By Brian J. Cole MD, MBA, M. Mike Malek MD (auth.)
This invaluable source, derived from Drs. Cole and Malek’s Articular Cartilage Lesions: a realistic advisor to overview and Treatment, positive aspects case stories that aid the reader boost an knowing of chondral affliction and hone the decision-making abilities crucial to profitable cartilage fix and answer implementation. The case reviews integrated have been chosen for maximum scientific worth and canopy such concerns as damage assessment, actual exam, radiographic review, and comorbidities. each one case is complemented by way of fabulous illustrations, many in colour, and concludes with bulleted decision-making components that may be simply integrated into medical perform. This useful, case-based publication is a perfect studying software for citizens and surgeons looking to achieve a greater knowing of chondral ailment and the numerous ways to its profitable treatment.
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Additional info for Chondral Disease of the Knee: A Case-Based Approach
She has no quadriceps atrophy and has a Q angle of less than 8 degrees. RADIOGRAPHIC EVALUATION Plain radiographs were within normal hmits. Magnetic resonance studies demonstrated both chondral lesions with subchondral edema behind the medial femoral condyle lesion. SURGICAL INTERVENTION Because of her persistent symptoms and failure to respond to previous debridement, she was indicated for a repeat right knee arthroscopy. An 8 mm by 8 mm, nearly grade IV chondral defect located centrally within the patella and an 8 mm by 8 mm, grade IV chondral defect of the weight-bearing zone of the medial femoral condyle were identified.
4). Case 13 DECISION-MAKING FACTORS 1. Physically demanding patient in her Mth decade with chondral lesions that failed to respond to initial arthroscopic debridement and physical therapy. 2. Small patellar lesion amenable to microfracture with few other viable or appropriate 41 solutions. Other options considered could include anteromedialization osteotomy, depending on the severity of her symptoms. 3. Small lesion of the medial femoral condyle easily treated with a second-line treatment using a single-plug osteochondral autograft.
She has an antalgic gait. Her right knee has a moderate effusion. Her range of motion is 0 to 130 degrees. She is tender to palpation over the medial joint line and femoral condyle. Meniscal findings are equivocal, with pain reported with a varus axial load and rotation, but no palpable click. Her hgament examination is within normal limits. 1). A magnetic resonance image (MRI) was obtained and found to be within normal limits. SURGICAL INTERVENTION Initially, it was believed that she had a medial meniscus tear and was therefore indicated for arthroscopy.