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

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Video Summary

The speaker discusses the complexities of combined joint preservation procedures, particularly involving cartilage repair, osteotomy, meniscal transplantation, and ligament reconstruction. They emphasize the importance of understanding the knee as an organ, where malalignment, cartilage status, meniscal health, and ligament stability interplay and influence treatment decisions. Due to the variability in patient conditions and surgical techniques, there is no one-size-fits-all approach; individualized planning is essential. A key consideration is whether to perform procedures in one stage or multiple stages, with a low threshold recommended for staging to reduce surgical risks. The presence of osteotomy often drives staging decisions, as it can complicate fixation and graft choices. Surgical sequencing typically involves arthroscopic work first, osteotomy second, and delicate procedures like cell-based cartilage repair last. Collaboration, thorough preoperative planning, and flexibility are crucial to managing these technically demanding but rewarding cases successfully.

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Armando Vidal, M.D.

Keywords

combined joint preservation

cartilage repair

osteotomy

meniscal transplantation

ligament reconstruction