Svježi koštano-hrskavični transplantat u liječenju žarišnih oštećenja zglobne hrskavice koljena

master's thesis

• Title (english): Fresh osteochondral graft transplantation for treatment of focal articular cartilage defects of the knee
• Author: Iva Zadro
• Mentor: Mislav Jelić (mentor)
• Committee member: Tomislav Smoljanović (predsjednik povjerenstva)
• Committee member: Tomislav Đapić (član povjerenstva)
• Committee member: Mislav Jelić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Orthopedics); Zagreb
• Defense date and country: 2021-09-02, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Orthopedics

Abstract

Žarišna oštećenja zglobne hrskavice predstavljaju veliki izazov u liječenju. Konzervativna terapija je u većini slučajeva prvi izbor liječenja, dok se operacijskim metodama pribjegava u slučaju neuspjelog konzervativnog liječenja. Transplantacija koštano-hrskavičnim tkivom postaje sve zastupljenija metoda u liječenju žarišnih koštano-hrskavičnih oštećenja. Transplantirati se mogu zglobne površine femura, tibije i patele. Neke od indikacija su unipolarna i bipolarna oštećenja 3. i 4. stupnja, simptomatska oštećenja površine veće od 3 mm2 i dubine od 6 do 10 mm. Prednosti ovakve metode su ispravljanje i koštanog i hrskavičnog oštećenja, dok su nedostaci relativno duga prijeoperacijska priprema transplantata zbog mikrobioloških testiranja, visoka cijena, teška dostupnost zbog čekanja donora i dugotrajna rehabilitacija. Svježi koštano-hrskavični homotransplantat je prikladan izbor za liječenje velikih koštano-hrskavičnih oštećenja s dobrim dugoročnim rezultatima preživljenja transplantata u više od 70% pacijenata. Uspješniji ishodi su viđeni u mlađih pacijenata, zatim onih koji su imali unipolarna oštećenja i koji su imali simptome kraće od 12 mjeseci prije operacije. Lošije rezultate su pokazali pacijenti s bipolarnim oštećenjima, osteoartritisom i osteonekrozom izazvanom kortikosteroidima.

Abstract (english)

Focal cartilage defects present a major challenge in treatment. In most cases conservative therapy is the first choice of treatment. Surgical methods are the choice of treatment in case of failed conservative treatment. Bone and cartilage tissue
transplantation is becoming an increasingly common method in the treatment of focal bone and cartilage damage. The articular surfaces of the femur, tibia and patella can be transplanted. Some of the indications are unipolar and bipolar lesions of grade 3 and 4 and symptomatic lesions larger than 3mm2 and 6 to 10 mm deep. The advantages of this method are the correction of both bone and cartilage damage, while the disadvantages are relatively long preoperative graft preparation due to microbiological testing, higher price, availability of donor tissue and long-term rehabilitation. Fresh bone and cartilage allograft is a suitable choice for the treatment of large bone and cartilage defects with good long graft survival results in more than 70% of patients. More successful outcomes were seen in younger patients, those who had unipolar lesion and who had symptoms less than 12 months before surgery. Patients with bipolar lesions, osteoarthritis and corticosteroid-induced osteonecrosis have shown poorer results.

• Keywords: koljeno; zglobna hrskavica; kirurške metode; transplantacija
• Keywords (english): knee; articular cartilage; surgical methods; transplantation
• Language: croatian
• URN:NBN: urn:nbn:hr:105:095935
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Public note: Pohranitelj objekta unio ključne riječi.
• Created on: 2022-05-20 10:20:51