Arthroscopic Abrasion Arthroplasty Research Articles

Mesenchymal stem cell therapy combined with arthroscopic abrasion arthroplasty regenerates cartilage in patients with severe knee osteoarthritis: a case series.

Aim: To evaluate the safety and efficacy of adipose-derived mesenchymal stem cell (ADMSC) therapy in combination witharthroscopic abrasion arthroplasty (AAA) in advanced knee osteoarthritis (OA). Materials & methods: 27 patients with Grade IV OA of the knee underwent AAA and ADMSC therapy (50×106 ADMSCs at baseline and 6months). Clinical outcome was assessed over 36months. Structural change was determined using MRI. Results: Treatment was well tolerated with no serious adverse events. Clinically significant improvements in pain and function were observed. Reproducible hyaline-like cartilage regeneration was seen in all participants. Conclusion: ADMSC therapy combined with AAA in Grade IV OA results in reproducible pain, functional and structural improvements. This represents a joint preservation technique for patients with advanced OA of the knee. Trial registration number: ACTRN12617000638336.

Evaluation of autologous adipose-derived mesenchymal stem cell therapy in focal chondral defects of the knee: a pilot case series.

Aim: To evaluate the safety, pain, functional and structural improvements after autologous adipose-derived mesenchymal stem cell (ADMSC) therapy in combination with arthroscopic abrasion arthroplasty in focal chondral defects of the knee. Methods: Eight patients with a focal full thickness chondral defect of the knee underwent arthroscopic abrasion arthroplasty followed by postoperative intra-articular injections of autologous ADMSCs (50×106 ADMSCs at baseline and 6 months). Clinical outcome was assessed using numeric pain rating scale, Knee Injury and Osteoarthritis Outcome Score and the Western Ontario and McMaster Universities Osteoarthritis Index. Structural outcome was determined bymagnetic resonance imaging. Outcome was assessed over 24 months. Results: No serious adverse events occurred. Participants observed clinically significant improvement in pain and function. Magnetic resonance imaging analysis showed cartilage regeneration with T2 mapping values comparable to hyaline cartilage. Conclusion: Arthroscopic abrasion arthroplasty in combination with intra-articular ADMSC therapy results in reproducible pain, functional and structural improvements with regeneration of hyaline-like cartilage. Trial registration number: ACTRN12617000638336.

Long-Term Results of Abrasion Arthroplasty for Full-Thickness Cartilage Lesions of the Medial Femoral Condyle

To evaluate the long-term functional results of arthroscopic abrasion arthroplasty for the treatment of full-thickness cartilage lesions of the medial femoral condyle. Between 1990 and 1996, 75 consecutive patients with isolated chondral lesions of the medial femoral condyle were treated with arthroscopic chondral abrasion. A retrospective analysis of the clinical results of this cohort was performed. The patients were evaluated according to the Knee Society Score questionnaire preoperatively, at 10 years postoperatively, and at final long-term follow-up at a mean of 20 years. At final follow-up, they were also assessed according to the Western Ontario and McMaster Universities Osteoarthritis Index. Patients were divided according to the lesion size and by age, and the Kaplan-Meier survivorship function (with second operation taken as an endpoint) for the various groups was calculated. At a mean of final follow-up of 20 years (range, 16.94 to 23.94 years), a positive functional outcome (Knee Society Score ≥70 points or no reoperation) was recorded in 67.9% of the patients. Twenty-year survivorship in this cohort was 71.4% (95% confidence interval, 0.5690 to 0.8590). The survivorship was 89.5% for patients younger than 50 years and 55.7% for patients aged 50 years or older. The functional results for patients with lesions smaller than 4 cm(2) were significantly better than those for patients with lesions of 4 cm(2) or greater (P = .031). There were no statistical differences between patients with and without associated lesions at the time of surgery. Our hypothesis that there would be survivorship greater than 86% was disproved. However, arthroscopic abrasion arthroplasty can be a valid treatment for medial femoral condylar full-thickness defects of the knee, even in the long-term, particularly for younger patients and those with smaller lesions. Level IV, therapeutic case series.

Arthroscopic abrasion arthroplasty of the knee follow-up of 140 cases

Arthroscopic abrasion arthroplasty of the knee follow-up of 140 cases

Role of arthroscopy in osteoarthritis of the knee

We compared arthroscopic patial meniscectomy with limited debridement versus arthroscopic abrasion arthroplasty in patients with osteoarthritis. Group I consisted of 131 knees in 131 patients treated by partial meniscectomy and debridement of loose articular cartilage or removal of loose bodies. All patients had grade 3 or 4 chondromalacia in the affected compartment. The patients were followed for a mean of 3 ± 1 years. Group II consisted of 28 knees in 28 patients treated by debridement with abrasion arthroplasty of exposed bone. The mean age of this group of patients was 63 years and they were followed for a mean of 3.8 years. The Group I patients noted 80% improvement by 1 year but this fell to 67% by 5 years after meniscectomy. Overall, 104 were improved, 16 unchanged, and 15 worse at the time of last evaluation compared to their preoperative status. In the Group II patients, 11 were improved, 8 unchanged, and 9 worse. Fifty percent of Group II subsequently underwent a total knee arthroplasty for salvage at a mean of 3 years following the abrasion procedure. Abrasion arthroplasty appears to offer little benefit over partial meniscectomy and debridement in the degenerative knee. Results of abrasion arthroplasty are unpredictable.

Arthroscopic treatment of gonarthrosis

59 cases, who had arthroscopic debridement or arthroscopic abrasion arthroplasty (±drilling) for gonarthrosis between June 1988 and December 1990 were evaluated. Follow-up period was 1 ,5 to 30 months (average 9,2 months) in the debridement group (Group I) and 1, 5 to 24 months (average 7,5 months) in the abrasion arthroplas group (Group II). All patients became subjectively well In the first group (39 patients in total) activity level increased in 30 patients, stayed the same in 6 patients and decreased in 3 patients. In the second group (20 patients in total) activity level increased in 12 patients. stayed the same in 8 patients. Early results are satisfactory in both methods. Results are not significantly different in any group. Arthroscopic debridement should be performed in indicated patients of gonarthrosis because of Iow postop morbidity and return to daily activities.

Arthroscopic abrasion arthroplasty historical and pathologic perspective: Present status

Arthroscopic abrasion arthroplasty is a modification of open Magnusson “housecleaning” arthroplasty. The arthroscopic approach decreases incision size enhancing postoperative rehabilitation. Arthroscopic techniques enhance the accuracy of diagnosis and provide accuracy of limiting debridement only to diseased tissue in various other dimensions of arthroplasty. The abrasion of a sclerotic lesion superficially removes dead bone, exposes vascularity providing a tissue bed for blood clot attachment. Postoperative joint protection provides an environment for clot organization and fibrous tissue formation. Subsequent fibrocartilage formation has maintained integrity for up to 6 years, the extent of experience. The clinical indication is pain. The patient benefit, therefore, is also subjective. Objective evidence of healing response is demonstrated by second-look arthroscopy, biopsy, and comparison x-ray films. If nothing else, these clinical and pathological observations have challenged “established concepts” and opened new vistas for investigation

The treatment of idiopathic osteonecrosis of the medial femoral condyle with arthroscopic debridement

Five patients with idiopathic ostconecrosis underwent arthroscopic debridement with instruments designed for arthroscopic abrasion arthroplasty. Each lesion was large enough to require total knee or tibial osteotomy using criteria previously published by other authors. Using the Hospital for Special Surgery Rating System, four of five patients were rated good postoperatively (average rating: preop 52 points and postop 82 points). Biopsies of two patients at repeat arthroscopy showed that fibrocartilage fills in the defects created by the debridement. Average follow-up was 31 months.

Treatment of spontaneous osteonecrosis of the medial femoral condyle with arthroscopic abrasion arthroplasty

Treatment of spontaneous osteonecrosis of the medial femoral condyle with arthroscopic abrasion arthroplasty