By Brian J. Cole MD, MBA, M. Mike Malek MD (auth.)
Drs. Cole and Malek, well-known leaders within the box, wrote this state of the art textual content to fill the void within the literature in regards to the administration of articular cartilage sickness and meniscal deficiency. The ebook allows orthopedic surgeons to improve an evidence-based decision-making framework that publications the administration of articular cartilage lesions. conscientiously selected members supply readers with a pragmatic historical past in articular lesions, sufferer evaluate, and administration techniques. next chapters deal with the gamut of present surgical options, from arthroscopy and debridement to unicondylar arthroplasty, in a step by step demeanour. greater than 500 specified illustrations, many in colour, support readers comprehend and grasp remedies. Case reports, which come with preoperative making plans and postoperative results, make stronger the decision-making approach. approximately each permutation and therapy alternative is roofed, making this article a main source for surgeons dedicated to workout sound judgement.
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Extra info for Articular Cartilage Lesions: A Practical Guide to Assessment and Treatment
By the same token, if the medial compartment experiences some early wear or injury, this loss of articular surface height may lead to progressive varus deformity and more rapid deterioration. Mechanical devices such as braces and orthotics may by useful in decreasing the stress of weight bearing in the affected compartment. Lateral heel wedge orthotics inclined at approximately 5° have been shown to significantly reduce knee varus torque during walking in patients with medial compartment OA. 131 Despite these findings, clinical studies have variably reported reliable pain relief with the use of these types of shoe inserts.
Comparative trials of NSAIDs versus simple analgesics found that acetaminophen alone is enough to control pain in many patients with osteoarthritis, and that in patients requiring NSAID therapy, the addition of acetaminophen may reduce the necessary dosage of NSAIDs. 5- 7 Traditional NSAIDs are effective at relieving pain associated with arthritis by reversibly and nonspecifically blocking the cyclooxygenase (COX) side of the arachidonic acid metabolism pathway. This blockade effectively decreases the production of inflammatory agents such as prostaglandins.
Typically, elevated levels of interleukin (IL)-1, IL-6, and tumor necrosis factor found within the synovial fluid indicate catabolic activity in articular cartilage or matrix breakdown in both early inflammatory arthritis and early OA. 4:1 The potential therapeutic value of glucosamine and chondroitin sulfate in arthrosis relies on their involvement in effecting articular cartilage biosynthesis and synovial metabolism. 44 Glucosamine is an amino acid precursor to GAGs endogenously synthesized from glucose and an amine group from glutamine.
Articular Cartilage Lesions: A Practical Guide to Assessment and Treatment by Brian J. Cole MD, MBA, M. Mike Malek MD (auth.)