[Cartilage chip transplantation for cartilage defects of the first metatarsophalangeal joint].
Minced Cartilage bei Knorpeldefekten am Großzehengrundgelenk.
AutoCart™
Autologous conditioned plasma (ACP)
Focal osteoarthritis of the metatarsophalangeal joint
Hallux rigidus
Minced cartilage
Journal
Operative Orthopadie und Traumatologie
ISSN: 1439-0981
Titre abrégé: Oper Orthop Traumatol
Pays: Germany
ID NLM: 9604937
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
05
02
2021
accepted:
06
06
2021
revised:
16
05
2021
pubmed:
2
11
2021
medline:
27
11
2021
entrez:
1
11
2021
Statut:
ppublish
Résumé
Treatment of circumscribed cartilage defects in the first metatarsophalangeal joint (MTP1) using autologous cartilage fragments. Full thickness cartilage defects (ICRS IV) or focal osteoarthritis in combination with hallux rigidus. Pre-existing ankylosis of the metatarsophalangeal joint; global osteoarthritis of the joint; advanced osteoarthritis of the sesamoidal articulation; osteonecrotic cysts in the head of the first metatarsal bone. Preparation of the metatarsophalangeal joint. Mobilization of the first metatarsal head. Harvesting of the cartilage fragments from the dorsal rim portion as part of the cheilectomy. Mincing the cartilage fragments with a 3.0 mm shaver in sterile conditions. Augmenting the cartilage fragments with autologous conditioned plasma (ACP). Preparing the defect area and creation of a "contained" defect. Replantation of the resulting minced cartilage mass into the defect of the articular surface on the first metatarsal head. Immobilization of the MTP1 for 48 h. Intensive physiotherapy for 3 months. Full weight bearing after reduced swelling. In 2020, 5 patients were treated with the method described and followed up for a period of 1 year. All patients were subjectively satisfied with the result of the operation. There were no relevant surgery-associated complications. OPERATIONSZIEL: Behandlung von umschriebenen Knorpeldefekten am Metatarsophalangealgelenk‑1 (MTP1) mittels autologen Knorpelfragmenten. Vollschichtige symptomatische Knorpeldefekte (ICRS Grad IV) oder fokale Degeneration bei Hallux rigidus. Allgemeine Kontraindikationen. Bereits bestehende Ankylose des Großzehengrundgelenkes. Globale Arthrose des Gelenkes. Fortgeschrittene Arthrose des Sesambeingleitlagers. Osteonekrosezysten im Kopf des 1. Metatarsale. Präparation des Großzehengrundgelenkes. Mobilisation des Metatarsale I und Entnahme der Knorpelfragmente aus dem später zu resezierenden dorsalen Gelenkanteil im Rahmen der Cheilektomie. Präparation des Defektbereiches und Schaffung eines „contained“ Defektes. Zerkleinern der Knorpelfragmente mit einem 3,0-mm-Shaver außerhalb des Operationsfeldes. Augmentieren der Knorpelfragmente mit autologem konditioniertem Plasma (ACP). Replantation der hieraus entstehenden pastösen Masse in den Knorpeldefekt am Metatarsale-I-Köpfchen. Ruhigstellung des MTP1 für 48 h. Intensive Physiotherapie für 3 Monate. Volle Lastaufnahme nach Abschwellen. Im Jahr 2020 wurden 5 Patienten mit der beschriebenen Methode behandelt und bis zu einem Zeitraum von 1 Jahr nachkontrolliert. Alle Patienten waren mit dem Ergebnis der Operation subjektiv sehr zufrieden. Es gab keine relevanten operationsassoziierten Komplikationen.
Autres résumés
Type: Publisher
(ger)
OPERATIONSZIEL: Behandlung von umschriebenen Knorpeldefekten am Metatarsophalangealgelenk‑1 (MTP1) mittels autologen Knorpelfragmenten.
Identifiants
pubmed: 34724079
doi: 10.1007/s00064-021-00745-4
pii: 10.1007/s00064-021-00745-4
doi:
Types de publication
Journal Article
Langues
ger
Sous-ensembles de citation
IM
Pagination
480-486Informations de copyright
© 2021. Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
Références
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