and/or trochlear mosaicplasties, and 94% of those treated with talar procedures. Long-term donor-site disturbances, assessed with use of the Bandi score, showed that patients had 3% morbidity after Mosaicplasty. Sixty-nine of eighty-three patients who were followed arthroscopically showed congruent gliding surfaces, histological evidence of the survival of the transplanted hyaline cartilage, and fibrocartilage filling of the donor sites. Complications of the surgery included four deep infections and thirty-six painful postoperative hemarthroses. Conclusions: On the basis of these promising results and those of other similar studies, autologous osteochondral Mosaicplasty appears to be an alternative for the treatment of small and medium-sized focal chondral and osteochondral defects of the weight-bearing surfaces of the knee and other weight-bearing synovial joints.
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osteochondral Mosaicplasty for the treatment of focal chondral and osteochondral lesions of the knee and talus in the athlete rationale indications techniques and results
Clinics in Sports Medicine, 1999Co-Authors: Gary Kish, Laszlo Modis, Laszlo HangodyAbstract:New techniques for articular cartilage transplantation have become available recently for traumatic chondral injuries. Applications to the athlete have generated considerable interest in the sports medicine community. The autogenous osteochondral grafting Mosaicplasty has been used to treat these injuries in the athlete population for the past six years. The rationale, indications, operative technique, results, and limitations of Mosaicplasty in the athlete are presented and discussed.
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Mosaicplasty for the treatment of articular cartilage defects application in clinical practice
Orthopedics, 1998Co-Authors: Laszlo Hangody, Gary Kish, Z Karpati, Ivan Udvarhelyi, Istvan Szigeti, Miklos BelyAbstract:: This article describes a one-step operative technique for the treatment of circumscript cartilage defects of weight-bearing surfaces of the knee. Since 1992, a total of 227 patients were treated using this technique for full-thickness lesions resulting from chondropathy, traumatic chondral defects, and osteochondritis dissecans; the procedure was evaluated in 57 patients who had > 3 years of follow-up. Magnetic resonance imaging, computed tomography arthrographies, ultrasound, and arthroscopy were used to evaluate the technique. Using the modified Hospital for Special Surgery (HSS) knee scoring system, 91% of the patients achieved a good or excellent result. The operative technique, clinical results, and complications are detailed.
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treatment of osteochondritis dissecans of the talus use of the Mosaicplasty technique a preliminary report
Foot & Ankle International, 1997Co-Authors: Laszlo Hangody, Gary Kish, Z Karpati, Imre Szerb, R. EberhardtAbstract:A one-stage autogenous osteochondral grafting technique for the treatment of talar dome osteochondritis dissecans is described. Eleven patients with osteochondritis dissecans lesions, 10 mm or greater in diameter, were operated on using the Mosaicplasty autogenous osteochondral transplantation technique. Osteochondral cylindrical grafts from the ipsilateral knee were delivered into the talar defect using specially designed tube chisels. These procedures were done by arthrotomy. With follow-up of 12 to 28 months (mean, 16 months), the patients returned to full activities and the results, using the Hannover scoring system, have been excellent.