RSS-Feed abonnieren
Bitte kopieren Sie die angezeigte URL und fügen sie dann in Ihren RSS-Reader ein.
https://www.thieme-connect.de/rss/thieme/de/10.1055-s-00042410.xml
PDF herunterladen
CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(04): e551-e556
DOI: 10.1055/s-0043-1772196
DOI: 10.1055/s-0043-1772196
Artigo de Atualização
Joelho
Tratamento das lesões condrais no joelho
Artikel in mehreren Sprachen: português | EnglishSuporte Financeiro A presente pesquisa não recebeu nenhum financiamento específico de agências de financiamento dos setores público, comercial ou sem fins lucrativos.
Resumo
As lesões da cartilagem articular são comuns e levam à deterioração precoce da articulação e ao desenvolvimento da osteoartrite. As técnicas de reparo da cartilagem articular visam a formação de um neo-tecido cartilaginoso capaz de suportar carga articular e evitar a progressão da degeneração. Há várias técnicas disponíveis para esse fim, como a microfratura e o transplante de condrócitos. Entretanto muitas vezes o desfecho do procedimento é a formação de fibrocartilagem, que não possui a mesma resistência mecânica do tecido cartilaginoso. Em outros procedimentos, nos quais é realizado enxerto osteocondral autólogo, há risco de morbidade associada ao procedimento, além da disponibilidade limitada de tecido. Por esse motivo, o transplante osteocondral, utilizando enxertos a fresco ou congelados tem sido utilizado para lesões de maior volume. Por fim, novas técnicas utilizando fragmentos de cartilagem picada ou particulada, assim como o uso de células tronco mesenquimais se apresentam como promissores. O objetivo desse artigo é realizar uma atualização dos procedimentos para tratamento das lesões condrais do joelho.
Palavras-chave
cartilagem articular - condrócitos - microfratura - transplantes de células - traumatismos do joelhoPublikationsverlauf
Eingereicht: 21. März 2023
Angenommen: 12. April 2023
Artikel online veröffentlicht:
30. August 2023
© 2023. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
Referências
- 1 Schreiner AJ, Stoker AM, Bozynski CC, Kuroki K, Stannard JP, Cook JL. Clinical application of the basic science of articular cartilage pathology and treatment. J Knee Surg 2020; 33 (11) 1056-1068
- 2 Ulrich-Vinther M, Maloney MD, Schwarz EM, Rosier R, O'Keefe RJ. Articular cartilage biology. J Am Acad Orthop Surg 2003; 11 (06) 421-430
- 3 Buckwalter JA, Mankin HJ. Articular cartilage: part I: design and chondrocyte-matrix interactions. J Bone Joint Surg Am 1997; 79 (04) 600-611
- 4 Poole AR, Kojima T, Yasuda T, Mwale F, Kobayashi M, Laverty S. Composition and structure of articular cartilage: a template for tissue repair. Clin Orthop Relat Res 2001; (391) S26-S33
- 5 Hjelle K, Solheim E, Strand T, Muri R, Brittberg M. Articular cartilage defects in 1,000 knee arthroscopies. Arthroscopy 2002; 18 (07) 730-734
- 6 Arøen A, Løken S, Heir S. et al. Articular cartilage lesions in 993 consecutive knee arthroscopies. Am J Sports Med 2004; 32 (01) 211-215
- 7 Makris EA, Gomoll AH, Malizos KN, Hu JC, Athanasiou KA. Repair and tissue engineering techniques for articular cartilage. Nat Rev Rheumatol 2015; 11 (01) 21-34
- 8 Cicuttini FM, Wluka AE. Osteoarthritis: Is OA a mechanical or systemic disease?. Nat Rev Rheumatol 2014; 10 (09) 515-516
- 9 Moyad TF. Cartilage injuries in the adult knee: Evaluation and management. Cartilage 2011; 2 (03) 226-236
- 10 Krych AJ, Saris DBF, Stuart MJ, Hacken B. Cartilage injury in the knee: Assessment and treatment options. J Am Acad Orthop Surg 2020; 28 (22) 914-922
- 11 Kopf S, Sava MP, Stärke C, Becker R. The menisci and articular cartilage: a life-long fascination. EFORT Open Rev 2020; 5 (10) 652-662
- 12 Cole BJ, Pascual-Garrido C, Grumet RC. Surgical management of articular cartilage defects in the knee. J Bone Joint Surg Am 2009; 91 (07) 1778-1790
- 13 Outerbridge RE. Further studies on the etiology of chondromalacia patellae. J Bone Joint Surg Br 1964; 46 (02) 179-190
- 14 Outerbridge RE. The etiology of chondromalacia patellae. J Bone Joint Surg Br 1961; 43-B: 752-757
- 15 Brittberg M, Winalski CS. Evaluation of cartilage injuries and repair. J Bone Joint Surg Am 2003; 85-A (Suppl. 02) 58-69
- 16 Steadman JR, Rodkey WG, Briggs KK. Microfrature: Its history, and experience of the developing surgeon. Cartilage 2010; 1 (02) 78-86
- 17 Redondo ML, Naveen NB, Liu JN, Tauro TM, Southworth TM, Cole BJ. Preservation of knee articular cartilage. Sports Med Arthrosc Rev 2018; 26 (04) e23-e30
- 18 Kwon H, Brown WE, Lee CA. et al. Surgical and tissue engineering strategies for articular cartilage and meniscus repair. Nat Rev Rheumatol 2019; 15 (09) 550-570
- 19 Orth P, Gao L, Madry H. Microfracture for cartilage repair in the knee: a systematic review of the contemporary literature. Knee Surg Sports Traumatol Arthrosc 2020; 28 (03) 670-706
- 20 van Tuijn IM, Emanuel KS, van Hugten PPW, Jeuken R, Emans PJ. Prognostic factors for the clinical outcome after microfracture treatment of chondral and osteochondral defects in the knee joint: A systematic review. Cartilage 2023; 14 (01) 5-16
- 21 Gomoll AH. Microfracture and augments. J Knee Surg 2012; 25 (01) 9-15
- 22 Sommerfeldt MF, Magnussen RA, Hewett TE, Kaeding CC, Flanigan DC. Microfracture of articular cartilage. JBJS Rev 2016; 4 (06) e6
- 23 Welton KL, Logterman S, Bartley JH, Vidal AF, McCarty EC. Knee cartilage repair and restoration: Common problems and solutions. Clin Sports Med 2018; 37 (02) 307-330
- 24 Solanki K, Shanmugasundaram S, Shetty N, Kim SJ. Articular cartilage repair & joint preservation: A review of the current status of biological approach. J Clin Orthop Trauma 2021; 22: 101602
- 25 Chimutengwende-Gordon M, Donaldson J, Bentley G. Current solutions for the treatment of chronic articular cartilage defects in the knee. EFORT Open Rev 2020; 5 (03) 156-163
- 26 Hinckel BB, Thomas D, Vellios EE. et al. Algorithm for treatment of focal cartilage defects of the knee: Classic and new procedures. Cartilage 2021; 13 (1_suppl) 473S-495S
- 27 Filardo G, Kon E, Roffi A, Di Martino A, Marcacci M. Scaffold-based repair for cartilage healing: a systematic review and technical note. Arthroscopy 2013; 29 (01) 174-186
- 28 Jiang S, Guo W, Tian G. et al. Clinical application status of articular cartilage regeneration techniques: Tissue-engineered cartilage brings new hope. Stem Cells Int 2020; 2020: 5690252
- 29 Miyahira MKC, Novaretti JV, Astur DC. et al. Lesões condrais maiores tratadas com uso de membrana de colágeno-condrogênese autóloga induzida por matriz-apresentam maiores escores clínicos. Rev Bras Ortop 2021; 56 (03) 333-339
- 30 Alvarez-Lozano E, Martinez-Rodriguez H, Forriol F. Tratamento de lesões condrais no joelho com condrócitos autólogos embebidos em arcabouço de fibrina. Avaliação clínica e funcional. Rev Bras Ortop 2021; 56 (04) 470-477
- 31 Inderhaug E, Solheim E. Osteochondral autograft transplant (mosaicplasty) for knee articular cartilage defects. JBJS Essential Surg Tech 2019; 9 (04) e34.1-2
- 32 Jacob G, Shimomura K, Nakamura N. Osteochondral injury, management and tissue engineering approaches. Front Cell Dev Biol 2020; 8: 580868
- 33 Howell M, Liao Q, Gee CW. Surgical management of osteochondral defects of the knee: An educational review. Curr Rev Musculoskelet Med 2021; 14 (01) 60-66
- 34 Karmali S, Guerreiro R, da Costa D. et al. Técnica de mosaicoplastia no tratamento de lesões osteocondrais isoladas do côndilo femoral do joelho-estudo retrospectivo. Rev Bras Ortop 2019; 54 (03) 316-321
- 35 Espregueira-Mendes J, Andrade R, Monteiro A. et al. Mosaicplasty using grafts from the upper tibiofibular joint. Arthrosc Tech 2017; 6 (05) e1979-e1987
- 36 Cavendish PA, Everhart JS, Peters NJ, Sommerfeldt MF, Flanigan DC. Osteochondral allograft transplantation for knee cartilage and osteochondral defects: A review of indications, technique, rehabilitation, and outcomes. JBJS Rev 2019; 7 (06) e7
- 37 Lai WC, Bohlen HL, Fackler NP, Wang D. Osteochondral allografts in knee surgery: Narrative review of evidence to date. Orthop Res Rev 2022; 14: 263-274
- 38 Sherman SL, Garrity J, Bauer K, Cook J, Stannard J, Bugbee W. Fresh osteochondral allograft transplantation for the knee: current concepts. J Am Acad Orthop Surg 2014; 22 (02) 121-133 [published correction appears in J Am Acad Orthop Surg 2014;22(3):199]
- 39 Zouzias IC, Bugbee WD. Osteochondral Allograft Transplantation in the Knee. Sports Med Arthrosc Rev 2016; 24 (02) 79-84
- 40 Vivacqua TA, Prinz RD, Cavanellas N. et al. Protocolo para a captação, transporte e preservação de tecido osteocondral humano. Rev Bras Ortop 2020; 55 (07) 163-169
- 41 Pisanu G, Cottino U, Rosso F. et al. Large osteochondral allografts of the knee: Surgical technique and indications. Joints 2018; 6 (01) 42-53
- 42 Bedi A, Feeley BT, Williams III RJ. Management of articular cartilage defects of the knee. J Bone Joint Surg Am 2010; 92 (04) 994-1009
- 43 Tirico LEP, Demange MK, Santos LUS. et al. Transplante osteocondral a fresco no joelho no Brasil: mínimo de dois anos de seguimento. Rev Bras Ortop 2017; 52 (01) 75-81
- 44 Tirico LE, Demange MK. O uso do transplante osteocondral a fresco no tratamento das lesões osteocondrais do joelho. Rev Bras Ortop 2012; 47 (06) 694-700
- 45 Salzmann GM, Ossendorff R, Gilat R, Cole BJ. Autologous minced cartilage implantation for treatment of chondral and osteochondral lesions in the knee joint: An overview. Cartilage 2021; 13 (1_suppl) 1124S-1136S
- 46 Ossendorff R, Walter SG, Schildberg FA. et al. Biologic principles of minced cartilage implantation: a narrative review. Arch Orthop Trauma Surg 2022; ••• [published online ahead of print, 2022 Nov 16]
- 47 Salzmann GM, Calek AK, Preiss S. Second-generation autologous minced cartilage repair technique. Arthrosc Tech 2017; 6 (01) e127-e131
- 48 Schneider S, Ossendorff R, Holz J, Salzmann GM. Arthroscopic minced cartilage implantantion (MCI): A technical note. Arthrosc Tech 2020; 10 (01) e97-e101
- 49 Pickett AM, Hensley Jr DT. Knee Cell-Based Cartilage Restoration. J Knee Surg 2019; 32 (02) 127-133
- 50 Farr J, Cole BJ, Sherman S, Karas V. Particulated articular cartilage: CAIS and DeNovo NT. J Knee Surg 2012; 25 (01) 23-29
- 51 Wodzig MHH, Peters MJM, Emanuel KS. et al. Minced autologous chondral fragments with fibrin glue as a simple promising one-step cartilage repair procedure: A clinical and MRI study at 12-month follow-up. Cartilage 2022; 13 (04) 19-31
- 52 Piuzzi NS, Khlopas A, Newman JM. et al. Bone marrow cellular therapies: novel therapy for knee osteoarthritis. J Knee Surg 2018; 31 (01) 22-26
- 53 Cotter EJ, Wang KC, Yanke AB, Chubinskaya S. Bone marrow aspirate concentrate for cartilage defects of the knee: from bench to bedside evidence. Cartilage 2018; 9 (02) 161-170
- 54 Russo A, Screpis D, Di Donato SL, Bonetti S, Piovan G, Zorzi C. Autologous micro-fragmented adipose tissue for the treatment of diffuse degenerative knee osteoarthritis: an update at 3 year follow-up. J Exp Orthop 2018; 5 (01) 52
- 55 Cattaneo G, De Caro A, Napoli F, Chiapale D, Trada P, Camera A. Micro-fragmented adipose tissue injection associated with arthroscopic procedures in patients with symptomatic knee osteoarthritis. BMC Musculoskelet Disord 2018; 19 (01) 176
- 56 Tremolada C, Colombo V, Ventura C. Adipose Tissue and Mesenchymal Stem Cells: State of the Art and Lipogems® Technology Development. Curr Stem Cell Rep 2016; 2 (03) 304-312
- 57 Filardo G, Perdisa F, Roffi A, Marcacci M, Kon E. Stem cells in articular cartilage regeneration. J Orthop Surg Res 2016; 11: 42
- 58 Cruz IB, Severo AL, Azzolin VF, Garcia LF, Kuhn A, Lech O. Regenerative potential of the cartilaginous tissue in mesenchymal stem cells: update, limitations, and challenges. Rev Bras Ortop 2016; 52 (01) 2-10