tailieunhanh - Các khiếm khuyết sụn khớp

Các khiếm khuyết sụn khớp là triệu chứng và không đáp ứng với điều trị nonoperative đại diện cho một thách thức quản lý lâm sàng. Mặc dù đã có những tiến bộ quan trọng trong việc kích thích cơ chế sửa chữa bên trong, | Cartilage Substitutes Overview of Basic Science and Treatment Options Douglas W. Jackson MD Mark J. Scheer MD and Timothy M. Simon PhD Abstract Articular cartilage defects that are symptomatic and refractory to nonoperative treatment represent a clinical management challenge. Although there have been important advances in stimulating intrinsic repair mechanisms cartilage regeneration and other substitution techniques to date none has unlocked the understanding necessary to duplicate normal articular cartilage. The objectives of treatment of cartilage lesions are to obtain pain relief reduce effusions and inflammation restore function reduce disability and postpone or alleviate the need for prosthetic replacement. As the field of articular cartilage repair continues to evolve rapidly the most appropriate treatment option for an individual patient should be based on the pathologic characteristics of the lesion and the patient s symptoms and expectations. The orthopaedic surgeon needs to be familiar with both the existing and the newly emerging cartilage treatment techniques in order to best educate patients and meet their expectations for long-term benefits. J Am Acad Orthop Surg 2001 9 37-52 Articular cartilage is a unique tissue and any substitute used to replace it is subjected to marked demands and stresses. Although a number of articular cartilage substitutes have been developed for treatment of chondral and osteochondral defects to date none has successfully replaced normal articular cartilage. Patients who have isolated traumatic chondral and osteochondral defects in an area without surrounding degenerative articular cartilage have the most favorable results. While the natural history of isolated chondral defects is unknown 1 it is assumed that these chondral and osteochondral defects may progressively enlarge with time and play a role in the development of more generalized osteoarthritic changes. The surgical goal is to replace these defects with .

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