Mikrofrakture u liječenju zglobne hrskavice

master's thesis

• Title (english): Microfracture technique in treatment of articular cartilage
• Author: David Čanić
• Mentor: Mislav Jelić (mentor)
• Committee member: Domagoj Delimar (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: 2023-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Orthopedics

Abstract

Ozljede i degenerativne promjene zglobne hrskavice česta su patologija, posebice u sportaša i starijoj populaciji. Ukupna prevalencija hrskavičnih ozljeda, posebice koljena, u sportaša iznosi i do 36% (1). Sama hrskavica zbog nedostatka vaskularizacije i inervacije ima ograničenu sposobnost regeneracije i time ograničenu mogućnost cijeljenja nastale ozljede. Do osamdesetih godina prošlog stoljeća zlatni standard u liječenju hrskavičnih ozljeda bila je artroplastika, kirurški postupak nadomještanja zglobne hrskavice umjetnim zglobom. Od 1980. godine na scenu stupa nova, manje invazivna metoda koja zahtjeva kraći oporavak, i kako su studije pokazale, bolje dugoročno smanjenje tegoba (2). Tehnika mikrofraktura bazira se na preciznom kirurškom formiranju lezija u hrskavici i podliježućoj subhondralnoj kosti, kako bi se omogućio prolazak multipotentnim matičnim stanicama do zglobne hrskavice, i njihova diferencijacija u fibrozno i hijalino tkivo (3). Zbog određene količine fibroznog tkiva, novostvorena hrskavica teže podnosi svakodnevne aktivnosti od prethodno zdrave hijaline hrskavice. Tehnika mikrofraktura se radi na svim zglobovima, a u ovom diplomskom radu posebno će se opisati češći zahvati, prvenstveno na koljenu, a nakon njega kuku, ramenu i gležnju (4). Također, opisan je detaljan i striktan rehabilitacijski protokol, koji uvelike igra ulogu u stupnju oporavka na kraju samog procesa.

Abstract (english)

Injuries and degenerative changes of articular cartilage are a common pathology, especially in athletes and the elderly population. The total prevalence of cartilage injuries, especially knee injuries, in athletes is up to 36% (1). Due to the lack of vascularization and innervation, the cartilage itself has a limited ability to regenerate and therefore a limited ability to heal the resulting injury. Up until the eighties, the gold standard in the treatment of cartilage injuries was arthroplasty, the surgical procedure of replacing articular cartilage with an artificial joint. Since 1980, a new, less invasive method has appeared on the scene that requires a shorter recovery and, as studies have shown, better long-term outcomes (2). The microfracture technique is based on the precise surgical formation of lesions in the cartilage and underlying subchondral bone, in order to enable the passage of multipotent stem cells to the articular cartilage, and their differentiation into fibrous and hyaline tissue (3). Due to a certain amount of fibrous tissue, newly formed cartilage is more difficult to withstand daily activities than previously healthy hyaline cartilage. The microfracture technique is performed on all joints, and in this thesis the more frequent interventions, primarily on the knee, followed by the hip, shoulder and ankle will be described (4). Also, a detailed and strict rehabilitation protocol is described, which greatly plays a role in the degree of recovery at the end of the process itself.

• Keywords: hijalina hrskavica; hondrociti; ozljede hrskavice; mikrofrakture; rehabilitacija
• Keywords (english): hyaline cartilage; chondrocytes; cartilage injuries; microfractures; rehabilitation
• Language: croatian
• URN:NBN: urn:nbn:hr:105:015959
• 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
• Created on: 2023-10-23 12:46:18