RESUMO
Osteochondral defects or injuries represent the most challenging entities to treat, especially when occur to young and active patients. For centuries, it has been recognized that such defects are almost impossible to treat. However, surgeons have never stopped the effort to develop reliable methods to restore articular cartilage and salvage the endangered joint function. Osteochondral allograft transplantation in human was first introduced by Eric Lexer in 1908. Since that era, several pioneers have been worked in the field of osteochondral allotransplantation, presenting and developing the basic research, the methodology and the surgical techniques. Herein we present in brief, the history and the early clinical results of osteochondral allograft transplantation in human.
Assuntos
Aloenxertos/história , Transplante Ósseo/história , Cartilagem Articular/cirurgia , Transplante Ósseo/métodos , Sobrevivência de Enxerto , História do Século XX , Humanos , Osteotomia/história , Osteotomia/métodos , Avaliação de Resultados em Cuidados de Saúde/história , Transplante Homólogo/história , Transplante Homólogo/métodosRESUMO
Throughout the history of orthopaedics, our understanding of the function and necessity of the meniscus has significantly evolved, and with it, our techniques of treating, repairing, preserving, and replacing it have progressed in parallel. Currently, it is known that a meniscus deficiency is a predisposing factor to the development of degenerative changes of the knee. Thus, it is incumbent upon the surgeon to preserve the meniscus to the extent that biology will allow. Unfortunately, circumstances arise when the meniscus cannot be preserved, and young patients afflicted by irreparable meniscus deficiency may be potential candidates for a meniscus transplant. Though its indications are limited and its execution technically complex, meniscal allograft transplant has been shown to provide good subjective outcomes and is a potentially joint preserving surgery. This paper provides a comprehensive and historical review of the meniscus, a brief review of meniscus anatomy and biomechanics, and commentary on the role of meniscal allograft transplant for the treatment of meniscal deficiency, including patient selection, graft selection and sizing, surgical technique, and outcomes.
