By Brian J. Cole MD, MBA, M. Mike Malek MD (auth.)
Drs. Cole and Malek, famous leaders within the box, wrote this state-of-the-art textual content to fill the void within the literature in regards to the administration of articular cartilage illness and meniscal deficiency. The e-book permits orthopedic surgeons to increase an evidence-based decision-making framework that publications the administration of articular cartilage lesions. conscientiously selected members offer readers with a pragmatic history in articular lesions, sufferer evaluation, and administration suggestions. next chapters deal with the gamut of present surgical thoughts, from arthroscopy and debridement to unicondylar arthroplasty, in a step by step demeanour. greater than 500 special illustrations, many in colour, support readers comprehend and grasp remedies. Case experiences, which come with preoperative making plans and postoperative results, strengthen the decision-making method. approximately each permutation and therapy choice is roofed, making this article a first-rate source for surgeons devoted to exercise sound judgement.
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Extra info for Articular Cartilage Lesions: A Practical Guide to Assessment and Treatment
In four, the control was arthrocentesis or intraarticular saline injections; in two, the comparison was with oral NSAIDs; and in one, the comparison was with a lower molecular weight hyaluronan. The first two trials were studies comparing two injections or three injections over a 2-week period versus control regimens of intraarticular saline. 97 Both hylan G-F 20 regimens were statistically superior to saline, and three injections were superior to two at a 6-month telephone follow-up. Following this, a largerscale study was performed with a saline control in which hylan G-F 20 was superior to control through a telephone follow-up at 26 weeks.
The size of the lesion is directly measured and then drawn on the chondral map of the knee. Of note, the areas of the particular lesions are measured by using an overlying grid system to determine what percentage of the condyle is involved. The status of the meniscus is included in Hunt's grading system, with the meniscallesion drawn directly on a specific map to correlate with the area of chondral injury. Any meniscal surgery, including repair or resection, may be recorded on this meniscal map.
I33 Soft knee braces provide only compressive forces without altering mechanical alignment. Even so, some patients report decreased pain with the use of compressive type wraps or braces, possibly due to alterations in proprioceptive feedback. Until the advent of newer unloading braces, mechanical nonoperative unloading of abnormal joint surfaces had not been demonstrated with conventional bracing. These unloader braces apply a three-point bending moment to the knee to create an alteration in the joint reactive force.