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Cartilage repair in the degenerative ageing knee: A narrative review and analysis

BACKGROUND AND PURPOSE: Cartilage damage can develop due to trauma, resulting in focal chondral or osteochondral defects, or as more diffuse loss of cartilage in a generalized organ disease such as osteoarthritis. A loss of cartilage function and quality is also seen with increasing age. There is a...

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Autores principales: Brittberg, Mats, Gomoll, Andreas H, Canseco, José A, Far, Jack, Lind, Martin, Hui, James
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5389429/
https://www.ncbi.nlm.nih.gov/pubmed/27910738
http://dx.doi.org/10.1080/17453674.2016.1265877
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author Brittberg, Mats
Gomoll, Andreas H
Canseco, José A
Far, Jack
Lind, Martin
Hui, James
author_facet Brittberg, Mats
Gomoll, Andreas H
Canseco, José A
Far, Jack
Lind, Martin
Hui, James
author_sort Brittberg, Mats
collection PubMed
description BACKGROUND AND PURPOSE: Cartilage damage can develop due to trauma, resulting in focal chondral or osteochondral defects, or as more diffuse loss of cartilage in a generalized organ disease such as osteoarthritis. A loss of cartilage function and quality is also seen with increasing age. There is a spectrum of diseases ranging from focal cartilage defects with healthy surrounding cartilage to focal lesions in degenerative cartilage, to multiple and diffuse lesions in osteoarthritic cartilage. At the recent Aarhus Regenerative Orthopaedics Symposium (AROS) 2015, regenerative challenges in an ageing population were discussed by clinicians and basic scientists. A group of clinicians was given the task of discussing the role of tissue engineering in the treatment of degenerative cartilage lesions in ageing patients. We present the outcomes of our discussions on current treatment options for such lesions, with particular emphasis on different biological repair techniques and their supporting level of evidence. RESULTS AND INTERPRETATION: Based on the studies on treatment of degenerative lesions and early OA, there is low-level evidence to suggest that cartilage repair is a possible treatment for such lesions, but there are conflicting results regarding the effect of advanced age on the outcome. We concluded that further improvements are needed for direct repair of focal, purely traumatic defects before we can routinely use such repair techniques for the more challenging degenerative lesions. Furthermore, we need to identify trigger mechanisms that start generalized loss of cartilage matrix, and induce subchondral bone changes and concomitant synovial pathology, to maximize our treatment methods for biological repair in degenerative ageing joints.
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spelling pubmed-53894292017-04-17 Cartilage repair in the degenerative ageing knee: A narrative review and analysis Brittberg, Mats Gomoll, Andreas H Canseco, José A Far, Jack Lind, Martin Hui, James Acta Orthop Articles BACKGROUND AND PURPOSE: Cartilage damage can develop due to trauma, resulting in focal chondral or osteochondral defects, or as more diffuse loss of cartilage in a generalized organ disease such as osteoarthritis. A loss of cartilage function and quality is also seen with increasing age. There is a spectrum of diseases ranging from focal cartilage defects with healthy surrounding cartilage to focal lesions in degenerative cartilage, to multiple and diffuse lesions in osteoarthritic cartilage. At the recent Aarhus Regenerative Orthopaedics Symposium (AROS) 2015, regenerative challenges in an ageing population were discussed by clinicians and basic scientists. A group of clinicians was given the task of discussing the role of tissue engineering in the treatment of degenerative cartilage lesions in ageing patients. We present the outcomes of our discussions on current treatment options for such lesions, with particular emphasis on different biological repair techniques and their supporting level of evidence. RESULTS AND INTERPRETATION: Based on the studies on treatment of degenerative lesions and early OA, there is low-level evidence to suggest that cartilage repair is a possible treatment for such lesions, but there are conflicting results regarding the effect of advanced age on the outcome. We concluded that further improvements are needed for direct repair of focal, purely traumatic defects before we can routinely use such repair techniques for the more challenging degenerative lesions. Furthermore, we need to identify trigger mechanisms that start generalized loss of cartilage matrix, and induce subchondral bone changes and concomitant synovial pathology, to maximize our treatment methods for biological repair in degenerative ageing joints. Taylor & Francis 2016-12 2016-12-02 /pmc/articles/PMC5389429/ /pubmed/27910738 http://dx.doi.org/10.1080/17453674.2016.1265877 Text en © 2016 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation. https://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non-Commercial License (https://creativecommons.org/licenses/by-nc/3.0)
spellingShingle Articles
Brittberg, Mats
Gomoll, Andreas H
Canseco, José A
Far, Jack
Lind, Martin
Hui, James
Cartilage repair in the degenerative ageing knee: A narrative review and analysis
title Cartilage repair in the degenerative ageing knee: A narrative review and analysis
title_full Cartilage repair in the degenerative ageing knee: A narrative review and analysis
title_fullStr Cartilage repair in the degenerative ageing knee: A narrative review and analysis
title_full_unstemmed Cartilage repair in the degenerative ageing knee: A narrative review and analysis
title_short Cartilage repair in the degenerative ageing knee: A narrative review and analysis
title_sort cartilage repair in the degenerative ageing knee: a narrative review and analysis
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5389429/
https://www.ncbi.nlm.nih.gov/pubmed/27910738
http://dx.doi.org/10.1080/17453674.2016.1265877
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