2023 Specialty Day All-Access Pass-Algorithm for Symptomatic Chondral Defects

Video Transcription

Video Summary

In this video, Christian Laderman discusses the topic of when a defect is symptomatic. He explains that non-activity related defects require careful consideration to determine if they are osteoarthritis or a symptomatic chondrodefect. Activity levels also play a role, with high-performance individuals requiring different management than those who have recently increased their activity or have a moderate activity level. Laderman discusses the importance of mechanical issues and warns of other symptoms that may indicate a non-symptomatic defect. He also mentions algorithms and published papers that cover different techniques. The video emphasizes the distinction between small and large defects and the need for data and evidence for larger lesions. Laderman highlights the significance of anatomic location, lesion size, and relative size in determining the impact on symptomatology. High-traffic areas, such as the central medial femoral condyle and edge of the lateral femoral condyle, require structural support for large lesions. Only osteochondral allografts (OATs) and matrix-induced autologous chondrocyte implantation (MACI) have sufficient data for large defect reconstructions. Laderman advises managing patient expectations and being more aggressive when needed. He emphasizes the importance of addressing what needs to be addressed and avoiding complexity. Laderman also discusses the need for personal evaluation of patients and the surprises that can arise in their biology. He mentions the importance of quadriceps strength and accelerated weight-bearing in rehabilitation. Laderman suggests that more aggressive rehab protocols and considering factors like blood flow restriction can be game-changers. The key takeaways are to plan treatment for cartilage defects using data and technical skills, understand the factors involved, and discuss expectations and outcomes with patients.

Asset Caption

Christian Lattermann, M.D.

Keywords

defect

symptomatic

osteoarthritis

chondrodefect

activity levels