Stem cell harvest and transplant for knee osteochondral defect (Synergy Medical technologies)
Subscribe to get full access to this operation and the extensive Knee Surgery Atlas.
Professional Guidelines Included
Learn the Stem cell harvest and transplant for knee osteochondral defect (Synergy Medical technologies) surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Stem cell harvest and transplant for knee osteochondral defect (Synergy Medical technologies) surgical procedure.
Osteochondral defects (OCDs) of the knee are a relatively common problem and can be challenging to treat. Articular cartilage is avascular and consequently has limited regenerative potential. The avascularity is speculated to limit progenitor cell infiltration, which is necessary for cartilage regeneration. Adequate treatment of OCDs is essential to prevent progressive tissue loss and ultimately degenerative joint disease.
Traditional methods of treatment such as microfracture or mosaicplasty are generally reserved for smaller defects (i.e. < 2 cm2) and result in fibrocartilage formation, which has inferior biomechanical and biochemical properties to hyaline cartilage and over time undergoes degeneration.
The use of a cellular repair (autologous chondrocyte implantation) is not new but recently became a NICE (National Institute for Clinical Excellence) recommended procedure in the UK. It involves two stages and laboratory culture of harvested chondrocyte cells.
This ‘stem cell harvest and transplant’ technique uses chondrocyte precursor cells (mesenchymal stem cells) harvested from the pelvis and has the advantage of being performed in a single stage; it is also cheaper than ACI. We have performed this at our institution for over 4 years and have demonstrated significant improvements in Cincinatti scores at two years. The three year graft survival is 96.3%. Poorer results are found in older patients and those who have had previous surgery.
Rehabilitation is crucial and return to sports is not expected before the six month mark.
The ‘Syngenit surgical’ kit is produced by Synergy Medical Technologies, UK. It comes sterile packed in one box and is based on a similar technique published by Buda et al at the Rizzolli Institute (Buda et al. J Bone Joint Surg Am 2010;92 [Suppl. 2]:2–11). They successfully used a hyaluronic acid membrance and 2mls of concentrated bone marrow aspirate for knee articular cartilage repair.
Readers will also find of interest the following related OrthOracle techniques:
Author:James Donaldson FRCS(Tr & Orth)
Institution: The Royal National Orthopaedic Hospital, Stanmore, London, UK.
- Each operation and the questions associated become a named course in the CPD section
- The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
- You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
- The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
- There are four possible answers of which one is correct (or on occasion more correct) than the others.
- There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
- The course is completed once all the lessons are read and quizzes submitted and passed.
- On successful completion of each quiz you will receive validated CPD points that add to the certificate in your CPD folder.
- Your dashboard also will contain a record of the time you have spent logged onto and using the site.
- The timer suspends after 5 minutes though if there is no activity.
- When you restart you will resume at the same point in the module.
- Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
The pass mark is 75%.
- If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
- Once these have been read you can re-do just the questions you failed on.
- Once you have passed the quiz you can return at a future stage & resit .
- Operation Quiz – 1 CPD point
- Surgical steps Quiz – 1/4 CPD point
- Implants Quiz – 1/4 CPD point
- Problem case Quiz – 1/2 CPD point
One CPD point equates to one hour of academic activity
Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.
Our content is designed for both Surgeons in independent practice and Surgeons in training.