Joint Preservation Techniques for the Knee in 2023: The Utility of Biologics, Osteotomies and Cartilage Restoration Procedures (2023 Annual Meeting)-Case Studies

Video Transcription

Video Summary

This expert panel discusses advanced knee preservation techniques in complex cases involving cartilage lesions, bone marrow edema, and meniscal injuries, focusing on treatment decisions for young, active patients and athletes. They explore options like bone marrow injections, cell-based cartilage repair, osteochondral allografts, osteotomies, and revisions of ACL and meniscus surgeries. Key considerations include the integrity of cartilage, alignment issues (varus/valgus), meniscal status, and patient activity level. The panel emphasizes individualized treatment plans, balancing joint preservation and realistic expectations of outcomes, acknowledging limitations and risks. They highlight challenges managing high-level athletes who often prioritize return to play, noting certain procedures like high tibial osteotomy may limit elite performance. Cases presented show a blend of surgical approaches including multi-plug osteochondral allografts for multifocal lesions, patellofemoral arthroplasty versus cartilage transplantation, and complex revision ACL combined with osteotomy in young athletes. The importance of patient education and setting appropriate expectations to optimize long-term joint health is stressed throughout.

Asset Caption

Rachel M. Frank, M.D. | Michael J. Alaia, M.D. | Seth L. Sherman, M.D. | Armando F. Vidal, M.D.

Keywords

knee preservation

cartilage repair

meniscal injuries

osteochondral allografts

high tibial osteotomy

ACL revision surgery