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Use of Particulated Juvenile Articular Cartilage Allograft for Osteochondral Lesions of the Wrist

机译:同种异体少年关节软骨移植治疗腕骨软骨病变的应用

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摘要

>Background: Articular cartilage injuries are a common injury among young, active patients, and the most appropriate treatment for these injuries remains controversial. A promising new technology in the treatment of high-grade cartilage injuries is particulated juvenile articular cartilage (PJAC) allograft (DeNovo NT, Zimmer, Warsaw, Indiana). This has been shown to be successful in multiple joints including the knee, talus, and elbow. No studies or case reports exist in supporting or discouraging its use in injuries of the wrist, in specific, the scaphoid. >Methods: The use of PJAC allograft is described for the treatment of an active 21-year-old male with an Outerbridge Grade IV chondral lesion on the proximal pole of his right scaphoid and right distal radius scaphoid facet who had failed conservative management. The patient was followed clinically and radiographically for 21 months. >Results: The patient had return to full sport (jujutsu) and full range-of-motion, both of which represented an improvement from his preoperative exam. Radiographically, the chondral lucency seen had decreased in size and was almost completely absent on radiographs after 21 months. >Conclusions: The results of this case suggest that PJAC can be used safely and effectively in the wrist thereby potentially broadening the indications for its use.
机译:>背景:关节软骨损伤是年轻活跃患者的常见损伤,对于这些损伤的最合适治疗方法仍存在争议。微粒关节软骨(PJAC)同种异体移植物(DeNovo NT,Zimmer,华沙,印第安纳州)是治疗高水平软骨损伤的有前途的新技术。已经证明这在包括膝盖,距骨和肘部在内的多个关节中是成功的。目前尚无研究或病例报告支持或劝阻其用于手腕(尤其是舟骨)的受伤。 >方法:描述了使用PJAC同种异体移植术治疗一名活跃的21岁男性,该男性在他的右舟骨和右radius骨远端小突节的近端极上有IV级软骨外病变保守管理失败。临床和影像学随访21个月。 >结果:患者恢复了全运动(柔术)和全动作范围,这都比术前检查有所改善。影像学上,所见的软骨透明度降低了,在21个月后的X光片上几乎完全消失了。 >结论:该案例的结果表明,PJAC可在手腕上安全有效地使用,从而有可能扩大其使用范围。

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