Tuesday, 15 September 2020

MRI Cartilage mapping guides treatment planning in

MRI Cartilage mapping guides treatment planning in Cartilage lesions
for the young
MGM Healthcare, a multi-specialty quaternary care hospital in the heart of the city, announced a successful Cartilage Defect Repair Surgery performed on a young patient with Osteo Chondral defect, led by Dr Govindaraj AB, Director – Institute of Orthopaedics and his team of specialists including Dr. Shriram Krishnamoorthy, Dr J Jagdeesan and Dr Vijayakumar Sohanlal

A 32-year-old computer professional presented at MGM HealthCare with complaints of painful locking and clunking of his knee of 1-year duration was investigated and evaluated.
He had previously undergone knee ligament reconstruction surgery in the same knee seven years earlier. He was diagnosed with Chondromalacia Patella and was undergoing treatment with medications and physiotherapy. His symptoms continued to worsen until he visited MGM Healthcare where the doctors repeated the MRI scan using advanced technology of Cartilage mapping to identify and quantify the size of the Chondral defect, which was mapped over the two adjoining surfaces of the patella and femoral trochlea. 
Various treatment options including Knee cap replacement, stem cell injection and cartilage implantation were discussed before finalizing on the novel All Autologous Cartilage Regeneration (AACR). AACR is a single-stage procedure, unlike Autologous Cartilage Implantation (ACI).
Cartilage harvested from other parts of the joint using arthroscopy was processed inside the operating room. Defect prepared, the cartilage mixed with PRP (patient’s stem cell) and the defect was filled with the graft prepared using a mini-open technique. Clotting factors were used to stabilize the graft, so that it stays in the defect and regenerates into Hyaline like cartilage, unlike in Bone Marrow Aspirate Concentrate (BMAC) technique.
Commenting on the success of the surgery Dr Govindaraj AB, Director – Institute of Orthopaedics said, “The success of this surgery is commendable considering the complexity of the problem. The patient’s long and complicated case history including the previous surgery made it difficult for us to identify the problem with ease and narrow down on the procedure to fix the condition. We had to keep in mind that the patient is 32 years old which is a very young age to consider major surgical procedures such as knee replacement which could make it difficult for the patient in the long run.
After the successful surgery he is being mobilised on a knee brace to prevent knee bending for up to 6 weeks, and avoid forces that might impinge on the grafted surface.

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