1. Title of the article: Basic Science and Treatment Options for Articular Cartilage Injuries
2. Explain the purpose(s) of this article:
- The ultimate purpose of this article is to provide an overview of the different treatment options for articular cartilage lesions. The authors characterize the treatment objectives as palliative, reparative, or restorative, noting that the various treatment options can overlap in terms of objective. The options described by the authors, along a continuum of palliative to restorative, include arthroscopic lavage and debridement, microfracture, autologous chondrocyte implantation, and osteochondral grafting. In order to optimize reader understanding of the indications and contraindications for each of the treatment options, the authors also include a brief anatomical review of articular cartilage, which includes the grading and epidemiology of chondral lesions, as well as the
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Articular cartilage is organized into four different layers/zones: superficial (tangential), middle (transitional), deep (radial), and calcified. The cellular structure of each layer is slightly different and corresponds to its role and type of force that it can withstand; the superficial layer has parallel alignment to withstand shear forces, the middle layer begins to resist compressive forces with a more oblique orientation, and the deep layer has a perpendicular alignment that largely resists compression. The calcified layer is where the cartilage connects to bone tissue, and is separated from the deep layer by the tidemark, which is a region of parallel-oriented fibers to reduce shear force. Since grading of chondral lesions (commonly on a Grade 0-4 scale) is based upon the depth of injury, it is important to understand these specialized
Calcaneocuboid and subtalar joints were carefully exposed, denuded of cartilage, and prepared with a 4mm osteotome for arthrodesis. The calcaneocuboid joint was exceptionally osteoarthritic.
Being an athlete and playing sports is fun, until you tear your ACL. Tearing your ACL is one of the most painful injuries for athletes. ACL injuries normally occur in non-contact activities like soccer, basketball, volleyball, skiing, and gymnastics. Not only do they occur in non-contact activities, but they also occur when you suffer a blow to the knee. Common symptoms of ACL injuries include a popping sensation, immediate pain, swelling, limping, stiffness, and feeling of the knee giving away.
Ever since I can remember, I have been playing sports. I played a sport each season and excelled in each sport I played, most likely due to a high level of coordination at a young age. Playing hockey and squash in the winter before middle school, soccer and football in the fall, and the best season of all due to the range of such high level sports, spring, in which I played baseball, lacrosse, and tennis. I knew that I had the most skill in baseball, tennis, and hockey. One day, the day of a little league baseball game, I was sick and been throwing up the night before, my coach told me I did not have to play. The decision was in
Whenever an athlete participates in a sport, whether it be practice or a meet/game, they run the risk of injuring themselves. When it comes to basketball, Anterior Cruciate Ligament (ACL) injuries are common. ACL tears are more likely to occur in female basketball players as opposed to males. In basketball, speed, strength, and power are the most important physical qualities to develop. Sometimes an athlete may be lacking in certain areas which puts them at a greater risk for tearing their ACL.
Some doctors may recommend therapy to strengthen the muscle. If the tear does not heal on its own, repair may be necessary. Either through arthroscopic surgery or open surgery, these two surgeries will be performed to trim off the pieces of cartilage damaged by the injury.
Anterior Cruciate Ligament (ACL) injuries comprise some of the highest incidents in athletic injuries, comprising up to a total of 3-5% (1) with nearly 70% coming from non-contact mechanisms. (2,3) Moreover, these injuries can lead to loss of time on the field in around 88% of the time (1). There is a substantial difference in gender as well, with female athletes being of higher risk to sustain an ACL injury. (4, 5, 6) Overall, ACL injuries can lead to early sport terminaton in athletes as well as serious disabilities in the non-athletic population (7).(Siegel’s anatomy, physiology, and pathol….(29))
A more recent surgical procedure, called a microfracture technique, has become more supported at the shoulder. 7 At the hip, McCarthy et al found 74% of patients with a labral pathology also had chondral lesions.18 The microfracture procedure is a technique that pierces subchondral bone to initiate the body’s natural response to injury. Through this, a pathway for cell migration to the chondral defect is formed where a clot will then become a stable scar of fibrocartilage and hyaline.19,8 This cartilaginous mixture can be seen as a disadvantage due to less mechanically stable fibrocartilage, making this scar mixture possibly more prone to future
The gradual wear and tear that is put on the joints of our human body causes cartilage to begin to gradually
The ACL injury becomes more prone to injured as sports increases. Female counterparts have been found the more susceptible than males. Many reasons suggesting for injury intrinsic as well as extrinsic factors.
Football is the most popular sport in the world.1 Playing football can improve musculoskeletal, metabolic, and cardiovascular functions.2 However, football is one of the sports that have the highest risk of ACL injury.3,4 The incidence rates of ACL injury in soccer range 0.15% - 3.67% per person per year and 0.07 - 1.08 per 1000 sports exposures across various age and competition levels.5,6 The majority of ACL injuries occur without external contact to the knee joint.4,8,15
The anterior cruciate ligament injuries (ACL) are the most common and detrimental injury in young athletes.1 More than 200,000 anterior cruciate ligament reconstructions (ACLR) are conducted in the United States annually to reconstruct the ligament and stabilize the knee.1,2 According to the CDC, ACLR cost over $1 billion dollars to the health care system.3 ACL injuries are increasing in female’s secondary to their increased involvement in sports activities, from recreational to competitive sports.4 ACL injuries are commonly classified into two categories, contact and non-contact injuries with approximately 70% of the injuries being non-contact and the remaining 30% a result of direct contact.4 Females athletes are 3 times more likely to
The majority of ACL injuries happen during athletic tasks with no external contact to the knee joint. This non-contact nature proves that these injuries are caused by abnormal movement which can possibly be changed through training. Understanding the pattern of movement for non-contact ACL injuries provides beneficial information for how to develop different strategies to train. A great effort has been made to identify risk factors for non-contact ACL injury by using different practices over the past 2 decades. An important strategy in particular used to identify movement characteristics during injuries is the analysis of video records of ACL injury cases. Cochrane et al analyzed video records of 34 ACL injury cases in Australian football (2007).
A torn ACL is one of the most serious and common knee injuries. Many aspects play a role in the treatment and rehabilitation of this injury. This paper will discuss the anatomy of the knee, describe a torn ACL, and the rehabilitation.
Imaging appearance of patellar GCTs is usually similar to the lesions occur in other sites(Singh et al., 2009), and they are characterized in radiographs and CT as eccentric soap bubble-like lytic bone lesions, without sclerotic margins or mineralization, transition zone to normal bone is narrow(Pluot, 2009). Pathologic fracture and septations are frequently reported, and the septations are usually thin and may extend throughout the tumor(Singh et al., 2009). MRI provides more details of the extraosseous extension cortical penetration and associated soft-tissue mass than X-ray and CT (Singh et al., 2009). GCTs is typically demonstrated as low to intermediate intensity on T1-weighted images and intermediate to high signal intensity on T2-weighted MRI(Pluot, 2009). Fluid to fluid level indicates blood-filled cavities of secondary ABC formation, and areas of low signal intensity suggest haemosiderin depositions(Pluot, 2009). Completely resection the tumor and patellectomy are the main treatment of GCT in the patella. Postoperative follow-up is necessary to detect local recurrence and remote metastasize (Malhotra, Sharma, Kumar, & Nataraj, 2010).
Injuries play a big role in an athlete's career and his or her overall health, although minor injuries are often nothing to worry about they can lead to something serious especially if the injury is repeatedly being aggravated. scrapes, cuts, bruises, and broken bones are all things to worry about. When a player is injured he or she is losing play time and money and why risk this when there is small but giant steps that can be taken to prevent injuries. But brain injuries are something much more serious even if the player says not to worry because something worse than losing playtime is losing your life. Albert C. hergenroeder has written an article on preventing sports injuries, he says that there are 3 million sports injuries among kids around