Artroplastia biológica do joelho
Palavras-chave:
cartilagem articular, transplante homólogo, artrite degenerativaResumo
Realizamos uma artroplastia biológica parcial do joelho em uma paciente portadora de artrose unicompartimental medial do joelho decorrente de meniscectomia medial prévia. A paciente apresentou boa integração inicial do enxerto no fêmur, sem sinais de rejeição. No entanto, apresentou artrofibrose e retardo de consolidação na tíbia, sendo reoperada e evoluindo com diminuição do arco de movimento total do joelho e dores aos grandes esforços. Este caso mostrou uma nova possibilidade técnica para a substituição da cartilagem, factível em nosso meio. Entretanto, um maior número de casos com maior seguimento é necessário para verificar o real benefício desta técnica.
Downloads
Referências
Cole B, Frederick RW, Levy AS, Zaslav KR. Management of a 37-year-old man with recurrent knee pain. J Clin Outcomes Manag. 1999;6(6):46-57.
Asik M, Ciftci F, Sen C, Erdil M, Atalar A. The microfracture technique for the treatment of full- thickness articular cartilage lesions of the knee: midterm results. Arthroscopy. 2008;24(11):1214-20.
Minas T, Nehrer S. Current concepts in the treatment of articular cartilage defects. Orthopedics. 1997;20(6):525-38.
Bartha L, Vajda A, Duska Z, Rahmeh H, Hangody L. Autologous osteochondral mosaicplasty grafting. J Orthop Sports Phys Ther. 2006;36(10):739-50.
Hangody L, Dobos J, Balo E, Panics G, Hangody LR, Berkes I. Clinical experiences with autologous osteochondral mosaicplasty in an athletic population: a 17-year prospective multicenter study. Am J Sports Med. 2010;38(6):1125-33.
Ma HL, Hung SC, Wang ST, Chang MC, Chen TH. Osteochondral autografts transfer for post- traumatic osteochondral defect of the knee- 2-5 years follow-up. Injury. 2004;35(12):1286-92.
Niemeyer P, Pestka JM, Kreuz PC, Erggelet C, Schmal H, Suedkamp NP, et al. Characteristic complications after autologous chondrocyte implantation for cartilage defects of the knee joint. Am J Sports Med. 2008;36(11):2091-9.
Stoker AM, Stannard JP, Cook JL. Chondrocyte viability at time of transplantation for osteochondral allografts preserved by the Missouri osteochondral preservation system versus standard tissue bank protocol. J Knee Surg. 2018 Sep;31(8):772-780.
Kuroki K, Stoker AM, Stannard JP, Bozynski CC, Cook CR, Pfeiffer FM, Cook JL. Biologic joint repair strategies: the Mizzou Biojoint story. Toxicol Pathol. 2017;45(7):931-8.
Stoker AM, Stannard JP, Kuroki K, Bozynski CC, Pfeiffer FM, Cook JL. Validation of the Missouri Osteochondral Allograft Preservation System for the Maintenance of Osteochondral
Allograft Quality During Prolonged Storage. Am J Sports Med. 2018;46(1):58-65.
Oladeji LO, Stannard JP, Cook CR, Kfuri M, Crist BD, Smith MJ, Cook JL. Effects of Autogenous Bone Marrow Aspirate Concentrate on Radiographic Integration of Femoral Condylar Osteochondral Allografts. Am J Sports Med. 2017;45(12):2797-803.
Stoker AM, Baumann CA, Stannard JP, Cook JL. Bone Marrow Aspirate Concentrate versus Platelet Rich Plasma to Enhance Osseous Integration Potential for Osteochondral Allografts. J Knee Surg. 2018;31(4):314-320.
