Long-term results of deep defects in articular cartilage

1977 ◽  
Vol 25 (1) ◽  
Author(s):  
J. A. Ghadially ◽  
R. Ghadially ◽  
F. N. Ghadially
Keyword(s):  
Articular Cartilage ◽  
Long Term Results ◽  
Deep Defects

Long-term results of superficial defects in articular cartilage: A scanning electronmicroscope study

1977 ◽  
Vol 121 (4) ◽  
pp. 213-217 ◽  
Author(s):  
F. N. Ghadially ◽  
I. Thomas ◽  
A. F. Oryschak ◽  
J-M. Lalonde
Keyword(s):  
Articular Cartilage ◽  
Long Term Results ◽  
Electronmicroscope Study

scholarly journals The long-term results of meniscus transplantation for articular cartilage defects in the knee joint

2006 ◽  
Vol 15 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Masataka Deie ◽  
Yoshio Sumen ◽  
Nobuo Adachi ◽  
Atsuo Nakamae ◽  
Ayato Miyamoto ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Knee Joint ◽  
Long Term Results ◽  
Cartilage Defects ◽  
Meniscus Transplantation ◽  
Articular Cartilage Defects

Impairment Tutorial: Rating Less Common Meniscal and Articular Cartilage Scenarios

2000 ◽  
Vol 5 (6) ◽  
pp. 13-14
Author(s):  
James B. Talmage ◽  
Robert H. Haralson
Keyword(s):  
Articular Cartilage ◽  
Joint Space Narrowing ◽  
Meniscal Tear ◽  
Knee Injuries ◽  
Joint Space ◽  
Long Term Results ◽  
Fourth Edition ◽  
Osteochondral Fracture ◽  
Limited Motion

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, provides methods to rate knee injuries treated by partial or total menisectomy and also provides methods to rate knee injuries treated by partial or total menisectomy. Although accompanying tables permit impairment rating of most knee injuries, arthroscopy and new surgical procedures have permitted early diagnosis of osteochondral fracture defects that are not easily rated. A peripheral meniscal tear in the fascular part of the meniscus potentially is repairable, but impairment rating after treatment is challenging. If the only surgical procedure was meniscal transplantation and if preoperative radiographs demonstrate joint space narrowing that is sufficiently significant to rate as an impairment, the knee probably can be rated using the joint space narrowing measurement and Table 62. The AMA Guides is silent about rating the impairment when an osteochondral fracture has occurred. If, after time for healing and rehabilitation, the joint has limited motion, atrophy in supporting muscles, or joint space narrowing on radiographs, the rating for those problems probably will adequately describe the impairment. Long-term results of operations that attempt to repair the meniscal or articular cartilage are not known, and impairment rating after one of these procedures may change with time and the publication of additional studies.

scholarly journals Autologous chondrocyte implantation in the knee: systematic review and economic evaluation

2017 ◽  
Vol 21 (6) ◽  
pp. 1-294 ◽  
Author(s):  
Hema Mistry ◽  
Martin Connock ◽  
Joshua Pink ◽  
Deepson Shyangdan ◽  
Christine Clar ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Observational Studies ◽  
Health Technology ◽  
Long Term Results ◽  
Cartilage Defects ◽  
Chondrocyte Implantation ◽  
Articular Cartilage Defects ◽  
Autologous Chondrocyte

BackgroundThe surfaces of the bones in the knee are covered with articular cartilage, a rubber-like substance that is very smooth, allowing frictionless movement in the joint and acting as a shock absorber. The cells that form the cartilage are called chondrocytes. Natural cartilage is called hyaline cartilage. Articular cartilage has very little capacity for self-repair, so damage may be permanent. Various methods have been used to try to repair cartilage. Autologous chondrocyte implantation (ACI) involves laboratory culture of cartilage-producing cells from the knee and then implanting them into the chondral defect.ObjectiveTo assess the clinical effectiveness and cost-effectiveness of ACI in chondral defects in the knee, compared with microfracture (MF).Data sourcesA broad search was done in MEDLINE, EMBASE, The Cochrane Library, NHS Economic Evaluation Database and Web of Science, for studies published since the last Health Technology Assessment review.Review methodsSystematic review of recent reviews, trials, long-term observational studies and economic evaluations of the use of ACI and MF for repairing symptomatic articular cartilage defects of the knee. A new economic model was constructed. Submissions from two manufacturers and the ACTIVE (Autologous Chondrocyte Transplantation/Implantation Versus Existing Treatment) trial group were reviewed. Survival analysis was based on long-term observational studies.ResultsFour randomised controlled trials (RCTs) published since the last appraisal provided evidence on the efficacy of ACI. The SUMMIT (Superiority of Matrix-induced autologous chondrocyte implant versus Microfracture for Treatment of symptomatic articular cartilage defects) trial compared matrix-applied chondrocyte implantation (MACI®) against MF. The TIG/ACT/01/2000 (TIG/ACT) trial compared ACI with characterised chondrocytes against MF. The ACTIVE trial compared several forms of ACI against standard treatments, mainly MF. In the SUMMIT trial, improvements in knee injury and osteoarthritis outcome scores (KOOSs), and the proportion of responders, were greater in the MACI group than in the MF group. In the TIG/ACT trial there was improvement in the KOOS at 60 months, but no difference between ACI and MF overall. Patients with onset of symptoms < 3 years’ duration did better with ACI. Results from ACTIVE have not yet been published. Survival analysis suggests that long-term results are better with ACI than with MF. Economic modelling suggested that ACI was cost-effective compared with MF across a range of scenarios.LimitationsThe main limitation is the lack of RCT data beyond 5 years of follow-up. A second is that the techniques of ACI are evolving, so long-term data come from trials using forms of ACI that are now superseded. In the modelling, we therefore assumed that durability of cartilage repair as seen in studies of older forms of ACI could be applied in modelling of newer forms. A third is that the high list prices of chondrocytes are reduced by confidential discounting. The main research needs are for longer-term follow-up and for trials of the next generation of ACI.ConclusionsThe evidence base for ACI has improved since the last appraisal by the National Institute for Health and Care Excellence. In most analyses, the incremental cost-effectiveness ratios for ACI compared with MF appear to be within a range usually considered acceptable. Research is needed into long-term results of new forms of ACI.Study registrationThis study is registered as PROSPERO CRD42014013083.FundingThe National Institute for Health Research Health Technology Assessment programme.

427: Long Term Results of Laparoscopic Retroperitoneal Lymph Node Dissection in Clinical Stage I NSGCT

2005 ◽  
Vol 173 (4S) ◽  
pp. 116-117
Author(s):  
Hannes Steiner ◽  
Reinhard Peschel ◽  
Tilko Müller ◽  
Christian Gozzi ◽  
Georg C. Bartsch ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Clinical Stage ◽  
Stage I ◽  
Long Term Results ◽  
Retroperitoneal Lymph Node Dissection ◽  
Node Dissection ◽  
Retroperitoneal Lymph Node
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