Description
This virtual presentation by Michael Pickell, an orthopedic surgeon based in Ottawa, focuses on cartilage restoration and joint preservation in the knee. In just 12 minutes, he covers the prevalence and implications of chondral defects found during knee arthroscopies, noting that 60-65% of knees examined show some form of chondral injury. Pickell discusses the transition of knee structure from convex to flat due to lesions, leading to increased edge loading and potential degenerative changes, including arthrosis.
Key factors influencing treatment decisions include the size, location, and nature of the cartilage lesions, as well as the patient's symptoms and expectations. Treatment options are reviewed, starting with traditional shaving chondroplasty and proceeding to more advanced techniques like microfracture, osteochondral grafting (both autograft and allograft), and cell-based repair methods.
Pickell emphasizes that smaller lesions (less than 10mm) typically require less aggressive interventions, while larger lesions present more significant challenges. He highlights that while microfracture has been a common procedure with varying results, there are emerging techniques and caution regarding the longevity of fibrocartilage grafts. The talk concludes with real-life case examples showcasing the balance orthopedic surgeons must strike between various treatment modalities, patient needs, and anticipated outcomes.