ICL 107 State of the Art Approach to Chondral Injury-State of the Art Approach to Chondral Injury Discussion

Video Transcription

Video Summary

In this lecture, Nick Scaglione introduces experts Dr. Jack Farr and Dr. Andreas Gamal to discuss advanced approaches to managing chondral injuries, particularly in complex cases involving medial meniscus tears, ACL tears, and significant chondral lesions. The presentation emphasizes the importance of patient profiling, including lesion size and depth, subchondral bone integrity, alignment, BMI, and prior treatments. Various treatment methods are reviewed: microfracture, autogenous osteochondral transplantation (OATS), osteochondral allografts, and newer cell-based therapies like autologous chondrocyte implantation (ACI) and particulated juvenile articular cartilage. Microfracture remains common but faces durability concerns, especially in active patients, with evolving techniques aiming to improve outcomes. OATS offers hyaline cartilage transfer but is technically challenging. Allografts provide viable tissue and bone treatment with promising long-term success. Cell-based therapies show potential but face reimbursement challenges in the U.S. Ultimately, management requires a broad toolset and personalized approaches, especially for younger patients with complex pathology.

Keywords

chondral injuries

medial meniscus tears

ACL tears

microfracture

osteochondral transplantation

autologous chondrocyte implantation