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Techniques in Cartilage Repair Surgery,

Tác giả: Shetty, Asode Ananthram; Kim, Seok-Jung; Nakamura, Norimasa; Brittberg, Mats

Chủ đề:

Chủ đề: Medicine; Cartilage repair surgery

Nhà xuất bản: Springer

Năm xuất bản: 2014

Loại tài liệu: Book

Mô tả vật lý: 377 p.

Định danh: 978-3-642-41921-8

Ngôn ngữ: en

Đọc trực tuyến

Cartilage defects are common. Cartilage repair surgery is not only fascinating but also surgically challenging. There are books dealing with basic science and some surgical aspect. This book fills a gap in surgical techniques for cartilage repair. All of the surgical chapters are logically organised, covering patient selection, patient setup/positioning, surgical approach, potential complications and troubleshooting. An attempt is made to compare with various surgical techniques. This book also covers anaesthesia, postoperative follow-up, pain management and rehabilitation. Both the editors and the authors are renowned experts in the field. This book will be invaluable for orthopaedic and sports medicine surgeons (consultants and training doctors) and is also of potential interest to physiotherapists, medical students, general practitioners, physical medicine and rehabilitation specialists and rheumatology specialists.

Cover
Title page
Foreword
Preface
Contents
Editorial Assistants
Contributors
Part I: Introduction
- 1: The History of the Treatment of Cartilage Injuries
  - 1.1 Introduction
  - 1.2 Shaving, Abrasion or Debridement of Fibrillated Cartilage
  - 1.3 Drilling, Resection or Abrasion of Subchondral Bone Plate
  - 1.4 Osteochondral Allo- and Autografting Techniques
    - 1.4.1 Allografts
    - 1.4.2 Autografts
  - 1.5 Periosteal and Perichondral Resurfacing (Soft Tissue Arthroplasty)
    - 1.5.1 Periosteum
    - 1.5.2 Perichondrium
  - 1.6 Chondrogenic Cell Transplantation
  - 1.7 Implantation of Stem Cells
  - 1.8 The Future
  - References
- 2: Articular Cartilage: Histology and Physiology
  - 2.1 Cartilage
  - 2.2 Articular Cartilage
  - 2.3 Chondrocytes
  - 2.4 Extracellular Matrix Zone
  - 2.5 Proteoglycans
  - 2.6 Water
  - 2.10 Cartilage Regeneration
  - 2.7 Collagens
  - 2.8 Noncollagenous Proteins and Glycoproteins
  - 2.9 Cartilage Degeneration
  - References
- 3: Treatment Algorithm for Articular Cartilage Repair of the Knee: Towards Patient Profiling Using Evidence-Based Tools
  - 3.1 Introduction
  - 3.2 General Indications and Contraindications for Cartilage Repair
  - 3.3 Indicators for Treatment
    - 3.3.1 Defect Size
    - 3.3.2 Age
    - 3.3.3 Patient Activity
  - 3.4 Treatment Selection for Patients with Smaller Defects
  - 3.5 Treatment Selection for Patients with Larger Defects
  - 3.6 Treatment Selection for Patients with Defects in the Patellofemoral Joint
  - 3.7 Early Osteoarthritic Defects and Salvage Repair
  - 3.8 Treatment Algorithm: Summarizing the Findings from the Literature
  - 3.9 Addendum: Treatment Selection for (Professional) Athletes
  - Conclusion
  - References
Part II: Marrow Stimulation Techniques
- 4: Stimulation Techniques: Microfracturing, Drilling
  - 4.1 Introduction
  - 4.2 Surgical Technique
  - 4.3 Control of Bleeding
  - 4.4 Pitfalls
  - 4.10 Drilling
  - 4.11 Results
  - 4.5 Postoperative Treatment
  - 4.6 Rehabilitation
  - 4.7 Indications
  - 4.8 Advantages
  - 4.9 Disadvantages
  - 4.12 Amplified Results/Literature
  - 4.13 Discussion
    - 4.13.1 Durability of Microfracture
    - 4.13.2 Quality of Cartilage Repair Tissue Following Microfracture
    - 4.13.3 Effect of Age on the Outcome of Microfracture
    - 4.13.4 Effect of Lesion Location on the Outcome of Microfracture
    - 4.13.5 Effect of Lesion Size on the Outcome of Microfracture
    - 4.13.6 How Important Are Postoperative CPM and Weight Bearing for the Outcome of Microfracture
  - Conclusion
  - References
Part III: Acellular Matrix Based Cartilage Regeneration Techniques
- 5: Matrix-Enhanced Microfracture: Autologous Matrix-Induced Chondroneogenesis (AMIC TM)
  - 5.1 Introduction
  - 5.2 Patient Selection
  - 5.3 Surgical Technique
    - 5.3.1 Chondral Reconstruction
    - 5.3.2 Osteochondral Reconstruction
  - 5.4 Rehabilitation
  - 5.5 Postoperative Follow-Up
  - References
- 6: Autologous Collagen-Induced Chondrogenesis (ACIC)
  - 6.1 Introduction
  - 6.2 Autologous Collagen
  - 6.3 Patient Selection
    - 6.3.1 Inclusion Criteria
    - 6.3.2 Exclusion Criteria
  - 6.4 Theatre and Patient Setup
  - 6.5 Surgical Technique
    - 6.5.1 Preparation of Atelocollagen Mixture
  - 6.6 Preparation of Chondral Defect for Implantation
  - 6.7 Postoperative Rehabilitation
  - 6.8 Results
  - References
- 7: TruFitđ
  - 7.1 Technical Details
  - 7.2 Patient Selection
  - 7.3 Patient Setup and Bone Marrow Concentrate (BMC) Preparation
  - 7.4 Surgical Approach
  - 7.5 Potential Complications and Troubleshooting
  - 7.6 Rehabilitation
  - 7.7 Postoperative Follow-Up
  - 7.8 Outcomes
  - References
- 8: MaioRegen: Our Experience
  - 8.1 Introduction
  - 8.2 Technical Details
    - 8.2.1 Scaffold Preparation
    - 8.2.2 Composite Characterization and Biological Validation
  - 8.3 Animal Studies
    - 8.3.1 Horses
    - 8.3.2 Sheep
  - 8.4 Clinical Application
    - 8.4.1 Indications
    - 8.4.2 Contraindications
    - 8.4.3 Surgical Technique [ 19 ]
    - 8.4.4 Postoperative Rehabilitation
  - 8.5 Clinical Results
  - 8.6 Discussion and Conclusion
  - References
- 9: BST-CarGel đ : An Enhanced Bone Marrow Stimulation Treatment
  - 9.1 Introduction
  - 9.2 BST-CarGel đ Background
    - 9.2.1 The Product
    - 9.2.2 Primary Mode of Action
  - 9.3 BST-CarGel đ Use
    - 9.3.1 Indications/Contraindications
    - 9.3.2 Concomitant Medications
    - 9.3.3 Surgical Technique
      - BST-CarGel đ Preparation
      - Lesion Positioning and BST-ưCarGel đ Delivery
      - Lesion Preparation
    - 9.3.4 Potential Complications and Troubleshooting
  - 9.4 BST-CarGel đ Rehabilitation
  - 9.5 BST-CarGel đ Clinical Experience
    - 9.5.1 Pilot Use
    - 9.5.2 BST-CarGel đ Randomized Clinical Trial
  - References
Part IV: Concentrated Cell Based Chondrogenesis
- 10: Mesenchymal Stem Cell Induced Chondrogenesis (MCIC)
  - 10.1 Introduction
  - 10.2 Preclinical Study
    - 10.2.1 Surgical Technique
    - 10.2.2 Assessment
    - 10.2.3 Results
      - Electron Microscopy
      - Gross Appearance
      - Histochemical Staining
      - Immunohistochemistry
  - 10.3 Patient Selection
    - 10.3.1 Clinical
    - 10.3.2 Radiographic
      - Exclusion Criteria
      - Inclusion Criteria
  - 10.4 Theatre and Patient Setup
  - 10.5 Surgical Technique
    - 10.5.1 Bone Marrow Harvest and Concentration
    - 10.5.2 Preparation of BMAC and Fibrin Gel (Tissellđ, Baxter, Thetford, UK) Mixture (Fig. 10.10)
    - 10.5.3 Preparation of Chondral Defect for Implantation
    - 10.5.4 Implantation of Graft
  - 10.6 Postoperative Rehabilitation
  - Conclusion
  - References
Part V: Repair Techniques
- 11: Surgical Techniques in Cartilage Repair Surgery: Osteochondral Autograft Transfer (OATS, Mosaicplasty)
  - 11.1 Introduction
  - 11.2 Indications and Contraindications for Surgery
  - 11.3 Operative Technique
    - 11.3.1 Recommendations for Preoperative Preparation
    - 11.3.2 Mosaicplasty Technique
      - 11.3.2.1 Surgical Approach
        
        Portal Selection for Arthroscopic Approach
        
        Open Mosaicplasty
      - 11.3.2.2 Defect Preparation
      - 11.3.2.3 Graft Harvest
      - 11.3.2.4 Implantation of the Grafts: DrillDilateDeliver
        
        Drill
        
        Deliver
        
        Dilate
    - 11.3.3 Recommendations for Postoperative Care
  - 11.4 Rehabilitation
  - 11.5 Complications
  - 11.6 Results
  - References
- 12: Osteochondral Allograft Transplantation For: Surgical Techniques in Cartilage Repair Surgery
  - 12.1 Principles of the Osteochondral Allografting Technique
  - 12.2 Indications for Osteochondral Allografts
  - 12.3 Preoperative Preparation: Graft Sizing
  - 12.4 Decision Making for Dowel or Shell Technique
  - 12.5 Surgical Approach
  - 12.6 Lesion Inspection and Preparation
  - 12.7 Graft Preparation
  - 12.8 Graft Insertion
  - 12.9 Shell Allograft Technique
  - 12.10 Postoperative Management
  - 12.11 Potential Complications
  - 12.12 Results
  - 12.13 Summary
  - References
    - Suggested Reading
- 13: ESSKA Book Series – Techniques in Cartilage Repair Surgery Minced Cartilage: DeNovo and CAIS
  - 13.1 Introduction
  - 13.2 Technical Details
    - 13.2.1 DeNovo NT (NT:ISTO, St. Louis, MO)
    - 13.2.2 CAIS (DePuy/Mitek, Raynham, MA)
  - 13.3 Patient Selection
  - 13.4 Preoperative Planning
  - 13.5 Patient Setup
  - 13.6 Surgical Approach
    - 13.6.1 Diagnostic Arthroscopy
    - 13.6.2 Exposure
      - Patellofemoral Joint
      - Tibiofemoral Joint
    - 13.6.3 Defect Preparation
    - 13.6.4 Implantation
      - CAIS
      - DeNovo NT
  - 13.7 Potential Complications and Troubleshooting
  - 13.8 Rehabilitation
  - 13.10 Comparison to Other Techniques
  - 13.9 Postoperative Follow-Up
  - References
Part VI: Cultured Cells for Cartilage Tissue Engineering
- 14: Classical ACI for Chondral and Osteochondral Defects
  - 14.1 Introduction
  - 14.2 Prospective Data and Audit
  - 14.3 Chondrocyte Culture
  - 14.4 Consent
  - 14.5 The Surgery
    - 14.5.1 Theatre Team
    - 14.5.2 First Stage: Harvest Biopsy
    - 14.5.3 Second Stage: Cell Implantation
  - 14.6 Preparation of the Defect
  - 14.7 Application of the Chondrogide Patch
  - 14.8 Testing and Cell Insertion
  - 14.9 Use of Air
  - 14.10 Osteochondral Defects
  - 14.11 Postoperative Care
  - 14.12 Rehabilitation
  - 14.13 Biomarkers
  - 14.14 Cost-Effectiveness
  - References
- 15: Gel ACI (GACI): Articular Cartilage Repair Technique
  - 15.1 Introduction
  - 15.2 Indications and Preoperative Planning
    - 15.2.1 Surgical Technique
    - 15.2.2 GACI First Stage
      - Biopsy and Chondrocyte Harvest
      - Culture Process
      - Transportation of Cultured Cells
    - 15.2.3 GACI Second Stage
      - In-Theater Mixing Procedure
      - Implantation of Cells
      - Theater Setup
  - 15.3 Postoperative Rehabilitation
    - 15.3.1 Weight Bearing
    - 15.3.2 Range of Motion
  - 15.4 Complications
  - 15.5 Results
  - References
- 16: A Scaffold-Free Mesenchymal Stem Cells-Based Implant to Repair a Three-Dimensional Chondral Lesion
  - 16.1 Introduction
  - 16.2 Characterization of Cultured Cells Derived from the Human Synovium
  - 16.3 Development of the Basic TEC
  - 16.4 The Basic Human TEC Has Adhesive Properties Which Facilitate Association and Adhesion to Cartilage Matrix
  - 16.5 Chondrogenic Differentiation Capacity of a Human TEC
  - 16.6 A Basic Porcine TEC Can Effectively Repair Chondral Defects In Vivo and Inhibit the Progression of Chondral Defects to Overt Osteoarthritis for a Wide Range of Ages
  - 16.7 The Mechanical Properties of Porcine Chondral Defects Treated with a Porcine-ưDerived TEC Approximates Those of Normal Cartilage 6 Months Postimplantation
  - 16.8 The TEC Derived from Synovial MSCs
    - 16.8.1 The Next-Generation Cell-ưBased Strategy to Regenerate Cartilage
  - References
- 17: Injectable Autologous Bone-Marrow-ưDerived Mesenchymal Stem Cells for Cartilage Repair: The Singapore Technique
  - 17.1 Introduction
  - 17.2 The Proposed Solution
  - 17.3 Patient Selection: Indications and Contraindications
  - 17.4 Preoperative Preparation
  - 17.5 Patient Setup and Surgical Approach
  - 17.6 Arthroscopic Evaluation and Initial Surgical Treatment
  - 17.7 Bone Marrow-Derived Mesenchymal Stem Cell Preparation
  - 17.10 Rehabilitation
  - 17.8 Complications
  - 17.9 Postoperative Follow-Up
  - 17.11 Initial Results and Future Directions
  - Conclusion
  - References
- 18: Stem Cell Research in Orthopaedic and Trauma Surgery
  - 18.1 Cartilage Injury
  - 18.2 Microfracture
  - 18.3 ACIC (Autologous ưCollagen-ưInduced Chondrogenesis)
    - 18.3.1 Surgical Procedure
    - 18.3.2 Injection of Atelocollagen and Fibrin Mixture
  - 18.4 Autologous Chondrocyte Implantation (ACI)
    - 18.4.1 Conventional ACI
    - 18.4.2 Gel AGI (GACI)
    - 18.4.3 Evaluation of Patient Suitability for Study Participation (Inclusion and Exclusion Criteria)
    - 18.4.4 Surgical Techniques
    - 18.4.5 Cell and Gel Mixture Ex Vivo Evaluation
    - 18.4.6 Gel ACI for RA or OA
      - Surgical Technique
    - 18.4.7 Rehabilitation
  - 18.5 Summary
  - References
- 19: Knee Cartilage Repair with Hyalograftđ (Hyaff-11 Scaffold with Seeded Autologous Chondrocytes)
  - 19.1 Introduction
  - 19.2 Cell Isolation, Expansion and Scaffold Culture
  - 19.3 Patient Selection
    - 19.3.1 Indications
    - 19.3.2 Contraindications
  - 19.4 The Operative Technique
    - 19.4.1 Harvest of Cartilage for Cell Expansion
    - 19.4.2 Operative Technique for the Knee
      - The Tibial Plateau
      - Transarthroscopic Technique
      - The Patella
      - Hyalograft with Seeded Chondrocytes + Bone Grafting for Osteochondral Defects
      - Open Surgery Hyalograft Implantation
  - 19.5 Postoperative Rehabilitation for an Implanted Knee Joint
  - References
- 20: Matrix-Induced Autologous Chondrocyte Implantation
  - 20.1 Background
    - 20.1.1 Chondral Injuries
    - 20.1.2 Chondrocyte Implantation
  - 20.2 Patient Selection
    - 20.2.1 Indications
    - 20.2.2 Contraindications
  - 20.3 Assessment
    - 20.3.1 Patient Assessment
    - 20.3.2 Assessment of Injury
      - Arthroscopic Assessment
      - Cartilage Biopsy
      - History and Examination
      - Radiological Evaluation
  - 20.4 Preoperative Management
    - 20.4.1 Patient Education
    - 20.4.2 Preoperative Physiotherapy
  - 20.5 Surgical Technique
    - 20.5.1 Exposure
    - 20.5.2 Preparation of the Defect
    - 20.5.3 Implantation of Cultured Chondrocytes
  - 20.6 Post-operative Management
    - 20.6.1 Graft Maturation
    - 20.6.2 Rehabilitation
  - 20.7 Post-operative Evaluation
    - 20.7.1 Assessment of the Defect
    - 20.7.2 Assessment of Clinical Outcomes
  - References
- 21: CaReSđ, Cartilage Regeneration System: Autologous Chondrocyte Transplantation in a Collagen Gel
  - 21.1 Background
  - 21.2 Patient Selection
  - 21.3 Surgical Procedures and Techniques
    - 21.3.1 Biopsy
    - 21.3.2 Cell Processing
    - 21.3.3 Implantation Procedure
    - 21.3.4 Concomitant Surgery
    - 21.3.5 Rehabilitation
    - 21.3.6 Postoperative Follow-Up
  - 21.4 Clinical Studies
  - References
Part VII: Cartilage Repair of Other Joints
- 22: Autologous Matrix-Induced Chondrogenesis (AMIC)-Aided Repair of Osteochondral Lesions of the Talus
  - 22.1 Historical Development
  - 22.2 Technical Details
  - 22.3 Patient Selection
  - 22.4 Preoperative Preparation
  - 22.5 Patient Setup/Patient Positioning
  - 22.6 Surgical Approach
  - 22.10 Comparison to Other Techniques
  - 22.7 Potential Complications and Troubleshooting
  - 22.8 Rehabilitation
  - 22.9 Postoperative Follow-Up
  - Conclusion
  - References
- 23: Cartilage Repair in the Hip
  - 23.1 Introduction
  - 23.2 Peculiarities Pertinent to the Hip
  - 23.3 Differences with Location in Joints
  - 23.4 Microfracture for Repair of Cartilage in the Hip
  - 23.5 Osteochondral Autograft Transplants in Femoral Head
  - 23.6 Autologous Chondrocyte Implantation in the Hip
  - 23.7 Post-operative Rehabilitation
  - Conclusions
  - References
Part VIII: Alignment, Stability and Meniscal Replacement
- 24: High Tibial Osteotomy in Cartilage Repair
  - 24.1 Introduction
  - 24.2 Indications and Contraindications of HTO in Cartilage Repair
  - 24.3 Pre-op Evaluation
    - 24.3.1 Clinical Examination
    - 24.3.2 Preoperative Planning
    - 24.3.3 Anesthesia
    - 24.3.4 Positioning of the Patient
    - 24.3.5 Surface Markings
    - 24.3.6 Techniques
    - 24.3.7 Arthroscopy
    - 24.3.8 Incision and Exposure
  - 24.4 Osteotomy
    - 24.4.1 Opening the Osteotomy Gap
    - 24.4.2 Postoperative Follow-Up
    - 24.4.3 Complications and Troubleshooting
      - Intra-articular Fracture
      - Loss of Lateral Hinge
      - Alteration of Tibial Slope
      - Delayed Union, Nonunion, and Loss of Angular Correction
      - Neurovascular Damage
      - Patella Baja
  - 24.5 Adjuvant Tibial Tuberosity Osteotomy (TTO) for the Treatment of Patellofemoral Chondral Ulcer: Technical Details
    - 24.5.1 Introduction
    - 24.5.2 Patient Selection: Indications and Contraindications
    - 24.5.3 Preoperative Preparation
    - 24.5.4 Anaesthesia
    - 24.5.5 Patient Setup
      - Examination Under Anesthesia
    - 24.5.6 Surgical Approach
      - Arthroscopic Evaluation
      - Pearls and Pitfalls
        
        Pearls
        
        Pitfalls
    - 24.5.7 Complications
    - 24.5.8 Rehabilitation
    - 24.5.9 Post-operative Follow-up
  - References
- 25: Distal Femoral Varus Osteotomy for Correction of Valgus Deformity
  - 25.1 Introduction
  - 25.2 Patient Selection
  - 25.3 Surgical Technique
  - 25.4 Postoperative Care
  - 25.5 Potential Complications
  - 25.6 Clinical Outcome
  - 25.7 Summary
  - References
- 26: Meniscal Allograft Transplantation
  - 26.1 Introduction
  - 26.2 Patient Selection and Preoperative Evaluation
    - 26.2.1 Indications
    - 26.2.2 Contraindications
    - 26.2.3 Clinical Evaluation
    - 26.2.4 Radiological Evaluation
  - 26.3 Graft Choice
    - 26.3.1 Graft Preservation
      - Fresh Allograft
      - Cryopreservation
      - Deep-Frozen (Fresh-Frozen)
      - Lyophilization
    - 26.3.2 Graft Sizing
      - Intraoperative Sizing
      - MRI and CT Sizing
      - Anthropometric-Based Sizing
      - Radiographic Sizing
  - 26.4 Techniques
    - 26.4.1 Open Techniques
      - Double Bone-Plug Technique
      - Trough (Bridge-in-ưSlot) Technique
      - Soft Tissue Fixation
    - 26.4.2 Arthroscopically Assisted
      - Double Bone-Plug Technique
      - Trough (Bridge-in-ưSlot) Technique
      - Keyhole Technique
    - 26.4.3 Arthroscopic Techniques
      - Double Tibial Tunnel
      - Single Tibial Tunnel
  - 26.5 Associated Procedures
    - 26.5.1 MAT and ACL
    - 26.5.2 MAT and Cartilage Treatment
    - 26.5.3 MAT and Osteotomies
  - 26.6 Rehabilitation
  - 26.7 Risks and Complication
    - 26.7.1 Immunological Reaction
    - 26.7.2 Disease Transmission
    - 26.7.3 Failure
      - Uncorrect Position of the Graft
      - Graft Extrusion
      - Uncorrect Size of the Graft
  - 26.8 Results
  - References
Part IX: ation, Pain Management and Follow-Up
- 27: Rehabilitation After Cartilage Repair Surgery: Part II Practical Issues
  - 27.1 Introduction
  - 27.2 Basic Principles
  - 27.3 Rehabilitation Phase (I): Protection Phase
    - 27.3.1 Restoring Joint Homeostasis
    - 27.3.2 Improvement of Range of Motion
    - 27.3.3 Improvement of Neuromuscular Function
    - 27.3.4 Weight Bearing and Gait Training
  - 27.4 Rehabilitation Phase II: Transitional Phase
    - 27.4.1 Improvement in Range of Motion
    - 27.4.2 Improvement of Sensomotoric Function, Endurance, and Strength
    - 27.4.3 Gait Training
  - 27.5 Rehabilitation Phase III: Remodeling Phase
    - 27.5.1 Improvement in Range of Motion
    - 27.5.2 Improvement of Sensomotoric Function, Endurance, and Strength
  - 27.6 Rehabilitation Phase IV: Maturation (Sports-Specific Recovery)
  - References
- 28: Orthobiologics
  - 28.1 Hyaluronic Acid
    - 28.1.1 Basic Science
    - 28.1.2 Viscosupplementation
    - 28.1.3 Clinical Use
  - 28.2 Platelet-Rich Plasma
    - 28.2.1 Basic Science
    - 28.2.2 PRP and Articular Cartilage Injury
    - 28.2.3 PRP and Osteoarthritis
  - 28.3 Corticosteroids
    - 28.3.1 Basic Science
    - 28.3.2 Efficacy
    - 28.3.3 Negative Effects
    - 28.3.4 Summary
  - 28.4 Bone Marrow Aspirate Concentrate
  - References
- 29: Anaesthesia in Cartilage Repair Surgery
  - 29.1 Introduction
  - 29.2 General Anaesthesia
  - 29.3 Regional Anaesthesia
    - 29.3.1 Epidural Anaesthesia
    - 29.3.2 Spinal Anaesthesia
    - 29.3.3 Spinal Anaesthesia for Ambulatory Surgery
    - 29.3.4 Peripheral Nerve Blockade
    - 29.3.5 Continuous Femoral Nerve Blockade
  - 29.4 Carbon Dioxide Arthroscopy
  - References
- 30: Preoperative and Postoperative Radiological Assessment
  - 30.1 Introduction
  - 30.2 Basic Requirements and Cartilage-Specific Sequences
    - 30.2.1 Morphological MRI
    - 30.2.2 Usage of Coils
    - 30.2.3 Preoperative Assessment
  - 30.3 Cartilage Classification Systems Based on Morphology
  - 30.4 Biochemical Imaging
    - 30.4.1 Delayed Gadolinium-ưEnhanced MRI of Cartilage (dGEMRIC)
    - 30.4.2 Sodium Imaging
    - 30.4.3 GAG-Specific Chemical Exchange Saturation Transfer (gagCEST)
    - 30.4.4 T2 Mapping
  - Conclusion
  - References
Part X: The Future
- 31: The Future of Cartilage Repair Surgery
  - 31.1 Introduction
  - 31.2 Surgical Options for Cartilage Repair
  - 31.3 Mesenchymal Stem Cells
  - 31.4 One-Step Surgery: Bone Marrow Aspirate Concentrate and a Collagen I/III-Based Matrix
    - 31.4.1 Surgical Technique
    - 31.4.2 Results
  - Conclusion
  - References
Index