less current treatment of cartilage defects
DESCRIPTION
http://www.frankmccormickmd.com/ Dr. Frank McCorimck is an orthopedic surgeon serving the greater Miami and Fort Lauderdale area. A navy vet and Harvard-trained, Dr. McCormick specializes in sports medicine, arthroscopic surgery, biologic joint preservation, and cartilage failure treatments.TRANSCRIPT
Current Concepts for Cartilage Defect
Treatment Options
Frank McCormick M.DSamuel Rosas MSIV
www.FrankMcCormickMD.comLESS Surgical Institute
Shoulder and Sports DivisionMiami/Fort Lauderdale/Boca Raton/West Palm Beach/ Orlando
Agenda
Cartilage physiology
Cartilage defects
Epidemiology
Current Modalities of treatment
Future of cartilage injury treatment
1.
2.
5.
3.
4.
6. Summary and Questions
Cartilage Physiology
Epidemiology
66% of patients had a cartilage defect N= 993
11% full thickness pathology
Athletic population:
N= 99336% full thickness lesion
2 Million Ankle sprains per yea. 50% likely result in a chondral defect
Diagnosis
Why treat?
1. Conservative treatment
2. Micro-fracture
3. Autologous Chondrocyte Implantation
4. Biological Approach
5. Different Graft options
Summary of treatment options
G. Bentley et al. / Injury, Int. J. Care Injured 44 (2013) S3–S10
Conservative Management
NSAIDSPhysical therapyChondritin SulfateActivity Modification
-Bone marrow stimulation technique
-Can be done arthroscopically
-No additional cost to the procedure
-No difference vs OAT vs chondroplasty in 32 patients at mean follow up period of 33 months.
-Best for small defects: less than 15mm
-Great option for competitive athlete who needs quick recovery
-Beyond 5 years, treatment failure may be expected
Microfracture
-Using a transplant from a fresh cadaver-Used for larger defects-Bacterial and PCR testing must be done first-transplant intact cartilage and bone-Only available in US
Osteochondral allograft transplantation
Autologous Chondrocyte Implantation ACI
Biological approachPlatelet rich plasma = PRP
-More than 800 proteins-More than 1.500 bioactive factors-Ex: Ca, IL, ADP, ATP, AA, Histamine, 5HT, Dopamine, IGF-1, TGF-B, HGH…
Adding PRP to MSC increased differentiation when in a chondrocyte medium
Stem Cells
-New development-Research under way-Different types
Combination therapy
Questions, comments, concerns?www.frankmccormickmd.com
Online Appointments available at zocdoc.com