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Literature Review Final
Literature Review Final
Literature Review
11/18/15
ENC1102
Articular Cartilage in the Knee
Since the beginning of mankind, humans have used their knees
continuously from hunting to running for pleasure. Because the knee is a
joint predominantly used, damage from wear and tear are prevalent. This
damage is particularly noticeable in the articular cartilage of the knee.
Articular cartilage is the layer of cartilage covering the end of a bone that
forms a joint surface, providing, among its many functions, shock absorption,
even distribution of load across the joint and nutrition of the underlying
bone(Livingstone). Although articular cartilage damage in the knee may
seem insignificant, there are various parts that affect the outcome of this
injury. This literature review focuses on the surge of cartilage damage, prior
injuries that negatively affect articular cartilage, inconclusive studies, and
short-midterm results.
The sources in this conversation are primarily from academic journals
because this is an academic profession. The authors of these academic
journals include doctors of medicine, PhDs, researchers, and students in
medical schools. This academic profession, the medical field, grows
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The most prominent thread is that although great deal of studies have
been done on repair techniques, most the data is inconclusive (Biant et al;
Chang et al; Gudas et al; Maldonda et al; Schuttler et al; Ravnihar et al).
Some studies including ACI, an effective procedure on damaged articular
cartilage in the knee that has a potential to produce hyaline cartilage, PRP, a
regenerative therapy that uses injections that are a natural concentrate of
autologous growth factors from the blood, OAT, a one-step surgery that repairs
fibrocartilage in the knee, and cell free collagen matrix 1, a one step
procedures that use former matrices in a stand-alone, cell-free manner to serve as a carrier
for chondrocytes to colonize the defect in vivo, are inconclusive because they are
newer procedures(Biant et al; Chang et al; Gudas et al; Schuttler et al). Other
inconclusive studies include an experiment on rats proving joint
immobilization stimulates degeneration of articular cartilage and an
experiment discussing the toxic effects of anesthetics on articular cartilage
(Maldonda et al; Ravnihar, Brolic, Drobnik).
An intertwining thread to the inconclusive experiments includes
surgeries that have short term (one to three years) to midterm successes
(four to fifteen years). Short term results include any study that has been
tracked from one to three years and midterm results include studies that
have follow ups from four until fifteen years. Studies with short term results
include microfracture, a form of bone marrow stimulation used on nonathletic
people, platelet rich plasma(PRP) injections that only last up to twelve
months, and shorter midterm outcomes include cell free collagen matrix 1
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that only had follow-ups after forty eight months (Camp Stuart, Krych; Chang
et al; Schuttler et al). Experiments resulting in midterm successes of ten
years include autologous chondrocyte implantation (ACI ) in which ninety
eight percent of patients were satisfied and osteochondral autologous
transplantation(OAT) in which more athletes returned to preinjury
activity( Biant et al; Gudas et al). The reason for their being primarily
short/midterm results for these procedures are because these experiments
have only been focused on in the past twenty years.
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more aware of risks that may occur in the future. With gathering criterion for
each surgery for long term results and having an education class on
prevention of articular cartilage injuries in the knee, hopefully one day there
will a procedure that will indefinitely repair previous damage.
Work Cited:
Anderson, Allen F., and Christian N. Anderson. "Correlation Of Meniscal And
Articular Cartilage Injuries In Children And Adolescents With Timing Of
Anterior Cruciate Ligament Reconstruction." American Journal Of Sports
Medicine 43.2 (2015): 275-281. SPORTDiscus. Web. 10 Oct. 2015.
"articular cartilage." Dictionary of Sport and Exercise Science and Medicine
by Churchill Livingstone. 2008. Elsevier Limited 25 Oct. 2015 http://medicaldictionary.thefreedictionary.com/articular+cartilage
Biant, Leela C, et al. "Long-Term Results Of Autologous Chondrocyte
Implantation In The Knee For Chronic Chondral And Osteochondral Defects."
The American Journal Of Sports Medicine 42.9 (2014): 2178-2183. MEDLINE.
Web. 22 Oct. 2015.
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Hambly, Karen. "The Use Of The Tegner Activity Scale For Articular Cartilage
Repair Of The Knee: A Systematic Review." Knee Surgery, Sports
Traumatology, Arthroscopy 19.4 (2011): 604-614. SPORTDiscus. Web. 12 Oct.
2015.
Ji-Hoon, BAE, et al. "Articular Cartilage Of The Knee 3 Years After ACL
Reconstruction." Acta Orthopaedica 86.5 (2015): 605-610. SPORTDiscus.
Web. 19 Oct. 2015.
Li, Hong, et al. "Quantitative MRI T2 Relaxation Time Evaluation Of Knee
Cartilage: Comparison Of Meniscus-Intact And -Injured Knees After Anterior
Cruciate Ligament Reconstruction." American Journal Of Sports Medicine 43.4
(2015): 865-872. SPORTDiscus. Web. 12 Oct. 2015.
Maldonado, Diogo Correa, et al. "The Effects Of Joint Immobilization On
Articular Cartilage Of The Knee In Previously Exercised Rats." Journal Of
Anatomy 222.5 (2013): 518-525. Academic Search Premier. Web. 19 Oct.
2015.
Schindler, Oliver S. "(Iv) Articular Cartilage Surgery In The Knee."
Orthopaedics & Trauma 24.2 (2010): 107-120 14p. CINAHL Plus with Full
Text. Web. 12 Oct. 2015.
Schttler, Karl, et al. "Use Of Cell-Free Collagen Type I Matrix Implants For
The Treatment Of Small Cartilage Defects In The Knee: Clinical And Magnetic
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