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In February 2008, Saris et al. published a large-scale study claiming that CCI results in better structural repair for symptomatic cartilage defects of the knee than microfracture surgery. According to the study, one year after treatment, the regenerated tissue associated with CCI is of better quality than that of microfracture surgery. [15]
An intraarticular fracture is a bone fracture in which the break crosses into the surface of a joint. This always results in damage to the cartilage . [ 1 ] Compared to extraarticular fractures , intraarticular have a higher risk for developing long-term complications, such as posttraumatic osteoarthritis .
In the longer term, the knee may not regain full movement, pain may persist and there is an increased likelihood of osteoarthritis of the knee. [7] If there is an associated open wound as in an open fracture , complications also include risk of infection, inability of the broken bones to reunite and osteonecrosis .
Articular cartilage does not usually regenerate (the process of repair by formation of the same type of tissue) after injury or disease leading to loss of tissue and formation of a defect. This fact was first described by William Hunter in 1743. [1] Several surgical techniques have been developed in the effort to repair articular cartilage defects.
When a bone fractures, the fragments lose their alignment in the form of displacement or angulation. For the fractured bone to heal without any deformity the bony fragments must be re-aligned to their normal anatomical position.
Bone grafting is a surgical procedure that replaces missing bone in order to repair bone fractures that are extremely complex, pose a significant health risk to the patient, or fail to heal properly. Some small or acute fractures can be cured without bone grafting, but the risk is greater for large fractures like compound fractures.
Arthroscopic lavage is a "cleaning up" procedure of the knee joint. This short-term solution is not considered as an articular cartilage repair procedure but rather a palliative treatment to reduce pain, mechanical restriction and inflammation. Lavage focuses on removing degenerative articular cartilage flaps and fibrous tissue.
External fixation is a surgical treatment wherein Kirschner pins and wires are inserted and affixed into bone and then exit the body to be attached to an external apparatus composed of rings and threaded rods — the Ilizarov apparatus, the Taylor Spatial Frame, and the Octopod External Fixator — which immobilises the damaged limb to facilitate healing. [1]