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ICL 16: Subchondral Bone and Reason for Surgery

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Abstract

The subchondral bone plays a key role in the integrity and repair of the entire osteochondral unit. Its unique anatomical structure is well suited to support the articular cartilage, even providing nutrition for its basal layers. The subchondral bone becomes a problem in reconstructive cartilage surgery when violated, for example, following osteochondral fractures or in osteochondritis dissecans (OCD), thus leading to an osteochondral lesion. Such osteochondral defects are difficult to treat because the subchondral bone and the articular cartilage have very dissimilar intrinsic healing capacities [35–37]. Recent clinical evidence also pointed to the role of the subchondral bone alterations in the course of spontaneous and surgical cartilage repair. In the treatment of cartilage defects, it is imperative to establish the etiology of the subchondral bone lesion and then address the specific pathology accordingly. This chapter will focus on the subchondral bone and its relevance for reconstructive cartilage surgery. It is based on individual presentations from the Instructional Course Lecture “Subchondral bone and reason for surgery” (Table 11.1).

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Acknowledgments

The authors thank B. Di Matteo, G. Venieri, F. Balboni: II Clinic, Biomechanics Laboratory, Rizzoli Orthopaedic Institute, Bologna, Italy. Mona Eldracher, Gertrud Schmitt: Center of Experimental Orthopaedics, Homburg, Germany for helpful discussions.

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Authors and Affiliations

  1. Nano-Biotechnology Laboratory, II Orthopaedic Clinic, Rizzoli Orthopaedic Institute, Via di Barbiano 1/10, Bologna, 40136, Italy

    Elizaveta Kon & Giuseppe Filardo

  2. Unité d’Orthopédie et Traumatologie du Sport, Swiss Olympic Medical Center, Service de chirurgie orthopédique et traumatologie de l’appareil moteur, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva, Switzerland

    Jacques Menetrey, Julien Billières & Etienne Ruffieux

  3. Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, 1100 DD, Amsterdam, 22660, The Netherlands

    C. Niek van Dijk

  4. Biomechanics Laboratory, II Orthopaedic Clinic, Rizzoli Orthopaedic Institute, Via di Barbiano 1/10, Bologna, 40136, Italy

    Francesco Perdisa & Luca Andriolo

  5. Biomechanics Laboratory – II Clinic, Bologna, Italy

    Maurilio Marcacci

  6. Center of Experimental Orthopaedics, Saarland University, Homburg/Saar, D-66421, Germany

    Patrick Orth & Henning Madry

  7. Department of Orthopaedic Surgery, Saarland University Medical Center, Saarland University, Homburg/Saar, Germany

    Patrick Orth & Henning Madry

  8. Department of Pathology, Smt NHL Municipal Medical College, Ellis Bridge, Ahmedabad, India

    Anjali Goyal

  9. Saumya Orthocare: Centre for Advanced Surgeries of the Knee Joint, 210, Baronet, Sabarmati, Ahmedabad, GU, 380005, India

    Deepak Goyal M.B.B.S., M.S.(Orthop), D.N.B.(Orthop), M.N.A.M.S.

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  1. Elizaveta Kon
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  2. Jacques Menetrey
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  3. C. Niek van Dijk
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  4. Giuseppe Filardo
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  8. Etienne Ruffieux
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  9. Patrick Orth
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  10. Maurilio Marcacci
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  11. Anjali Goyal
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  12. Deepak Goyal M.B.B.S., M.S.(Orthop), D.N.B.(Orthop), M.N.A.M.S.
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  13. Henning Madry
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Corresponding author

Correspondence to Henning Madry .

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Editors and Affiliations

  1. Istituti Ortopedico Rizzoli Clinica Ortopedica Traumatologica III, Bologna, Italy

    Stefano Zaffagnini

  2. Klinikum Brandenburg Orthopädie und Unfallchirurgie, Brandenburg an der Havel, Germany

    Roland Becker

  3. Department of Orthopedic Surgery, Academic Medical Centre Amsterdam University of Amsterdam, Amsterdam, The Netherlands

    Gino M.M.J. Kerkhoffs

  4. Clínica Espregueira Mendes, Porto, Portugal

    João Espregueira Mendes

  5. Orthopedic Surgery, University of Amsterdam Academic Medical Centre, Amsterdam, The Netherlands

    C. Niek van Dijk

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Kon, E. et al. (2014). ICL 16: Subchondral Bone and Reason for Surgery. In: Zaffagnini, S., Becker, R., Kerkhoffs, G., Espregueira Mendes, J., van Dijk, C. (eds) ESSKA Instructional Course Lecture Book. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-53983-1_11

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  • DOI: https://doi.org/10.1007/978-3-642-53983-1_11

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