Case report, case study
https://doi.org/DOI 10.69589/hsv.39.1.6
Simultaneous autologous minced cartilage implantation and open wedge high tibial osteotomy in the treatment of knee cartilage defect
Alan Ivković
; Department of Orthopedics and Traumatology, University Hospital „Sveti Duh“, Zagreb, Croatia
Matej Črep
; School of Medicine, University of Zagreb, Zagreb, Croatia
Marko Pećina
; Department of Medical Sciences, Croatian Academy of Sciences and Arts, Zagreb, Croatia
Abstract
Autologous Minced Cartilage Implantation (AMCI) presents a new approach to treating cartilage damage in the knee. Correcting any underlying lower extremity malalignment is essential for this treatment to succeed. We present a 50-year-old patient with pain in the left knee without a history of trauma. Radiological findings revealed a varus deformation of the knee, and a magnetic resonance imaging (MR) showed a cartilage lesion of the medial femoral condyle measuring 3 cm2. The patient first underwent open wedge osteotomy of the proximal left tibia, which corrected the varus deformity that caused cartilage damage due to increased mechanical load. Afterward, arthroscopy was performed while the healthy cartilage from the edge of the damage was taken and finely minced. The obtained cartilage mass was mixed with the patient’s platelet-rich plasma (PRP). Part of the PRP is additionally processed to produce autologous thrombin. An autologous implant in the form of a paste from minced cartilage and PRP is placed over the defect on the femoral condyle and infused with autologous thrombin to activate the coagulation cascade and fix the transplant in the defect. In a final step, autologous fibrin is then instilled over the implant, which additionally stabilizes it. Radiological findings showed postoperative healing of the proximal tibia, and the MRI revealed the filling of the femoral condyle defect. The patient was without complaints in daily activities, and postoperative subjective and objective findings significantly improved. Autologous minced cartilage implantation in combination with correction of the direction of the lower extremities has shown promising results in treating cartilage damage.
Keywords
Transplantation, Autologous, Cartilage, Genu Varum, Orthopedics, Osteotomy
Hrčak ID:
321675
URI
Publication date:
28.6.2024.
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