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1.
Cartilage ; 11(4): 447-457, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-30280586

RESUMEN

OBJECTIVE: To determine performance and repair kinetics of the ChonDux hydrogel scaffold for treating focal articular cartilage defects in the knee over 24 months. DESIGN: This assessor-blinded trial evaluates ChonDux hydrogel scaffold implantation in combination with microfracture in 18 patients across 6 sites. Male and female patients 18 to 65 years of age with full-thickness femoral condyle defects 2 to 4 cm2 in area were enrolled. Eligible patients received ChonDux treatment followed by rehabilitation. Defect volume fill was evaluated after 3, 6 (primary outcome), 12, 18, and 24 months by assessor blinded magnetic resonance imaging (MRI) analysis. Secondary outcomes were T2-weighted MRI relaxation time and patient surveys via visual analogue scale (VAS) pain and International Knee Documentation Committee (IKDC) knee function scoring. RESULTS: ChonDux maintained durable tissue restoration over 24 months with final defect percent fill of 94.2% ± 16.3% and no significant loss of fill volume at any time points. Tissues treated with ChonDux maintained T2 relaxation times similar to uninjured cartilage between 12 and 24 months. VAS pain scoring decreased between 1 and 6 weeks, and IKDC knee function scores improved by approximately 30.1 with ChonDux over 24 months. CONCLUSION: ChonDux treatment is a safe adjunct to microfracture therapy and promotes stable restoration of full thickness articular cartilage defects for at least 24 months.


Asunto(s)
Enfermedades de los Cartílagos/tratamiento farmacológico , Cartílago Articular/lesiones , Fracturas por Estrés/rehabilitación , Hidrogeles/administración & dosificación , Traumatismos de la Rodilla/rehabilitación , Adolescente , Adulto , Anciano , Enfermedades de los Cartílagos/etiología , Enfermedades de los Cartílagos/rehabilitación , Cartílago Articular/diagnóstico por imagen , Cartílago Articular/fisiopatología , Terapia Combinada , Evaluación de la Discapacidad , Femenino , Fémur , Estudios de Seguimiento , Fracturas por Estrés/complicaciones , Fracturas por Estrés/fisiopatología , Humanos , Cinética , Traumatismos de la Rodilla/complicaciones , Traumatismos de la Rodilla/fisiopatología , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/fisiopatología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Recuperación de la Función , Método Simple Ciego , Resultado del Tratamiento , Adulto Joven
2.
Arch Orthop Trauma Surg ; 123(1): 17-21, 2003 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-12582791

RESUMEN

BACKGROUND: A retrospective study investigated the advantages of the intraoperative application of the anti-adhesion barrier gel Adcon-L after lumbar microdiscectomy. METHODS: For the study, 92 patients were recruited. Following the operation, 46 patients (study group) received Adcon-L application. In other 46 patients (control group), wounds were closed without Adcon-L application. Median follow-up was 32 (range 26-33) months in the study group and 37 (range 32-41) months in the control group postoperation. All patients were examined clinically, and spinal MRIs were carried out on 12 randomly selected patients in each group. RESULTS: According to the score of the Low Back Pain Committee of the Japanese Orthopedic Association, no significant clinical difference could be established between the two groups. Subjective evaluation of the operation results (score according to Weber) was not significant. Peridural scarring on the postoperative MRI of 24 patients did not differ significantly between the groups. CONCLUSION: A significant effect on the clinical results after Adcon-L application could not be found.


Asunto(s)
Discectomía/métodos , Fibrosis/prevención & control , Geles/uso terapéutico , Desplazamiento del Disco Intervertebral/cirugía , Adulto , Estudios de Casos y Controles , Discectomía/efectos adversos , Femenino , Estudios de Seguimiento , Humanos , Desplazamiento del Disco Intervertebral/diagnóstico , Imagen por Resonancia Magnética , Masculino , Microcirugia/métodos , Persona de Mediana Edad , Compuestos Orgánicos , Dimensión del Dolor , Dolor Postoperatorio/diagnóstico , Complicaciones Posoperatorias/prevención & control , Probabilidad , Recuperación de la Función , Estudios Retrospectivos , Estadísticas no Paramétricas , Resultado del Tratamiento
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