Meniscal Cartilage Replacement Therapy
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Meniscal Cartilage Replacement Therapy
Left knee-joint from behind, showing interior ligaments Meniscal cartilage replacement therapy is surgical replacement of the meniscus of the knee as a treatment for where the meniscus is so damaged that it would otherwise need to be removed. Anatomy The meniscus is a C-shaped piece of fibrocartilage located at the peripheral aspect of the knee joint that offers lubrication and nutrition to the joint. Each knee has two menisci, medial and lateral, whose purpose is to provide space between the tibia and the femur, preventing friction and allowing for the diffusion of articular cartilage. The majority of the meniscus has no blood supply. As a result, if the meniscus is damaged, from trauma or with age, it is unable to undergo the body’s normal healing process. Therefore, a torn piece can begin to move inside the joint, get caught between the bones, and cause pain, swelling, and decreased mobility. However, recent research has called into question whether many meniscus tears ...
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Arthroscopic
Arthroscopy (also called arthroscopic or keyhole surgery) is a minimally invasive surgical procedure on a joint in which an examination and sometimes treatment of damage is performed using an arthroscope, an endoscope that is inserted into the joint through a small incision. Arthroscopic procedures can be performed during ACL reconstruction. The advantage over traditional open surgery is that the joint does not have to be opened up fully. For knee arthroscopy only two small incisions are made, one for the arthroscope and one for the surgical instruments to be used in the knee cavity. This reduces recovery time and may increase the rate of success due to less trauma to the connective tissue. It has gained popularity due to evidence of faster recovery times with less scarring, because of the smaller incisions. Irrigation fluid (most commonly 'normal' saline) is used to distend the joint and make a surgical space. The surgical instruments are smaller than traditional instruments. ...
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Knee Cartilage Replacement Therapy
Articular cartilage, most notably that which is found in the knee joint, is generally characterized by very low friction, high wear resistance, and poor regenerative qualities. It is responsible for much of the compressive resistance and load bearing qualities of the knee joint and, without it, walking is painful to impossible. Osteoarthritis is a common condition of cartilage failure that can lead to limited range of motion, bone damage and invariably, pain. Due to a combination of acute stress and chronic fatigue, osteoarthritis directly manifests itself in a wearing away of the articular surface and, in extreme cases, bone can be exposed in the joint. Some additional examples of cartilage failure mechanisms include cellular matrix linkage rupture, chondrocyte protein synthesis inhibition, and chondrocyte apoptosis. There are several different repair options available for cartilage damage or failure. "Maci" or autologous cultured chondrocytes on porcine collagen membrane, is a ...
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Total Joint Replacement
Replacement arthroplasty (from Greek ''arthron'', joint, limb, articulate, + ''plassein'', to form, mould, forge, feign, make an image of), or joint replacement surgery, is a procedure of orthopedic surgery in which an arthritic or dysfunctional joint surface is replaced with an orthopedic prosthesis. Joint replacement is considered as a treatment when severe joint pain or dysfunction is not alleviated by less-invasive therapies. It is a form of arthroplasty, and is often indicated from various joint diseases, including osteoarthritis and rheumatoid arthritis. Joint replacement surgery has become more common, with knees and hips replaced most often. About 773,000 Americans had a hip or knee replaced in 2009.Joint Replacement Surgery and You. (April, 2009) In ''Arthritis, Musculoskeletal and Skin Disease online''. Retrieved from http://www.niams.nih.gov/#. Uses Shoulder For shoulder replacement, there are a few major approaches to access the shoulder joint. The first is the delt ...
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Meniscus Transplant
A meniscus transplant or meniscal transplant is a transplant of the meniscus of the knee, which separates the thigh bone (femur) from the lower leg bone (tibia). The worn or damaged meniscus is removed and is replaced with a new one from a donor. The meniscus to be transplanted is taken from a cadaver, and, as such, is known as an allograft. Meniscal transplantation is technically difficult, as it must be sized accurately for each person, positioned properly and secured to the tibial plateau. As of 2012, only a few surgeons have significant volume of experience in meniscus transplantation worldwide. Background Each knee has an inside (medial) and an outside (lateral) meniscus. The menisci play several key roles that are vital in maintaining the health of the knee. Specifically, they act as shock absorbers and load sharers, increase the stability of the knee, and provide lubrication and nutrition to the bearing surface (articular cartilage) of the knee. They were once thought of a ...
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Meniscal Tear
A tear of a meniscus is a rupturing of one or more of the fibrocartilage strips in the knee called meniscus (anatomy), menisci. When doctors and patients refer to "torn cartilage" in the knee, they actually may be referring to an injury to a meniscus at the top of one of the tibiae. Menisci can be torn during innocuous activities such as walking or squatting position, squatting. They can also be torn by Physical trauma, traumatic force encountered in sports or other forms of physical exertion. The traumatic action is most often a twisting movement at the knee while the leg is bent. In older adults, the meniscus can be damaged following prolonged 'wear and tear'. Especially acute injuries (typically in younger, more active patients) can lead to displaced tears which can cause mechanical symptoms such as clicking, catching, or locking during motion of the joint. The joint will be in pain when in use, but when there is no load, the pain goes away. A tear of the medial meniscus can oc ...
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Cannula
A cannula (; Latin meaning 'little reed'; plural or ) is a tube that can be inserted into the body, often for the delivery or removal of fluid or for the gathering of samples. In simple terms, a cannula can surround the inner or outer surfaces of a trocar needle thus extending the effective needle length by at least half the length of the original needle. Its size mainly ranges from 14 to 24 gauge. Different-sized cannula have different colours as coded. Decannulation is the permanent removal of a cannula (extubation), especially of a tracheostomy cannula, once a physician determines it is no longer needed for breathing. Medicine Cannulas normally come with a trocar inside. The trocar is a needle, which punctures the body in order to get into the intended space. Many types of cannulas exist: Intravenous cannulas are the most common in hospital use. A variety of cannulas are used to establish cardiopulmonary bypass in cardiac surgery. A nasal cannula is a piece of plastic tu ...
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Articular Cartilage
Hyaline cartilage is the glass-like (hyaline) and translucent cartilage found on many joint surfaces. It is also most commonly found in the ribs, nose, larynx, and trachea. Hyaline cartilage is pearl-gray in color, with a firm consistency and has a considerable amount of collagen. It contains no nerves or blood vessels, and its structure is relatively simple. Structure Hyaline cartilage is covered externally by a fibrous membrane known as the perichondrium or, when it's along articulating surfaces, the synovial membrane. This membrane contains vessels that provide the cartilage with nutrition through diffusion. Hyaline cartilage matrix is primarily made of type II collagen and chondroitin sulphate, both of which are also found in elastic cartilage. Hyaline cartilage exists on the sternal ends of the ribs, in the larynx, trachea, and bronchi, and on the articulating surfaces of bones. It gives the structures a definite but pliable form. The presence of collagen fibres makes ...
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Meniscus (anatomy)
A meniscus is a crescent-shaped fibrocartilaginous anatomical structure that, in contrast to an articular disc, only partly divides a joint cavity.Platzer (2004), p 208 In humans they are present in the knee, wrist, acromioclavicular, sternoclavicular, and temporomandibular joints; in other animals they may be present in other joints. Generally, the term "meniscus" is used to refer to the cartilage of the knee, either to the lateral or medial meniscus. Both are cartilaginous tissues that provide structural integrity to the knee when it undergoes tension and torsion. The menisci are also known as "semi-lunar" cartilages, referring to their half-moon, crescent shape. The term "meniscus" is from the Ancient Greek word (), meaning "crescent". Structure The menisci of the knee are two pads of fibrocartilaginous tissue which serve to disperse friction in the knee joint between the lower leg (tibia) and the thigh (femur). They are concave on the top and flat on the bottom, articula ...
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Femur
The femur (; ), or thigh bone, is the proximal bone of the hindlimb in tetrapod vertebrates. The head of the femur articulates with the acetabulum in the pelvic bone forming the hip joint, while the distal part of the femur articulates with the tibia (shinbone) and patella (kneecap), forming the knee joint. By most measures the two (left and right) femurs are the strongest bones of the body, and in humans, the largest and thickest. Structure The femur is the only bone in the upper leg. The two femurs converge medially toward the knees, where they articulate with the proximal ends of the tibiae. The angle of convergence of the femora is a major factor in determining the femoral-tibial angle. Human females have thicker pelvic bones, causing their femora to converge more than in males. In the condition ''genu valgum'' (knock knee) the femurs converge so much that the knees touch one another. The opposite extreme is ''genu varum'' (bow-leggedness). In the general populatio ...
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Tibia
The tibia (; ), also known as the shinbone or shankbone, is the larger, stronger, and anterior (frontal) of the two bones in the leg below the knee in vertebrates (the other being the fibula, behind and to the outside of the tibia); it connects the knee with the ankle. The tibia is found on the medial side of the leg next to the fibula and closer to the median plane. The tibia is connected to the fibula by the interosseous membrane of leg, forming a type of fibrous joint called a syndesmosis with very little movement. The tibia is named for the flute ''tibia''. It is the second largest bone in the human body, after the femur. The leg bones are the strongest long bones as they support the rest of the body. Structure In human anatomy, the tibia is the second largest bone next to the femur. As in other vertebrates the tibia is one of two bones in the lower leg, the other being the fibula, and is a component of the knee and ankle joints. The ossification or formation of the bone ...
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