To demonstrate the current strategies for treating cartilage defects of knees and the related research. Published papers about cartilage defects were searched and reviewed. The current strategies for the treatment were summarized. Based on the research of our study and others, the conclusion how to treat cartilage defects was made. The current ways for treating cartilage defects include micro-fractures, chondrocytes transplantation, mosaicplasty and tissue engineering; Research on functional magnetic resonance imaging in the early diagnosis of cartilage defects, cartilage degeneration is gradually increasing. There is still no effective treatment of cartilage defects and tissue engineering has brought new hopes for the treatment of cartilage defects , functional magnetic resonance imaging has some significance in early diagnosis of cartilage defects, cartilage degeneration.
Animals ; Cartilage Diseases ; surgery ; therapy ; Cartilage, Articular ; surgery ; Humans ; Knee ; surgery ; Tissue Engineering ; Transplantation, Autologous

Bone Neoplasms/surgery* ; Cartilage Diseases ; Cartilage, Articular ; Humans ; Lipoma/surgery* ; Tibia/surgery*

OBJECTIVE: To investigate the correlation between the medial meniscal indentation index (MDI) and medial tibiofemoral articular cartilage damage more than 3 degrees in patients aged 40 to 60 years old with suspected or complicated knee osteoarthritis at non-weight-bearing position, and to determine the predictive threshold. METHODS: From June 2016 to June 2020, a total of 308 patients who underwent initial knee arthroscopic exploration for chronic knee pain were collected. The age ranged from 36 to 71 years old with an average of(56.40±1.82) years old, including 105 males and 203 females. And patients with extra-articular malformations (abnormal force lines), a history of trauma, inflammatory arthritis and other specific arthritis were excluded. Finally, 89 eligible cases were obtained, aged from 42 to 60 years old with an average of (59.50±0.71) years old, including 45 males and 44 females. The degree of cartilage damage in the medial compartment of the knee joint was recorded, which was divided into two groups(≥degree 3 andcartilage injury of more than grade 3 were determined by further binary Logistic regression analysis. If MDI was taken as an independent risk factor, receiver operating characteristic (ROC) analysis was performed to confirm whether it had diagnostic value for cartilage damage of above degree 3 and calculate the critical value of MDI. RESULTS: A total of 89 eligible patients were obtained. Univariate analysis showed age, BMI, MDI and meniscus injury may be the independent risk factors for cartilage damage of more than 3 degrees, further binary Logistic regression analysis confirmed that MDI[OR=1.66, 95%CI(1.64, 1.69), P=0.01]and BMI [OR=1.58, 95%CI(1.17, 2.15), P=0.03] were independent risk factors for cartilage injury of more than degree 3 in enrolled patients. ROC analysis showed that MDI had more diagnostic value than BMI, and the critical value was 0.355 with a sensitivity of 89.1% and a specificity of 88.2%. CONCLUSION In doubt or accompanied by 40 to 60 years old patients with knee osteoarthritis, the MDI measured by non-weight-bearing knee MRI has predictive value for cartilage injury of more than degree 3 in medial tibiofemoral joint, and the critical value for diagnosis of cartilage injury of more than degree 3 is 0.355.
Male ; Female ; Humans ; Adult ; Middle Aged ; Aged ; Osteoarthritis, Knee/surgery* ; Cartilage, Articular/surgery* ; Knee Joint/surgery* ; Meniscus ; Menisci, Tibial/surgery* ; Cartilage Diseases ; Magnetic Resonance Imaging/adverse effects*

Adult ; Cartilage Diseases ; diagnosis ; etiology ; Female ; Humans ; Knee Joint ; surgery ; Menisci, Tibial ; surgery

Adult ; Female ; Humans ; Laryngeal Diseases ; surgery ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Thyroid Cartilage ; surgery

OBJECTIVE: To explore the influencing factors of the postoperative effect of arthroscopic treatment of symptomatic discoid lateral meniscus (DLM). METHODS: From September 2008 to September 2015, patients with symptomatic DLM treated by arthroscopic surgery were retrospectively analyzed. The knee function was evaluated by Lysholm scoring system. According to the scoring results, it was divided into excellent (≥90 points), good (80 to 89 points), fair (70 to 79 points) and poor (<70 points). Sixteen research factors were collected, namely gender, operation age, body mass index, work intensity, symptom duration, history of knee injury, involved knee side, DLM classification, DLM injury type, DLM injury site, medial meniscus injury, knee cartilage injury site and degree, Kellgren-Lawrence (K-L) classification, operation method, and latest follow-up time. According to the data type, Kruskall-Wallis rank sum test or RESULTS: According to the inclusion and exclusion criteria, 502 patients were included. Lysholm functional grade at the latest follow-up was higher than that before operation ( CONCLUSION Arthroscopy is a safe and effective method for the treatment of symptomatic DLM. The gender, body mass index, work intensity, age of operation, duration of symptoms and degree of knee cartilage injury are independent influencing factors for the postoperative efficacy of symptomatic DLM.
Arthroscopy ; Cartilage Diseases ; Female ; Humans ; Knee Joint/surgery* ; Menisci, Tibial/surgery* ; Retrospective Studies ; Risk Factors

OBJECTIVEFor the purpose of improving the surgical effect of contact granuloma of larynx, a new surgical method was used and its effect observed.

METHODSUnder suspension laryngoscope, a part of cartilage of vocal process of arytenoid cartilage was removed until the cartilage was covered by local soft tissue after the granuloma was excised. Among 8 patients in this group, 7 were male, 1 female. Their ages ranged from 29 to 51(median 45 years old). The courses were 1 to 9 months (median 7 months). All patients experienced 1 to 5 times operations (median 2 times).

RESULTSUsing the new operative method, all 8 patients were cured for only 1 time, without recurrence followed- up for 1.5 years.

CONCLUSIONSThe granuloma were very easily recurred after the operation. The reason might be related to the exposure and inflammation of the local vocal process cartilage. The difficult key of the operation is exposure of granuloma and cartilage of vocal process because of intratracheal anesthetic tube.

Adult ; Arytenoid Cartilage ; surgery ; Female ; Granuloma ; etiology ; surgery ; Humans ; Laryngeal Diseases ; surgery ; Laryngoscopy ; methods ; Male ; Middle Aged

OBJECTIVETo investigate the clinical characteristics of arytenoid cartilage dislocation and the outcome of modified closed reduction.

METHODSSixty-seven patients with vocal fold immobility underwent modified closed reduction under local anesthesia through indirect laryngoscope. During reduction, a right-angled laryngeal forceps was used to hold the superior surface of the affected arytenoids and rotate in posterolateral or anteromedial direction according different situation of dislocation. Fifty-seven patients had previously undergone endotracheal intubation for surgery and 10 patients had nonintubated injury with blunt laryngeal trauma in 6 cases. Clinical characteristics, voice function, procedural skill and therapy outcome of those cases were evaluated.

RESULTSAll patients complained of persistent hoarseness. Stroboscopy revealed vocal fold immobility (50 of 67 cases on the left side, 74.6%) and incomplete glottal closure with anterior arytenoid dislocations in 63 cases and posterior dislocations in 4 cases. The laryngeal electromyography (LEMG) results for 10 of 38 patients (26.3%) of postintubation arytenoids dislocation displayed abnormal patterns with denervated potentials. The voice of all patients for postintubation arytenoids dislocation improved after modified closed reduction with normal in 51 cases and slight hoarseness in 6 cases. The movement of the affected vocal folds recovered to normal in 54 cases and improved in 3 cases. Among the 10 patients with nonintubated vocal fold immobility, the voice and the movement of vocal folds were normal in 7 cases, improved in 1 case and no effective in 2 cases.

CONCLUSIONSSome cases of arytenoid dislocation were accompanied by an recurrent laryngeal nerve abnormality (mostly temporary and resolved after a reduction). The modified reduction technique under local anesthesia can restore patients' voice and vocal fold mobility within 6 weeks after dislocation. Nevertheless, the causes of vocal fold immobility following blunt laryngeal trauma were complicated, so the curative effect of arytenoids reduction in those cases may be limited by cicatricial contracture of laryngeal injured tissue.

Arytenoid Cartilage ; surgery ; Electromyography ; Hoarseness ; Humans ; Intubation, Intratracheal ; Laryngeal Diseases ; surgery ; Laryngoscopy ; Recurrent Laryngeal Nerve ; Vocal Cords ; surgery

Cornus ; Deglutition Disorders ; Humans ; Laryngeal Diseases ; Neck Injuries ; Thyroid Cartilage/surgery*

Adult ; Aged ; Airway Obstruction ; therapy ; Cricoid Cartilage ; surgery ; Female ; Humans ; Laryngeal Diseases ; therapy ; Male ; Middle Aged ; Punctures ; methods ; Thyroid Cartilage ; surgery