Joint Preservation Techniques in Orthopaedic Surgery.
CONTEXT
With increasing life expectancy, there is growing demand for preservation of native articular cartilage to delay joint arthroplasties, especially in younger, active patients. Damage to the hyaline cartilage of a joint has a limited intrinsic capacity to heal. This can lead to accelerated degeneration of the joint and early-onset osteoarthritis. Treatment in the past was limited, however, and surgical treatment options continue to evolve that may allow restoration of the natural biology of the articular cartilage. This article reviews the most current literature with regard to indications, techniques, and outcomes of these restorative procedures.


EVIDENCE ACQUISITION
MEDLINE and PubMed searches relevant to the topic were performed for articles published between 1995 and 2016. Older articles were used for historical reference. This paper places emphasis on evidence published within the past 5 years.


STUDY DESIGN
Clinical review.


LEVEL OF EVIDENCE
Level 4.


RESULTS
Autologous chondrocyte implantation and osteochondral allografts (OCAs) for the treatment of articular cartilage injury allow restoration of hyaline cartilage to the joint surface, which is advantageous over options such as microfracture, which heal with less favorable fibrocartilage. Studies show that these techniques are useful for larger chondral defects where there is no alternative. Additionally, meniscal transplantation can be a valuable isolated or adjunctive procedure to prolong the health of the articular surface.


CONCLUSION
Newer techniques such as autologous chondrocyte implantation and OCAs may safely produce encouraging outcomes in joint preservation.
['York|Philip J|PJ|', 'Wydra|Frank B|FB|', 'Belton|Matthew E|ME|', 'Vidal|Armando F|AF|']
D001178:Arthroplasty D001182:Arthroscopy D016025:Bone Transplantation D002356:Cartilage D002358:Cartilage, Articular D019902:Chondrocytes D006801:Humans D000072600:Meniscus D059630:Mesenchymal Stem Cells D010027:Osteotomy D014182:Transplantation, Autologous D014184:Transplantation, Homologous D014945:Wound Healing
articular cartilage autologous chondrocyte implantation osteochondral allograft meniscal transplantation