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Alvero AB, Wright-Chisem J, Vogel MJ, Wright-Chisem A, Mather RC, Nho SJ. Treatment of Hip Cartilage Defects in Athletes. Sports Med Arthrosc Rev 2024; 32:95-103. [PMID: 38978203 DOI: 10.1097/jsa.0000000000000378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Chondral defects in the athlete's hip are a relatively common occurrence, often presenting with debilitating pain and activity limitation. Preoperative identification of cartilage defects is challenging and there are many different modalities for treatment. Nonsurgical interventions, including activity modification, physical therapy, and injections, play a vital role, especially in less severe cases and as adjuncts to surgical intervention. Treating surgeons must be familiar with the cartilage restoration procedures available, including debridement, microfracture, and various implantation and transplantation options. Safe and effective management of cartilage defects is imperative to an athlete's return to sport. It is also imperative that surgeons are aware of all these various treatment options to determine what modality is best for their patients. This review serves to outline these options, cover the published literature, and provide general guidelines for surgeons when they encounter chondral defects in the office and the operating room.
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Affiliation(s)
- Alexander B Alvero
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush Medical College of Rush University, Rush University Medical Center; Chicago, IL
| | - Joshua Wright-Chisem
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush Medical College of Rush University, Rush University Medical Center; Chicago, IL
| | - Michael J Vogel
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush Medical College of Rush University, Rush University Medical Center; Chicago, IL
| | - Adam Wright-Chisem
- Department of Orthopedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Richard C Mather
- Department of Orthopedic Surgery, Duke University Medical Center, Durham, NC
| | - Shane J Nho
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush Medical College of Rush University, Rush University Medical Center; Chicago, IL
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Lubowitz JH, Matzkin E, Rossi MJ. The Second Annual Musculoskeletal Biologics Special Issue Highlights Evidence-Based Therapies. Arthroscopy 2024; 40:1379-1383. [PMID: 38354761 DOI: 10.1016/j.arthro.2024.01.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 01/25/2024] [Indexed: 02/16/2024]
Abstract
Orthopaedic biologics continues to hold great promise. The editors of Arthroscopy; Arthroscopy Techniques; and Arthroscopy, Sports Medicine, and Rehabilitation once again Call for Papers and invite authors to submit clinical musculoskeletal biologics original scientific research and technical notes with video. Our top articles are awarded inclusion in the Annual Musculoskeletal Biologics Special Issue.
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Weissman AC, Yazdi AA, Cole BJ. Orthopaedic Musculoskeletal Biologics Research Impacts Patient Care: The Second Annual Arthroscopy Orthobiologics Virtual Special Issue. Arthroscopy 2024; 40:1384-1385. [PMID: 38342285 DOI: 10.1016/j.arthro.2024.01.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 02/13/2024]
Abstract
The field of orthobiologics is rapidly evolving, offering clinicians a shift in treatment from symptom relief to the potential for disease modification and tissue repair. These agents, derived from autologous tissues, components of blood, and growth factors, are used as surgical adjuncts or as standalone treatments. Their clinical applications are expanding to encompass a variety of conditions, supported by a growing base of research efforts. Arthroscopy and its companion publications are committed to evidence-based research with a robust history of publications that enhance clinical decision-making and impact patient care. This curated collection of articles highlights the year's most compelling advancements in orthopaedic musculoskeletal biologics research.
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Allahabadi S, Jawanda H, Khan ZA, Brusalis CM, Chahla J, Cole BJ, Verma NN. Bone Marrow Aspirate Concentrate Harvest Techniques for the Sports Medicine Surgeon. Arthrosc Tech 2024; 13:102850. [PMID: 38435256 PMCID: PMC10907908 DOI: 10.1016/j.eats.2023.09.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 09/24/2023] [Indexed: 03/05/2024] Open
Abstract
The use of bone marrow aspirate concentrate (BMAC) as a surgical augment to enhance biologic healing has been gaining popularity in a variety of sports medicine procedures. Due to its reliable availability from multiple sites, including the proximal tibia, proximal humerus, and anterior superior iliac spine, BMAC can be harvested at a location selected to be adjacent to the primary procedure. This Technical Note aims to highlight 3 different harvest sites for BMAC, allowing orthopaedic sports medicine surgeons to localize their harvest site based on the proximity of the planned procedure and ultimately increase efficiency.
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Affiliation(s)
| | | | - Zeeshan A. Khan
- Rush University Medical Center, Chicago, Illinois, U.S.A
- Rush Medical College, Chicago, Illinois, U.S.A
| | | | - Jorge Chahla
- Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Brian J. Cole
- Rush University Medical Center, Chicago, Illinois, U.S.A
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Dean MC, Torabian KA, LaPorte ZL, Dowley KS, Cherian NJ, Martin SD. Regarding "Hip Arthroscopy With Bone Marrow Aspirate Injection for Patients With Symptomatic Labral Tears and Early Degenerative Changes Shows Similar Improvement Compared With Patients Undergoing Hip Arthroscopy with Symptomatic Labral Tears Without Arthritis". Arthroscopy 2023; 39:1954-1955. [PMID: 37543375 DOI: 10.1016/j.arthro.2023.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/10/2023] [Indexed: 08/07/2023]
Affiliation(s)
- Michael C Dean
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A
| | - Kaveh A Torabian
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A
| | - Zachary L LaPorte
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A
| | - Kieran S Dowley
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A
| | - Nathan J Cherian
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A
| | - Scott D Martin
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A
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Day MA, Hancock KJ, Selley RS, Olsen R, Ranawat AS, Nwachukwu BU, Kelly BT, Nawabi DH. Author Reply: Labrum-Preserving Hip Arthroscopy and Bone Marrow Aspirate Injection for Patients With Symptomatic Labral Tears and Early Degenerative Changes. Arthroscopy 2023; 39:1955-1957. [PMID: 37543376 DOI: 10.1016/j.arthro.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 08/07/2023]
Affiliation(s)
- Molly A Day
- Sports Medicine Institute, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A.; Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A
| | - Kyle J Hancock
- Sports Medicine Institute, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A.; Department of Sports Medicine, Desert Orthopaedic Center, Las Vegas, Nevada, U.S.A
| | - Ryan S Selley
- Sports Medicine Institute, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A
| | - Reena Olsen
- Sports Medicine Institute, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A
| | - Anil S Ranawat
- Sports Medicine Institute, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A
| | - Benedict U Nwachukwu
- Sports Medicine Institute, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A
| | - Bryan T Kelly
- Sports Medicine Institute, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A
| | - Danyal H Nawabi
- Sports Medicine Institute, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A
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Hartwell MJ, Zhang AL. Editorial Commentary: Hip Arthroscopy in Patients With Early Degeneration Who Receive Intra-Articular Bone Marrow Aspirate Concentrate Can Achieve Outcomes Similar to Nonarthritic Patients. Arthroscopy 2023; 39:1438-1439. [PMID: 37147073 DOI: 10.1016/j.arthro.2023.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 05/07/2023]
Abstract
The management of patients with early joint degeneration is challenging. In this setting, biologic interventions, from platelet-rich plasma to bone marrow aspirate concentrate (BMAC) to hyaluronic acid, may be beneficial. Recent research, with 2-year follow-up, shows that patients with early degenerative changes (Tönnis grade 1 or 2) who received intra-articular injection of BMAC after hip arthroscopy procedure had improvements in outcomes similar to nonarthritic patients (Tönnis 0) with symptomatic labral tears who underwent arthroscopy and did not receive BMAC. Although confirmatory investigation using patients with early degenerative changes as a control is required, it is possible that with BMAC, patients with early degenerative changes of their hip could achieve functional outcomes similar to patients with nonarthritic hips.
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