Table Of ContentJ. GRIFKA D.J. OGILVIE-HARRIS (Eds.) . Osteoarthritis
Springer
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J. GRIFKA D. J. OGILVIE-HARRIS
Editors
Osteoarth ritis
Fundamentals and Strategies
for Joint-Preserving Treatment
With 102 Figures, 46 in Colour, and 36 Tables
, Springer
JOACHIM GRIFKA, MD
Professor of Orthopaedic Surgery
Department of Orthopaedics, St. Josef-Hospital
Ruhr-University Bochum
Gudrunstrasse 56, 44791 Bochum, Germany
DARRELL J. OGILVIE-HARRIS, MD
;>rofessor of Orthopaedic Surgery
University of Toronto and the Toronto Hospital
Edith Cavell Wing 1-032
399 Bathurst Street, Toronto M5T 2S8, Canada
ISBN 978-3-642-87754-4
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Die Deutsche Bibliothek - CIP-Einheitsaufnahme
Osteoarthritis: fundamentals and strategies for joint preserving treatment; with 36 tablesl
J. Grifka; D. J. Ogilvie-Harris (ed.). - Berlin; Heidelberg; New York; Barcelona; Hong
Kong; London; Milan; Paris; Singapore; Tokyo: Springer, 2000
ISBN 978-3-642-87754-4 ISBN 978-3-642-87752-0 (eBook)
DOI 10.1007/978-3-642-87752-0
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Preface
Osteoarthritis is one of the biggest challenges in orthopaedics
today. Knee joint surgery has gone through a revolution dur
ing the last two decades. In the 1980s arthroscopy found a
wide-spread application, due to developments in technology,
i.e. optical systems and miniaturized instruments. In the 1990s
we experienced a significant improvement in knee endopro
thetics with functionally optimized designs to avoid major
stress and to support correct load distribution. Nevertheless,
joint replacement means a surrender. It marks the limits of
our capability to keep the joint itself in physiological function.
Moreover, our possibilities for treating cartilage destruction by
common arthroscopic techniques are limited to debridement
and abrasion arthroplasty, which is controversial because of
postoperative problems and fibrocartilage substitute tissue. For
years arthroscopy has seemed to remain at a plateau.
Big expectations had been placed on laser cartilage smooth
ing, but laser treatment has not yielded convincing results in
follow-ups over the last five years; new laser techniques are yet
to be seen.
On the other hand an increasing number of people are
reaching old age, causing a higher percentage of our popula
tion to suffer from osteoarthritis with typical symptoms such
as swelling, reduced mobility and restricted fitness for every
day life. Moreover, we are facing specific problems of osteoar
thritis in young and middle-aged people due to cartilage de
struction.
Due to these different circumstances the authors felt that
there was a need to present today's knowledge of the patho
genesis and biomechanics of osteoarthritis, the different opera
tive techniques for joint preservation and conservative treat
ment. We are happy that we can present a collection of contri
butions from leading experts working in the different fields for
many years. As new techniques for cartilage restoration, such
as autologous chondrocyte transplantation or bone cartilage
VI Preface
transposition are the focus of clinical and scientific analyses
we also gave room to present these.
We like to thank all the contributors for sharing their ex
perience with us, giving us an overview of the different as
pects of joint-preserving treatment. We are optimistic that this
synopsis will enhance our understanding of present concepts,
initiate further discussion, help us to assess our own points of
view and hopefully to develop ideas for further improvement.
For considerable financial support for this project we should
like to thank the Ministry of Schools and Education, Sciences
and Research of Nordrhein-Westfalen.
Autumn 1999 JOACHIM GRIFKA
DARRELL J. OGILVIE-HARRIS
Contents
Epidemiologic and Economic Aspects of Osteoarthrosis
M. WILDNER and O. SANGHA .................... 1
Clinical Picture of Osteoarthrosis
S. KLUG and G. WESELOH . . . . . . . . . . . . . . . . . . . . . . . 9
Morphogenesis of Osteoarthrosis
W. MOHR................................... 23
Movement-Induced Orientation: A Potential Mechanism
of Cartilage Collagen Network Morphogenesis
K. ITO and S. TEPIC ........................... 36
Pharmacological Basis for the Therapy of Osteoarthrosis
J. STEINMEYER ............................... 54
Drug Treatment of Osteoarthritis: Clinical Aspects
K. K. FORSTER ................................ 66
Histological Changes of Cartilage and Subchondral Bone
in Varus Gonarthrosis: Comparison with Radiographic
and Macroscopic Findings
H. REICHEL and M. HEIN . . . . . . . . . . . . . . . . . . . . . . . 82
Arthroscopic Management of Degenerative Joint Disease
D. J. OGILVIE-HARRIS, C.-H. CHOI ................ 93
Arthroscopic and Open Techniques for Transplantation
of Osteochondral Autografts and Allografts in Different
Joints
A. IMHOFF, G. M. OETTL, P. SCHOTTLE,
J. ANGESKIRCHER, and A. BURKART . . . . . . . . . . . . . . . 103
Tissue Engineering in Cartilage Repair: In Vitro
and In Vivo Experiments on Cell-Seeded Collagen Matrices
S. NEHRER and M. SPECTOR ..................... 111
VIII Contents
Autologous Chondrocyte Grafting for the Treatment
of Cartilage Defects
M. BRITT BERG ................................. 121
Perichondrial Grafting for the Treatment of Hyalin
Cartilage Defects: Experimental In Vitro and In Vivo Data
J. BRUNS ...................................... 129
Cartilage Destruction of the Knee
Due to Partial Meniscal Resection
J. GRIFKA, T. KALTEIS and W. PLITZ 138
Meniscus Replacement and Osteoarthrosis
D. LAZOVIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 148
Evaluation of Arthroscopic Techniques and Osteotomies
in Gonarthritis
W. SCHULTZ ................................... 165
Gonarthrosis Treatment According to the "Knee School"
Method - A Prospective Randomized Study
E. BROLL-ZEITVOGEL, J. Tyws, A.M. MULLER,
and J. GRIFKA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 176
Knee School: Practical Management in Rehabilitation
J. KIRMAIR .................................... 184
Psychologic Aspects of Training Therapy
D. WINDEMUTH ................................ 196
Subject Index .................................. 211
Contributors
JENS AGNESKIRCHER, MD
Department of Orthopaedic Sports Medicine
Technical University of Munich
Connollystrasse 32
80809 Munchen, Germany
MATS BRITTBERG, MD, PhD, SOBE
Cartilage Research Unit, Department of Orthopaedics
Kungsbacka Hospital
S-43440 Kungsbacka, Sweden
ELIANE BROLL-ZEITVOGEL, MD
Parkklinik Bad Rothenfelde, Parkstrasse 12-14
49214 Bad Rothenfelde, Germany
JURGEN BRUNS, MD
Professor of Orthopaedic Surgery
Department of Orthopaedic Surgery, University of Hamburg
Martinistrasse 52
20246 Hamburg, Germany
ANDREAS BURKART, MD
Department of Orthopaedic Sports Medicine
Technical University of Munich
Connollystrasse 32
80809 Munchen, Germany
CHONG-HYUK CHOI, MD
Assistant Professor,
Department of Orthopaedic Surgery
Yonsie University, College of Medicine
Seoul, Korea
KLAUS K. FORSTER, PhD
Igelweg 3
51766 Engelskirchen, Germany
X Contributors
JOACHIM GRIFKA, MD
Professor of Orthopaedic Surgery
Department of Orthopaedics, St. Josef-Hospital
Ruhr-University Bochum, Gudrunstrasse 56
44791 Bochum, Germany
MARKUS HEIN, MD
Department of Orthopaedics, Martin-Luther-University
Halle-Wittenberg, Magdeburger Strasse 22
06097 Halle (Saale), Germany
ANDREAS IMHOFF, MD
Professor of Orthopaedic Surgery
Director Department of Orthopaedic Sports Medicine
Technical University of Munich, Connollystrasse 32
80809 Miinchen, Germany
KEITA ITO, MD, ScD
Group Head, Cartilage Biomechanics, AO ASIF Research Institute
Clavadelerstrasse
7270 Davos Platz, Switzerland
THOMAS KALTEIS, MD
Department for Surgery, Klinikum Innenstadt
Ludwig-Maximilians-University Munich, Pettenkoferstrasse 8
80336 Miinchen, Germany
JOHANN KIRMAIR, MD
Vor den Eichen 1
32756 Detmold, Germany
STEFAN KLUG, MD
Department of Orthopaedic Rheumatology
Friedrich-Alexander-University Erlangen-Niirnberg
Waldkrankenhaus St. Marien, Rathsberger Strasse 57
91054 Erlangen, Germany
DJORDJE LAZOVIC, MD
Associate Professor, Orthopaedic Department
Medizinische Hochschule Hannover, Heimchenstrasse 1-7
30625 Hannover, Germany
ARNDT-MATTHIAS MULLER, MD
Department of Orthopaedics, Ruhr-University Bochum
St. Josef-Hospital, Gudrunstrasse 56
44791 Bochum, Germany
